SM_108b-108b: Depression and Bipolar Disorder I and II Flashcards
Describe phenomenology of depression episodies
Depression episodes
- Mood: depressed / sad / despondent / empty or blue, anxiety and irritability can be more prominent, lack of interest in pleasurable activities
- Behavior: agitated or retarded, appetite and sleep disturbances
- Thought: hopelessness / pessimisim / lack of self-esteem / guilt, somatic preoccupations, suicidality, and slowed mentation
Depressive symptoms include
- ____
- ____
- ____
- ____
- ____
- ____
- ____
- ____
Depressive symptoms include
- Sleep disturbance
- Interest reduced (anhedonia)
- Guilt and worthlessness
- Energy loss and fatigue
- Concentration problems
- Appetite problem
- Psychomotr agitation or retardation
- Suicidality
(SIGECAPS)
Describe DSM-5 criteria for major depressive episode
Major depressive episode DSM-5 criteria
- Five or more of the following during the same 2 week period: depressed mood most of day nearly every day, markedly diminished interest or pleasure in activities, significant weight loss / gain or change in appetite, insomnia / hypersomnia, psychomotor agitation / retardation, fatigue / loss of energy, worthlessness / inappropriate guilt, diminished ability to think / concentrate / indecisiveness, recurrent thoughts of death or suicidal ideation
- Symptoms cause significant distress or impairment in social, occupation, or other areas of functioning
- Not attribuate to physiological effects of a substance or other medical condition
Depression may have ____ or ____ features
Depression may have melancholic or atypical features
Describe the phenomenology of mania
Mania
- Mood: expansion / euphoric / grandiose / irritable / hospital, anxiety can be prominent
- Behavior: decreased need for sleep, extravagance, agitation, impulsivity, high pursuit of pleasurable activities, pressured speech, loud
- Cognition: racing thoughts, distractability, poor judgement, possible delusions, and hallucinations
Describe DSM-5 criteria for a manic episode
Manic episode DSM-5 criteria
- ≥ 1 week of abnormally and persistently elevated, expansive, or irritable mood and persistently elevated activity / energy
- During the period, 3 or more of: inflated self esteem / grandiosity, decreased need for sleep, more talkative, racing thoughts / flight of ideas, distractability, increase in goal-directed activity / psychomotor agitation, and excessive involvement in activities that have a high potential for painful consequences
- Causes marked impairment in functioning
- Not attributable to physiological effects of a substance or other medical condition
Describe DSM-5 criteria for a hypomanic episode
Hypomanic episode DSM-5 criteria
- ≥ 4 days of abnormally or persistently elevated, expansive, or irritable mood and persistently increased activity or energy
- During the period, 3 or more of: inflated self-esteem / grandiosity, decreased need for sleep, more talkative, flight of ideas / racing thoughts, distractability, increased goal directed activity / agitation, excessive involvement in activities that have a high potential for painful consequences
- Unequivocal changes in functioning uncharacteristic of individual when not symptomatic
- Change is observable by others
- Not severe enough to cause marked impairment in social / occupational functioning or require hospitalization
- Not attributable to physiological effects of a substance or other medical condition
Mixed features specifier applies when ____
Mixed features specifier applies when at least 3 subthreshold symptoms from the opposite pole are present during a mood episode
(can be used to describe depressive, manic, or hypomanic episodes)
Major depressive disorder with mixed features has ____ prognosis
Major depressive disorder with mixed features has poorer prognosis
(use mood stabilizers and some atypical antipsychotics)
Psychotic features specifier can be either ____ or ____
Psychotic features specifier can be either mood-congruent or mood-incongruent
(occur in major depressive, mania, or hypomania)
Depressive disorders include ____ and ____, while bipolar disorders include ____, ____, and ____
Depressive disorders include major depressive disorder and persistent depressive disorders, while bipolar disorders include bipolar I disorder, bipolar II disorder, and cyclothymic disorder
Describe DSM-5 criteria for major depressive disorder
Major depressive disorder DSM-5 criteria
- One major depressive episode
- Not better explained by other psychotic disorder
- Never experienced a manic or hypomanic episode
Persistent depressive disorder requires never having had a ____ or ____
Persistent depressive disorder requires never having had a manic / hypomanic episode or cyclothymia
Bipolar I disorder requires a history of ____
Bipolar I disorder requires a history of manic episodes
Bipolar II disorder requires a history of ____
Bipolar II disorder requires a history of hypomanic episodes
(no manic episodes)
Conditions commonly comorbid with major depressive disorder and bipolar disorder include ____, ____, and ____
Conditions commonly comorbid with major depressive disorder and bipolar disorder include alcohol / substance abuse, OCD / anxiety disorders, and other medical illnesses
Depression with melancholic features involves ____ and ____
Depression with melancholic features involves loss of pleasure and lack of reactivity
Depression with atypical features involves ____, ____, ____, ____, and ____
Depression with atypical features involves mood reactivity, significant weight gain / appetite increase, hypersomnia, leaden paralysis, longstanding pattern of interpersonal rejectio
