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28 Cards in this Set

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List the general categories of etiology of mood disorders? x4
Biochemical

Hormonal

Genetic

Sleep
In suicidal, destructive, and violent patients; what would you see in the CSF?
Decreased 5-HIAA
In DEPRESSED patients, what occurs to the Hypothalamic-pituitary-adrenal axis, and what does this lead to?
Hyperactive

Increased cortisol
In DEPRESSION, what would you expect in the hormone levels? x6
Decreased
- FSH
- LH
- TSH
- GH
- Testosterone
In DEPRESSION, what would you see in the sleep cycle? x4
1. Increased REM density in first half of sleep

2. Increased REM overall

3. Decreased REM latency

4. Decreased stage 4 sleep
Bipolar disorder TYPE I

- mania?
- depressive episodes?
Mania or mixed mania

Major depressive episodes
Bipolar disorder TYPE II

- mania?
- depressive episodes?
Hypomania

Major depressive episodes
Cyclothymia

- mania?
- depressive episodes?
Hypomania

Depressive symptoms
Vegetative signs for Mania

- sex drive
- weight
- sleep
- energy
Increased libido

Weight loss

Insomnia

Excess energy
Mania HPI/MSE

- behavior
- frustration tolerance
- activities
- responsibilities
- appearance
- speech
- self esteem
- delusions
erratic and disinhibited

low

overextended

overextended

colorful clothes, excess makeup

Pressured, loud, and dramatic

Increased

Yes
DSM-IV-TR Criteria for Manic Episode

- Duration
- Criteria
- Impairment
- Secondary to?
1 week or greater

3 or more (4 if irritable)
Impulsivity
Decreased sleep
Increased speech
Distractability
Racing thoughts
Increased activity
Grandiosity

Nothing
Bipolar Type I disorder

- hallucination or delusion %
2/3
DSM-IV-TR Criteria for Hypomania

- Duration
- Criteria
- Impairment
- Secondary to?
at least 4 days

3 or more of:
Impulsivity
Decreased sleep
Incresed speech
Distractibility
Racing thoughts
Increased activity
Grandiosity

No marked impairment

Nothing
Prognosis of hypomania patients
5-15% later have a full manic episodes
Prognosis of cyclothymia
50% develop Bipolar disorder
What is the general treatment strategy for mood disorders?
Include a mood stabilizer during every phase of a bipolar illness.
Describe bipolar disorder prevalence with pregnancy. x2
8x increase postpartum (first month)

2x increase postpartum (2-12 months)
When would you need three mood stabilizers?
For Rapid cycling in bipolar patients
List three depressive disorders
Major Depression

Dysthymic Disorder

Bereavement
Depression

- Primary symptom
- social scene
- motivation
- worse at what time of day?
Anhedonia

withdrawal from friends

none

Worse in AM
Vegetative signs of Depression

- Sex drive
- weight
- energy
- menses
- sleep
Loss of libido

weight gain or loss

low energy

excess menses

early AM wakenings
Criteria for major depression?
5 of 9 symptoms

for 2 weeks
Criteria for dysthymia
2 symptoms for 2 years
What is the psychoanalytic theory of depression?
Real or symbolic loss of loved object seen as REJECTION
T/F - Major Depression is very common?
True
What is the association of depression with gender and bone?
Women with depression show decrease in trabecular bone.
List psychoactive substance associated with high rates of major depression.
Benzodiazepines,
Opiates,
Stimulant withdrawal,
EtOH
Brief Psychotherapy approach for the PCP.
Schedule

Pleasurable activities

Exercise

Assertiveness

Kind thoughts about oneself.