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28 Cards in this Set
- Front
- Back
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List the general categories of etiology of mood disorders? x4
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Biochemical
Hormonal Genetic Sleep |
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In suicidal, destructive, and violent patients; what would you see in the CSF?
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Decreased 5-HIAA
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In DEPRESSED patients, what occurs to the Hypothalamic-pituitary-adrenal axis, and what does this lead to?
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Hyperactive
Increased cortisol |
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In DEPRESSION, what would you expect in the hormone levels? x6
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Decreased
- FSH - LH - TSH - GH - Testosterone |
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In DEPRESSION, what would you see in the sleep cycle? x4
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1. Increased REM density in first half of sleep
2. Increased REM overall 3. Decreased REM latency 4. Decreased stage 4 sleep |
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Bipolar disorder TYPE I
- mania? - depressive episodes? |
Mania or mixed mania
Major depressive episodes |
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Bipolar disorder TYPE II
- mania? - depressive episodes? |
Hypomania
Major depressive episodes |
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Cyclothymia
- mania? - depressive episodes? |
Hypomania
Depressive symptoms |
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Vegetative signs for Mania
- sex drive - weight - sleep - energy |
Increased libido
Weight loss Insomnia Excess energy |
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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 |
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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 |
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Bipolar Type I disorder
- hallucination or delusion % |
2/3
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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 |
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Prognosis of hypomania patients
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5-15% later have a full manic episodes
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Prognosis of cyclothymia
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50% develop Bipolar disorder
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What is the general treatment strategy for mood disorders?
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Include a mood stabilizer during every phase of a bipolar illness.
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Describe bipolar disorder prevalence with pregnancy. x2
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8x increase postpartum (first month)
2x increase postpartum (2-12 months) |
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When would you need three mood stabilizers?
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For Rapid cycling in bipolar patients
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List three depressive disorders
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Major Depression
Dysthymic Disorder Bereavement |
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Depression
- Primary symptom - social scene - motivation - worse at what time of day? |
Anhedonia
withdrawal from friends none Worse in AM |
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Vegetative signs of Depression
- Sex drive - weight - energy - menses - sleep |
Loss of libido
weight gain or loss low energy excess menses early AM wakenings |
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Criteria for major depression?
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5 of 9 symptoms
for 2 weeks |
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Criteria for dysthymia
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2 symptoms for 2 years
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What is the psychoanalytic theory of depression?
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Real or symbolic loss of loved object seen as REJECTION
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T/F - Major Depression is very common?
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True
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What is the association of depression with gender and bone?
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Women with depression show decrease in trabecular bone.
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List psychoactive substance associated with high rates of major depression.
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Benzodiazepines,
Opiates, Stimulant withdrawal, EtOH |
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Brief Psychotherapy approach for the PCP.
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Schedule
Pleasurable activities Exercise Assertiveness Kind thoughts about oneself. |
