Week 3 - Mood Disorders Flashcards
What are the three types of mood episodes?
Major Depressive, Manic, Hypomanic
What is the required time line for MDE?
2 weeks
What are the symptoms of MDE?
depressed mood, anhedonia, wt gain/loss, insomia/hypersomnia, pyschomotor agitation/retardation, fatigue/loss of energy, worthlessness/guilt, difficulty concentrating or indecisiveness, recurrent thoughts of death
How many symtoms do you need for MDE dx?
> /= 5
What MDE symptoms have to be present regardless of others?
depressed mood and anhedonia
What is the short DSM requirement for MDE?
A. >5 symptoms B. clinically significant distress C. episode not due to substance or medical condition
What are the four hallmarks of MDE?
depressed mood, anhedonia, physical symptoms, psychological symptoms
What is part a manic episode?
A. period of elevated, expansive mood, goal directed energy/activity, last for 1 week, last most of day
How long does a manic episode have to occur for dx?
1 week
What are the symptoms of manic episode?
inflated self esteem, decreased need for sleep, more talkative/pressured speech, flight of ideas, distractibility, increased goal oriented, excessive risky behavior
How many of the manic symptoms do you need for dx?
> /=3
What is part C of manic episode requirement?
severe enough to cause significant impairment in functioning or requires hospitalization
What is the total manic episode DSM-5 requirements?
A. one week of high activity
B. >3 symptoms
C. cause distress or hosp
D. not caused by something else
What is the timeline for hypomanic episodes?
at least 4 consecutive days
How many of the symptoms of mania required for hypomanic episode?
> /=3
What is the criteria for hypomania?
A. >4 days of high activity B. >3 symptoms C. change in normal function D. change observed by others E. NOT severe enough to cause marked impairment of fxn, no hospitalization F. not due other disease
What are some modifiers of MDD?
mild, moderate, sever, peripartum, seasonal, w/ or w/o psychotic
What is the major difference btw hypomania and mania?
timeline - mania 1 wk hypo 4 days
Impact - mania is usually hosp or distress, hypomania does not cause this
What is the criteria for MDD?
A-C. at least 1 MDE
D. not better accounted by other disorder
E. NEVER had a manic or hypomanic episode
What is the criteria for PDD?
A. depressed for 2 years (1 year kids) B >/= 2 symptoms C. not w/o symptoms for 2 mo D. MDD may be present for 2 years E. NEVER had manic episode or hypomanic or cyclothymic F. not better explain by other G. not due to medical condition H. causes clinical significant distress or impairment
What are the symptoms for PDD?
poor appetite/overeating, insomnia/hypersomia, low energy/fatigue, low self esteem, poor concentration, feeling hopeless
What are some specifers for PDD?
early 21, mild, moderate, severe
What is MDE + PDD =
Double depression
What is another depressive disorder?
premenstraul dysphoric disorder
What is the DSM for BP I?
A. at least 1 manic episode
B. mood not explained by something else
What is rapid cycling?
switch from depression to mania, no normal period
How many cycles do you need to have to have rapid cycling?
4 or more per year
What is the DSM for BP II?
A. 1 hypomanic episode and 1 MDE
B. never had a manic episode
C. not better explained
D. clincally distressing or impairment
What is the DSM for cyclothymic disorder?
A. 2 years (1 for kids) 0 - hypomanic symptoms and depressive symptoms that dont meet dx
B. present for at least half the time and not w/o for 2 mo
C. never had MDE, manic, hypomanic episode
D. not better explained
E. not due to drugs or medical
F. clinically distressing or impairment
What gender has more depressive disorders?
women
When is the onset for depressive disorders?
puberty or early adulthood
What is the gender with bipolar disorders?
w=m
When is the onset of bipolar disorders?
adolescence to young adult
What are some comorbid depressive disorders?
substance use, anxiety, OCD, anorexia, bulimia, borderline personality, suicidal
What are some comorbid bipolar disorders?
substance, anxiety, ADHD, disruptive, conduct disorder, eating disorders
What do you always include with your pt interview for mood disorders?
suicide assessment
When should you only give a survey?
if you plan to look at it before you meet with your pt
What is safety plan?
crisis intervention, safety contract, hospitalization or crisis team
What is an eclectic approach treatment that focuses on improving interpersonal relationships and loss?
interpersonal therapy
What are the types of psychotherapy?
CBT, IPT, family or marital, mindfulness
What is the SPEAK approach for depression?
schedule, pleasurable activies, exercise, assertiveness, kind thoughts about oneself
What are teh niuts and bolts of CBT?
be present, goal oriented/problem focused, collaboration/active participation, psychoeducation, own therapist, respond to dysfunctional thoughts and beliefs, teach skill or strategies,
What is the CBT triangle?
thoughts, feelings, behaviors
What are cognitive distortions?
unrealistic or irrational thoughts
What is changing cognitive distortions that are presumed to be causing maladaptive benavior or emotions?
cognitive restructuring
What are the TLC cognitive coping strategies?
Talk to a friend, Look for the silver lining, Change the channel
What is ECT?
electrodes to brain to give szs, under anesthesia, 6-12 sessions over 2-4 wks
What is ECT good for?
short term tx for refractory severe major depression
What is rTMS?
magnet on head, non-invasive, no anesthesia, repeat stim to restore connections
Is ECT or rTMS more effective?
ECT
What is a good treatment for major depressive disorder with seasonal pattern?
light therapy
