Other Random Psych

Question 1

Lifetime prevalence of MDD in men? Women?

Answer 1

12% in men

20% in women

Question 2

What is the RR of MDD in first degree relatives of probands?

Answer 2

2-3

41%:13% (monozygotic:dizygotic) condordance

Question 3

SIG E CAPS?

Answer 3

Sleep, Interest, Guilt
Energy
Concentration, Appetite, Psychomotor, Suicide

Question 4

Is bereavement an exclusion for MDD?

Answer 4

No because 2-month rule didn’t reflect reality, responds to same tx, same natural course

Question 5

MDD + 2 or more of the following: keyed-up/tense, unusually restless, can’t concentrate b/c of worry, fear something awful will happen, might lose control

Answer 5

MDD with anxious distress

Question 6

MDD + 3 or more manic/hypomanic sxs (minus distractibility)

Answer 6

MDD with mixed features

Question 7

MDD + absolute anhedonia OR mood non-reactivity + 3 or more of the following: distinct quality of mood, worse in AM, early AM awakening, marked PMA or PMR, significant appetite or wt loss, excessive guilt

Answer 7

MDD with melancholic features

Question 8

MDD + mood reactivity + 2 or more of the following: significant appetie or wt increase, hypersomnia, leaden paralysis, long-standing interpersonal rejection sensitivity leading to social/work problems

Answer 8

MDD with atypical features

Question 9

What med works well for MDD with atypical features? What is first line?

Answer 9

SSRIs 1st line

MAOIs work well

Question 10

MDD + delusions and/or hallucinations (congruent: personal inadequacy, guilt, death, nihilism, deserved punishment)

Answer 10

MDD with psychotic features (congruent or incongruent)

Question 11

MDD + during MOST of the episode, 3 or more of the following: stupor, catalepsy, waxy flex, mutism, stereotypy, grimacing, echolalia, mannerisms, negativism

Answer 11

MDD with catatonia

Question 12

MDD during pregnancy or in the 4 weeks after delivery

Answer 12

MDD with peripartum onset

Question 13

MDD with relapses/remissions at characteristics times year (at least 2 MDE in last 2 yrs with no non-seasonal MDE)

Answer 13

MDD with seasonal pattern

Question 14

If patients always gets depressed with seasonal unemployment (or beginning of school year), is that MDD with seasonal pattern?

Answer 14

NO!

Question 15

Do antidepressants have additional actions besides inhibition of reuptake transporters?

Answer 15

Ys, increase neurogenesis in hippoccampus

Question 16

What is the response rate to SSRIs in MDD?

Answer 16

47%

Question 17

What is the remission rate with SSRIs in MDD?

Answer 17

33%

Question 18

What is the remission rate with ECT in MDD?

Answer 18

80-90%

Question 19

What is the relapse rate at 6 months with ECT in MDD?

Answer 19

50-80%

Question 20

How many with MDD recover within 3 months? 1 year?

Answer 20

2 in 5 recover in 3 months

4 in 5 recover in 1 year

Question 21

What’s the risk of subsequent MDE if 1 episode in last 3 years? 2 episodes? 3 episodes?

Answer 21

1 episode = 50%
2 episodes = 70%
3 episodes = 90%

Question 22

What percent of MDD will eventually be diagnosed with bipolar? RIsk factors?

Answer 22

5-10%
Onset of MDD in adolescence
Family hx of bipolar
‘Mixed fx’

Question 23

What is the lifetime suicide risk with MDD?

Answer 23

6%, up to 15% with severe MDD

Question 24

Persistent depressive disorder (dysthymia)

Answer 24

2 yrs depressed mood (1 yr in kids/adolescents) most of the day, more days than not, PLUS 2 of the following:
- appetite change - sleep change - low energy - low esteem - poor concentration - hopeless
Never sx free for more than 2 months

Question 25

What is early onset MDD or dysthymia?

Answer 25

Before age 21

Question 26

Can you have MDD and dysthymia?

Answer 26

YES! | w/ persistent MDE, w/ intermittent MDE

Question 27

Lifetime prevalence of persistent depressive disorder? 12-month prevalence?

Answer 27

6% lifetime | 0.5% 12 month prevalence (compared with 1.5% for MDD)

Question 28

Persistent depressive disorder has high comorbidity with what?

Answer 28

Personality disorder (esp. clusters B, C)

Question 29

Premenstrual dysphoric d/o

Answer 29

In most menstrual cycles, 5 or more sxs in week before onset with improvement after onset PLUS 1 or more: mood lability, irritability, anxiety PLUS 1 or more: anhedonia, impaired conc., anergia, appetite change, sleep change, feeling overwhelmed, physical sxs (breast tenderness, bloat)

Question 30

How do you diagnose premenstrual dysphoric d/o?

Answer 30

Prospective daily rating scales during at least 2 symptomatic cycles

Question 31

Tx for Premenstrual dysphoric d/o?

Answer 31

SSRI daily or luteal phase only | OCP for anovulation

Question 32

Disruptive mood dysregulation disorder?

Answer 32

6-18 y/o Severe temper outbursts, not appropriate, 3 or more per week, usually irritable mood for more than 12 months in 2 settings, can't be symptom free more than 3 consecutive months

Question 33

Disruptive mood dysregulation disorder onset must be BEFORE what age?

Answer 33

10 y/o

Question 34

Why does disruptive mood dysregulation disorder diagnosis exist?

Answer 34

Avoid excessive dx of bipolar disorder in kids

Question 35

BD prevalence?

Answer 35

0. 4-1.6% bipolar I | 0. 5% bipolar II

Question 36

RIsk of BD with 1 first degree relative? Risk of BD with 1 second degree relative?

Answer 36

7% (up from 1%) with first degree | Stays 1% with second degree

Question 37

Specifiers for rapid cycling BD?

Answer 37

4 mood episodes per year | 20-30% of BD patients, 2/3 are women

Question 38

Manic switch in BD with what meds?

Answer 38

Reuptake blockers | Lamotrigine!

Question 39

What is the lifetime prevalence of at least one suicide attempt in BD?

Answer 39

35%

Question 40

Risk of suicide completion in BD vs. general population?

Answer 40

15x higher risk

Question 41

What is the suicide completion rate in BD?

Answer 41

15%

Question 42

Does BD1 or BD2 have more lethality of suicide attempts?

Answer 42

BD2

Question 43

Cyclothymic disorder

Answer 43

2 y fluctuating mood (1 y in kids/adolescents) with hypomanic sxs (NOT EPISODES) and dysthymic sxs (NOT MDEs)

Question 44

Adjustment disorder?

Answer 44

Response to stressors within 3 months | Terminated within 6 months of end of stressor