B.s Ch. 13 Mood

Front 1

Attenuated depression

Back 1

Dysthymia

Front 2

Attenuated Mania

Back 2

Hypomania

Front 3

Mood disorder sx

Back 3

Impaired judgement
problems with physical func.
disruption of life
Severe = psychotic sx

Front 4

4 Primary Mood Disorders

Back 4

Major Depressive Disorder
Bipolar Disorder (I and II)
Dysthymic Disorder
Cyclothymic Disorder

Front 5

9 symptoms for Major Depressive Disorder

Back 5

1. Subjective report of depression
2. Dec interest or pleasure in activities
3. Change in appetite (weight change, up or down)
4. Insomnia/Hypersomnia
5. Psychomotor agitation or retardation
6. Fatigue or energy loss
7. Feel worthless of guilty
8. Problems concentrating or thinking.
9. Thoughts of death or suicide

Front 6

5 Criteria to Diagnose MDD (not the 9 sx, but the criteria)

Back 6

A. 5 of 9 sx present during same 2 week period
B. No Mania sx
C. Significant distress or impairment in social func.
D. Sx not caused by substance or medical condition
E. Sx not caused by bereavement (depression cannot be diagnosed <2mos after loss of loved one)

Front 7

What % weight loss often seen with depression

Back 7

>5% of body weight lost

Front 8

Type of depression more likely to show weight gain and excess somnolence

Back 8

Atypical Depression

Front 9

Is there diurnal variation in depression? Explain.

Back 9

Yes.
More depressed in the morning

Front 10

What % of depressed pt's deny depression? What is this called?

Back 10

50%.
Masked Depression

Front 11

Tx for Seasonal Affective Disorder (SAD)

Back 11

Full Spectrum Light Exposure

Front 12

MDD is usually cause by:

Back 12

A combination of biological and social factors

Front 13

Which of the following is a significant risk factor for MDD?
a. ethnicity
b. education
c. marital status
d. income
e. being female

Back 13

E. being female

Front 14

Which sex is more depressed?

What are the stats?

Back 14

Female

M = 5-12%
F = ~2x M (10-24%)

Front 15

What % of depressed people seek treatment?

Back 15

25%

Front 16

What happens to most episodes of depression without tx?

Back 16

Self-limiting. Resolves in 6-12 months

Front 17

Successfully tx'd episodes of depression last?

Back 17

Less than 3 months

Front 18

3 classes of antidepressants

Back 18

HCA's
SSRIs
MAOIs

Front 19

Example SSRI used for depression

Back 19

fluoxetine (Prozac)

Front 20

Antidepressants take at least ____ weeks to work.

Back 20

3 weeks

Front 21

Psychostimulants are sometimes used to tx depression quickly. What is a drawback of these drugs?

Back 21

Tolerance and Dependence

Front 22

Treatment in which a grand mal seizure is introduced by passing an electric current through the brain.

Back 22

ECT

Front 23

3 examples of when ECT is indicated for depression?

Back 23

When pt with severe depression doesn't respond to antidepressent meds.

When drugs are too dangerous or have intolerable side effects

When rapid resolution is needed (suicidal pt, etc)

Front 24

5 criteria for Bipolar Disorder

Back 24

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week or less if hospitalization is necessary

B. At least 3 sx (4 if mood is only irritable)

C. No sx of depression
D. Significant distress or social/occupational impairment
E. Sx not caused by substance or medical condition

Front 25

7 sx of mania

Back 25

1. Inflated self esteem
2. dec need for sleep
3. talkativeness
4. flight of ideas
5. distractibility
6. inc activity or agitation
7. engagement in activity likely to have negative consequences

Front 26

Difference between Bipolar I and II

Back 26

I = depression + mania
II = depression + hypomania

Front 27

Describe psychotic sx of mania

Back 27

Occur during manic episodes
Mainly delusions of power
pt returns to nl between episodes

Front 28

Particularly strong biological influence on development of mania

Back 28

Genetics

Front 29

Describe Bipolar tx in full (side effects, preferred drugs, bad drugs)

Back 29

Lithium (SE = renal and thyroid dysfunction, tremor, weight gain).

If pt shows "rapid cycling" (>4 episodes/year) then rx = Anticonvulsants (divalproex, carbamazepine).

Sedatives (lorazepam)

Acute mania = Antipsychotics (haloperidol, olanzapine, risperidone)

Front 30

Less severe form of MDD

Back 30

Dysthymic disorder

Front 31

Less severe form of Bipolar disorder

Back 31

Cyclothymic disorder

Front 32

Sx of dysthymic disorder

Back 32

low self esteem
dec productivity
No anhedonia or suicidality

Front 33

Sx of cyclothymic disorder

Back 33

alternating states of dysthymia and hypomania

Front 34

How long must sx persist to dx dysthymic/cyclothymic disorders

Back 34

At least 2 years

Front 35

Dysthymic and Cyclothymic population statistics

Back 35

Dysthymic = 6% of pop.
Female 2x > Males

Cyclothymic = 1% of pop.
No sex difference

Front 36

Dysthymic disorder tx

Back 36

antidepressants
psychotherapy

Front 37

Cyclothymic tx

Back 37

mood stabilizers (similar to tx for bipolar)

Front 38

Medical conditions that could cause mania

Back 38

Hyperthyroid
Stroke
Brain Neoplasm
Infection (particularly in the R orbitofrontal cortex)

Front 39

Medical causes of depression

Back 39

CA (pancreatic, GI)
viral (PNA, flu, aids)
endocrine (hypothyroid, cushings)
Neuro (parkinson's, MS, huntington's, stroke, dementia)
Nutritional
Renal, Cardiopulmonary

Front 40

Rx drugs that can cause depressive sx

Back 40

Reserpine
other antihypertensives
antineoplastic agents
steroids
Opiate withdrawal

Front 41

Rx drugs that can elevate mood

Back 41

Steroids
Amphetamines
Cocaine

Front 42

Adjustment disorder with depressed mood is dx'd when:

Back 42

sx do not meet criteria for major depressive episode, follow within 2 mos of a significant stressor, persist for up to 6 mos after stressor has terminated

Front 43

Normal Bereavement time frame

Back 43

2 mos ( > 2 mos = MDD)

Front 44

2 common misdiagnoses of depressed patients

Back 44

Anxiety disorder
somatoform disorder