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42 Cards in this Set
- Front
- Back
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Affect
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observed expression
inconsistant with emotion |
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Mood
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pervasive and sustained emotion
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Mood disorders
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sustained path disturbance
cause sig. distress and neg. impact individual's social and occupational functioning not transitory emotional state |
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MDD epi
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15-17% prevalence
25% in women, more common onset early 30s |
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Bipolar I epi
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1% 4% with biopolar II
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Suicide Epi
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8th leading cause of death
45-50K 35k depression 2nd leading cause in teenages/young adults |
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Major Depression
signs |
5 of 9 symptoms
1 of which is depressed mood or loss on interest for 2 weeks |
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MDD
Symptoms 9 |
SIG E CAPS
1. depressed mood 2. anhedonia 3. inc/dec appetite/wt 4. feelings of worthlessness/guilt 5. insomnia/hyper 6. diminished conc 7. psychomotos agitation/retard 8. fatigue 9. thoughts of death |
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Sicide Epi -
Risk Factors |
prior history
family history |
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Mania
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abnormally elevated expansive or irritable mood for 1 week
3 of 7 characterisitics |
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Mania
Symptoms 7 |
DIG FAST
D distractibility I inflated self esteem/grandiose G goal directed F flight of ideas A involvement in pleasurable activities S sleep - dec T talkative |
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Mania
etc |
can have psycosis
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Mixed episode
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fits both mania and depression
med every day in 1 week period within a single episode |
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Hypomanic
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elevated mood for 4 days
3 symptoms of mania 4 symptoms if irritable mood |
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Hypomanic
distinguishing |
no psychosis, not markedly impaired
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Dysthymic
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chrnoic, persistent, disturbance in mood for at least 2 YEARS
DEPressive symptoms (2) do not sig. impair |
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Dysthymic
Can't have |
no MDD, mania or hypomania during 2 year period
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Dysthymic
Double depression |
goes from low grade to high grade
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cyclothymic
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chronic; mild swings between depression and hypomania for 2 years. not severe enough for MDD
normal fxn |
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Depression
postpartum onset |
hormones; differ from normal
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Depression
Catatonic |
mutism, not eating
ECT |
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Depression
seasonal |
atypical, women, cortisol levels; light therapy
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Depression
rapid cycling |
In bipolar:
4 episodes in 12 mo period for depression, manic, mixed or hypomanic |
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Types of Depression
Atypical |
hypersomnia, wt. gain
hypersensitive to rejection - MAOIs and SSRIs |
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Types of Depression
Melancholic |
insomnea; wt loss, excessive guilt
responds better ECT |
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Bipolar II
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hypomania and Depression
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Depression
Characterisitcs |
most remit spon.
20% become chronic |
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Depression
Remittance |
1 episode 50%
2 75% 3+ 90% |
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Depression
Suicide |
10-15% of hospitalized patients
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Bipolar
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usually starts with depression
manic - 90% chance to reoccur |
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DDX for Mood Disorders
Drugs |
Drugs, sedatives, antihypertensives, oral contraceptives, glucocorticoids.
Mania - PCP, cocaine, antiD depressive - alcohol, sedatives, antihypertensives, withdrawal from psychostimulants (cocaine) |
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DDX for Mood Disorders
medical |
endocrine; viral illness; HIV; cancer; carcinoid syndrome
depressive - cerebrovascular disease, Parkignson's, mononucleosis, cancer, SLE Manic - hyperthyroidism, temporal lobe seizures, neoplasm |
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DDX for Mood Disorders
schizo and schizoaffective |
psychosis similar
have more gradual course, prodromal syndromes, more severe deterioration of fxn persistance psych symptoms |
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DDX for Mood Disorders
Mania V. schizo and schizoaffective |
family hist of mood disorder, speech less likely to be disorganized
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Mood Neurobiology
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NE, serotonin, dec. 5-HIAA (metabolite)
low serotonin receptors |
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Genetics
bipolar |
one parent 25% chance child
both paretns have bipolar 50-75% chance child will have mood disorder 50-75% in monozygotic twins 10-25% in dizygotic |
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Neuroendocrine
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andrenal and thyroid axis issues
50% of MDD have excessive cortisol Low thryroid and GH |
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Neurophychological
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sleep disturbances common
insomnea or hypersomnea |
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Neurophychological
Sleep - EEG |
decrease slow wave sleep (delta wave)
shortened time before onset of REM (decreased REM latency) longer REM density and longer overall first REM period |
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Psychosocial
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chronic stress changes brain's biology
stressful life event losing parent before age 11 leads to MDD - best study/only good study social support/occupational fxning good sign for prognosis |
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Clinical treatment
Adjuvent |
augments effectiveness of standard drug - resistance common
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Psychotherapy
Cognitive Behavior Therapy |
how view world how react to world based on view
as effective as meds in mild to moderate depression |
