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71 Cards in this Set
- Front
- Back
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How are mood disorders defined?
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pattern of episodes over time
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How is each episode defined?
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By a pattern of symptoms and signs
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How many of the following symptoms are needed to say someone has a Major Depressive Attitude?
1. Depressed mood (or irritability in adolescents) 2. Anhedonia (loss of interest) 3. Change in wt. or appetite 4. Insomnia or hypersomnia 5. Psychomotor agitation or retardation 6. Fatigue or loss of energy 7. Fellings of worthlessness or guilt 8. Diminished ability to think or concentrate 9. Recurrent thoughts of death or suicide |
At least five of the following symptoms nearly every day for TWO weeks
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To define a Major Depressive Episode, at least one of 2 symptoms needs to be present
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1. Depressed mood (or irritability in adolescents)
2. Anhedonia (loss of interest/pleasure of daily activities) |
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Besides the typical feature of being depressed, how else might mood in major depression be expressed?
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Anger or Irritability
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Anhedonia means?
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Decreased enjoyment
*You must have a CHANGE to help define a major depression |
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Anhedonia can be compared w/
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Depersonalization
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What are some typical delusional thoughts a person w/ Major Depression might have?
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delusional or overvalued ideas
-poverty, persecution, guilt, sickness |
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Anhedonia means?
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Decreased enjoyment
*You must have a CHANGE to help define a major depression |
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What is the duration needed to classify a "Manic Episode"?
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distinct period of elevated, or irritable mood, lasting at least one week, or requiring hospitalization
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Anhedonia can be compared w/
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Depersonalization
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What is the duration needed to classify a "Hypomania"?
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distinct period of elevated, or irritable mood, lasting at least 4 days
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What are some typical delusional thoughts a person w/ Major Depression might have?
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delusional or overvalued ideas
-poverty, persecution, guilt, sickness |
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How many of the following symptoms are needed to classify a Manic Episode?
1. Inflated self-esteem or grandiosity 2. Decreased need for sleep 3. More talkative than usual 4. Flight of ideas 5. Distractability 6. Increased activity (socially, at work, at school, sexually or agitiation) 7. Impulsiveness (eg, overspending) |
at least 3 of the following (4 if the mood is only irritable)
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What is the duration needed to classify a "Manic Episode"?
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distinct period of elevated, or irritable mood, lasting at least one week, or requiring hospitalization
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What are other ways to differentiate a problem as being a Manic episode
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-MARKED impairment
-No organic factor (including antidepressant treatment) -No mixed state -No schizophrenia or schizoaffective disorder |
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What is the duration needed to classify a "Hypomania"?
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distinct period of elevated, or irritable mood, lasting at least 4 days
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What are some features of "Elevated Mood"?
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elation
irritability or anger mood wings paranoia |
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How many of the following symptoms are needed to classify a Manic Episode?
1. Inflated self-esteem or grandiosity 2. Decreased need for sleep 3. More talkative than usual 4. Flight of ideas 5. Distractability 6. Increased activity (socially, at work, at school, sexually or agitiation) 7. Impulsiveness (eg, overspending) |
at least 3 of the following (4 if the mood is only irritable)
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Grandiosity?
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ability to do things around you that others can't
-unrealistic thoughts |
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What are other ways to differentiate a problem as being a Manic episode
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-MARKED impairment
-No organic factor (including antidepressant treatment) -No mixed state -No schizophrenia or schizoaffective disorder |
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What is common about Mania and Hypomania?
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Both require a week of elevated mood plus 3-4 symptoms
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What are some features of "Elevated Mood"?
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elation
irritability or anger mood wings paranoia |
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Grandiosity?
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ability to do things around you that others can't
-unrealistic thoughts |
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What is common about Mania and Hypomania?
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Both require a week of elevated mood plus 3-4 symptoms
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What is different between mania and hypomania? (define Mania)
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requires "MARKED IMPAIRMENT" in funciton (occupational or social); impairment or incapacitation is presumed if there is hospitalization or psychotic features
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What is different between mania and hypomania (define hypomania)?
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may include mild or moderate impairment, BUT may also be associated with ENHANCEMENT of function
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What are delusional ideas?
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have thoughts that no one else agrees with, maybe believe have powers no one else does, may seem as if someone controlling thoughts
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What is a hallucination?
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hear/see things that are not really there
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How is mania different than schizophrenia (hint, is it an episodic illness or chronic illness)?
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Mania is an episodic illness. Both can include psychotic symptoms, but in mania the symptoms go away when the episode clears.
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How is schizophrenia different than mania(hint, is it an episodic illness or chronic illness)?
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schizophrenia is a chronic illness where the symptoms persist (either positive symptoms like delusions or hallucinations or negative symptoms like flat affect or cognitive impairment)
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How is schizoaffective disorder different from schizophrenia
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there are major components of both psychotic and mood symptoms (some of which occur together) as well as > 2 weeks of psychotic symptoms w/ no mood symptoms (either chronic or episodic) -
*basically it is not constantly mood and psychotic, but can have periods w/o mood disorders |
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In order to be a Substance-Induced Mood disorder, w/in what timeframe of substance use must symptoms begin?
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-during or w/in a month of substance abuse
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are certain substances etiologically related to disorders (ie: certain substances tend to cause certain disorders?)
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Yes
-ie: mania w/ stimulants like cocaine |
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What differentiates a substance-induced mood disorder from a primary mood disorder?
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symptoms did not precede substance use or persist >1 mo.; symptoms not in excess of expected; no hx of primary mood disorder
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How does a bipolar dz usually evolve/progress?
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begins as minor depressions, slowly have periods of mania, and then cycle back and forth
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W/ bipolar disorder, does mania or depression usually appear first?
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Depression usually occurs earlier than mania
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About what percent of people (with an affective disorder) visited a general medical provider only and did so for reasons other than affective symptoms?
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46%
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Are these mood disorders thought to be genetically inherited?
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studies suggest that all disorders are genetically related to each other
(don't think we need to know this, but for example G72/G30-13q33 BDNF-11p15 5HTT-17q COMT-22q MAO-A-X |
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What are a few examples of specific organic causes of depression: drugs and medications?
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1. catecholamine depletion or blockade
2. Cholinergic agonists 3. CNS depressants other: steroids, H2 blockers, analgesics |
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What are a few examples of specific organic causes of depression:
Endocrine Dz? |
Hypothyroidism (rarely)
Cushings |
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What are a few examples of specific organic causes of depression:
Neurologic DZ? |
CVA (stroke)(esp. frontal)
Parkinson's Huntington's Alzheimer's |
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What are a few examples of specific organic causes of depression:
Infecious DZ? |
HIV
Hepatitis Mononucleosis Influenza |
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What are a few examples of specific organic causes of depression:
Neoplastic? |
lung, pancreas, CNS
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What are a few examples of specific organic causes of depression:
Metabolic? |
folate or B12 deficiency
high calcium low magnesium |
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What are a few examples of specific organic causes of depression:
Other? |
alcoholism, any condition causing CNS depression
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What are a few examples of specific organic causes of MANIA:
drugs and medications |
-sympathomimetics (stimulants)
-dopamine agonsits -ANTIDEPRESSANTS! -Steroids |
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What are a few examples of specific organic causes of MANIA:
Endocrine DZ |
Hyperthyroidism
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What are a few examples of specific organic causes of MANIA:
Neurologic DZ |
Temporal lobe seizures, temporal loe stroke, MS, Huntingtons
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What are a few examples of specific organic causes of MANIA:
Infectious DZ? |
HIV, encephalitis
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What are a few examples of specific organic causes of MANIA:
Neoplastic? |
CNS tumors
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What are a few examples of specific organic causes of MANIA:
Metabolic? |
Hypocalcemia, dialysis, encephalopathy
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How is Psychotic depression different from normal depression?
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presence of DELUSIONS or Hallucinations along w/ DEPRESSION
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What is the clinical significance of psychotic depression?
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-indicator of severity
-rq extra assessment of potential HARM to self or others; may Rq hospitalization -pharmacologic management diff. |
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In order to have rapid cycling bipolar disorder, how many affective episodes needed per year?
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4 affective episodes per year
-10-15% of all bipolar patients |
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What initiates rapid cycling in rapid cycling bipolar disorder?
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Depressive episode
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What may trigger Rapic Cycling bipolar disorder?
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use of TCA's (antidepressants)
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Who is rapid cycling bipolar disorder more common in?
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long-term illness
females controlled and uncontrolled hypothyroidism -poor response to lithium |
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About how may persons will have Major Depression during their lifetime?
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1/6
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How many people will have a bipolar illness in their lifetime?
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1/25
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Mood disorders can be EPISODIC and RECURRENT, but can they be tx'd or prevented?
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Yes- can be tx'd and prevented
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What is the average age of onset for bipolar illness?
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20
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what is the average age of onset for unipolar depression- greater for men or women?
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25 for unipolar depression
-risk for depression greater in women than men |
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Will most people who seek tx for mood disorder see a mental health specialist?
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No
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What types of things should you ask about to help screen for a major depressive disorder?
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sleep
appetite enjoyment of activities depressive thoughts |
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Among those w/ depression, about how many have a bipolar disorder?
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1/4
- a hx of episodes w/ overactivity, increased energy and mood, decreased need for sleep, and impulsiveness will ID many of them |
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What will ID most specific medical causes of mood disorders
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A simple hx and physical
-lab screening (CBC, chem profile, TFT's may be helpful) |
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Do mood disorders run in families?
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they do, and genetic factors are important
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what are common co-occurring conditions with mood disorders?
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substance abuse
anxiety disorders |
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What are some subcategories of mood disorders?
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BPI
BPII UPR Dysthymia Psychotic depression Rapid cycling |
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How is Bipolar I Disorder different from Bipolar II?
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Bipolar II is recurrent
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