Psychopathology of Mood Disorders and Anxiety Flashcards
What are the criteria for Biopolar I?
one or more episodes of idiopathic mania; usually one or more episodes of idiopathic major depression. Mixed episodes of mania and depression at the same time are possible (dysphoric mania)
What are clanging associations?
words strung together based on sound rather than on meaning.
What is the prevalence of bipolar disorder? What is the typical onset?
Lifetime prevalence around 1%
typical onset: teens and 20s.
What do we know about the neurobiology of bipolar disorder?
circadian rhythms play a role. phase advance of sleep deprivation contributes to mania in vulnerable ppl. may also involve a dysregulation of frontostriatal functioning.
What should I know about the medications for mania?
in active mania use antipsychotics and mood stabilizers
in acute depression, you may use antidepressants, but do so with caution because antidepressants can cause a flip into mania.
What does bipolar II refer to?
episodes of hypomania and major depression.
What is cyclothymic disorder?
episodes of hypomania and low-level depression. may be hard to tell the difference between cyclothymic disorder and affective instability seen in personality disorders.
What is premenstrual dysphoric disorder?
recurrent depressive symptoms only during the late luteal phase.
What is adjustment disorder with depressed mood?
symptoms in response to astressor that don’t meet diagnostic criteria for a mood disorder.
Besides anxiety disorders, what other psychiatric problems can cause anxiety and trump an anxiety diagnosis?
delirium/dementia
mood disorders
psychotic disorders
anxiety secondary to a general medical condition (ex. pheochromocytoma)
What is a major source of disability in panic disorder?
anticipatory anxiety (worry about having another panic attack) and avoidance behaviors (altered behavior to minimize chances of having another attack or to reduce consequences of the attack) often occurs with agoraphobia.
What should I know about panic attacks?
last minutes rather than seconds/days. have a crescendo onset.
How prevalent is panic disorder?
1-2% point prevalence. usually onset is late adolesence to early 30s.
What are the characteristics of obsession in OCD?
recurrent/persistent thoughts which are foreign and inappropriate.
they are anxiety producing.
What is the prognosis/natural history for OCD?
usually waxing and waning, but 15% get progressive deterioation in function.
What is the difference btw PTSD and acute stress disorder? Prognosis?
time. acute distress disorder is less than a month; PTSD is more than a month.
50% recover in 3 months.
What are the symptoms of PTSD?
intesne fear, helplessness, horror, followed by re-experiencing the trauma (intrusive memories, nightmares, flashbackes, strong responses when exposed to reminders), avoidance of things that remind the person of the trauma or more general symptoms, hyperarousal ( insomnia, irritability, hypervigilanc,e exaggerated startle)
How long does generalized anxiety disorder last?
more than 6 mo, though course tends to fluctuate over time.
What structure do we think is involved in panic disorder and PTSD?
central nucleus of the amygdala. gets input from the cortical sensory areas and thalamus and gives outputs to NE, DA, and 5HT neurons. can orchestrate multiple aspects of anxiety reactions. part of the “salience network.”
What are links between PTSD and emotional regulation?
overmodulation of corticolimbic areas may lead to dissociation and withdrawal symptoms, while undermodulation may be related to hyperarousal.
What structures are involved in OCD?
frontal and striatal mechanisms; 5HT systems important. Basal ganglia most important structure; may be part of other movement disorders (tics, PANDAS)
What si the cognitive behavioral psychology approach to OCD?
catastrophic misinterpretaion of normal bodily sensations, which initiate a downward cascade. CBT effective for treating OCD.
What are some social factors that contribute to OCD?
enablers: family companions/ppl who alter life to allow OCD pt to perform compulsions.
What meds work for anxiety (classes)?
most antidepressants except bupropion
for OCD, only SSRIs.
anxiolytics only used for acute/adjunctive roles
beta blockers for pefromance anxiety
