Psychiatry

Question 1

Major Depressive Disorder

Answer 1

At least 2 major depressive episodes at least 2 months apart

Genetics:

• polymorphisms of a serotonin transporter increase chance of mood disorder
• genes encoding for dopamine transporters
• gene for brain-derived neurotrophic factor
• cAMP response element-binding protein gene

Localization:
Dorsolateral prefrontal cortex hypometabolic in patients with depression, whereas the orbitofrontal cortex is hypermetabolic

• subcallosal cingulate gyrus a potential target for DBS for depression bc metabolically overactive in depression
• ventral portion of anterior limb of internal capsule also a target for DBS

Question 2

Dissociative Disorders

Answer 2

Diss Amnesia–extreme amnesia with typically loss of personal experiences, usually loss of memory of stressful event

Depersonalization disorder–intermittent or constant feelings of detachment from oneself as if person is viewing himself or herself as an outside observer

Dissociative identity disorder aka multiple personality disorder–person exists in 2 or more distinct identities or states

Dissociative fugue–patients suddenly and unexpectedly travel away from their environment and are unable to recal their past or identity and may assume new identity

Question 3

Cyclothymic disorder

Answer 3

clinically attenuated form of bipolar disorder
periods of hypomania and separate periods of depressive symptoms (which do not meet criteria for MDD) that have been occurring for at least 2 years
Often pervasive conflicts in interpersonal relations

Question 4

Brief psychotic disorder
Schizophreniform disorder
Schizophrenia

Answer 4

Brief psychotic disorder–up to 1 month
Schizophreniform–1-6 months–2/3 will eventually meet criteria for schizophrenia
Schizophrenia–Over 6 months; affects 1% of world’s population

All 3 have positive and negative symptoms

Question 5

Dysthymic disorder

Answer 5

aka persistent depressive disorder
insidious and chronic symptoms of depression that occur most of the day for more days than not
SI not a common occurrence in dysthyic disorder
often difficult to treat with meds

DIFFERENT from chronic depression, which is persistent residual symptoms of depression after onset of a clear-cut major depressive episode