Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
54 Cards in this Set
- Front
- Back
|
Define mood
|
Description of one's internal emotional state
|
|
|
What is another name for mood disorder?
|
Affective disorder
|
|
|
What is the difference between a mood episode and mood disorder?
|
Mood episode are distinct periods of time when abnormal mood is present; mood disorder are patterns of mood episodes
|
|
|
What are the types of mood episodes?
|
1) Major depressive
2) Manic 3) Hypomanic 4) Mixed episode |
|
|
What are the types of mood disorders?
|
1) Major depressive disorder
2) Bipolar I & II disorder 3) Dysthymic disorder 4) Cyclothymic disorder |
|
|
What are the DSM-IV criteria to be a major depressive episode?
|
Must have at least 5 of the following during the same 2 week period...(must include anhedonia or depressed mood)
SIG E CAPS D - depressed mood S - sleep disturbances I - interest (anhedonia) G - guilt or worthlessness E - energy or fatigue C - concentration, can't think A - appetite up or down P - psychomotor agitation or retardation S - suicidal ideation *must cause social or occupational impairment |
|
|
What are the DSM-IV criteria to be a manic episode?
|
Must have at least 3 of the following for at least 1 week...
DIG FAST D - distractability I - insomnia G - grandiosity F - flight of ideas A - activity/agitation increased S - speech pressured T - thoughtlessness *must cause social or occupational impairment |
|
|
What is a manic episode?
|
A condition characterized by elevated or irritable (easily annoyed) mood lasting at least 1 week
|
|
|
Is a manic episode a psychiatric emergency? Why?
|
Yes because severely impaired judgment makes patient dangerous to self and others
|
|
|
What is a mixed episode?
|
Episode that meets the criteria of both manic and major depressive episode for at least 1 week
*psychiatric emergency |
|
|
What is the predominant mood in patients with mixed episodes?
|
Irritable mood
|
|
|
Does lithium work well for mixed episodes?
|
Patients with mixed episodes have a poorer response to lithium; anticonvulsants may help
|
|
|
What is a hypomanic episode?
|
Condition characterized by period of elevated or irritable mood; lower of degree of impact on functioning than mania
|
|
|
What is the difference between a manic and hypomanic episode?
|
Mania - causes severe impairment in social/occupational functioning, may require hospitalization, may have psychotic symptoms
Hypomania - no marked impairment in social/occupational functioning, no hospitalization, no psychotic features |
|
|
What is the DSM-IV criteria for major depressive disorder (MDD)?
|
At least 1 major depressive episode and no history of manic/hypomanic episode
|
|
|
What is seasonal affective disorder?
|
Subtype of MDD in which major depressive episodes occur only during winter months (fewer daylight hours)
|
|
|
What is the treatment for seasonal affective disorder?
|
Light therapy
|
|
|
What are the sleep problems associated with MDD?
|
1) Multiple awakenings
2) Hard to fall asleep, early morning awakenings 3) Hypersomnia 4) REM affected |
|
|
What is the triad for seasonal affective disorder?
|
1) Irritability
2) Hypersomnia 3) Carbohydrate drawing - crave sweets and starchy food |
|
|
How is serotonin related to depression? How can this be used to treat depression?
|
Decreased brain levels of serotonin and 5-HIAA (hydroxyindolacetic acid) are found in depressed patients
Drugs that increase the availability of serotonin, NE and dopamine alleviate the symptoms of depression |
|
|
What are other neuroendocrine abnormalities that are associated with depression?
|
1) high cortisol
2) thyroid disorders |
|
|
What psychosocial life event is associated with MDD?
|
Loss of a parent before age 11
|
|
|
Is there a genetic component to depression?
|
1st degree relatives are 2-3x more likely to have MDD
|
|
|
Can MDD be associated with psychotic features?
|
Yes, hallucinations or delusions
|
|
|
What are the different treatment modalities of MDD?
|
1) Hospitalization
2) Pharmacotherapy 3) Psychotherapy 4) ECT |
|
|
When is hospitalization indicated for MDD?
|
If patient at risk for suicide, homicide or unable to care for self
|
|
|
What is the difference btwn all of the antidepressant medications?
|
All are equally effective but differ in side effect profile; medications take 4 to 8 weeks to work
|
|
|
Describe SSRI's
|
Selective serotonin reuptake inhibitor - safe, well tolerated, mild side effects; main one is sexual dysfunction
|
|
|
Describe TCA's
|
Tricyclic antidepressants - overdose is lethal, side effects include anticholinergic effects and can aggravate prolonged QT syndrome
|
|
|
Describe MAOIs
|
Monoamine oxidase inhibitors, useful for refractory depression
*risk of hypertensive crisis when used with tyramine-rich foods (wine, cheese) *risk of serotonin syndrome when used in combination with SSRIs; triad of cognitive, autonomic, and somatic effects |
|
|
Describe stimulants for treating MDD?
|
For refractory patients, action is rapid, potential for dependence limits its use
|
|
|
Describe ECT for treating MDD?
|
Electroconvulsive therapy is indicated if patient is unresponsive to pharmacotherapy or patient cannot tolerate pharmacotherapy or rapid reduction of symptoms is desired
*Retrograde amnesia is a common side effect, which usually disappears within 6 months |
|
|
Describe serotonin syndrome.
|
1) Autonomic instability
2) Hyperthermia 3) Seizures autonomic, cognitive, somatic |
|
|
What type of patients may not be able to tolerate the side effects of antidepressant medications?
|
Elderly and pregnant woman
|
|
|
What are the unique types of depressive disorders?
|
1) Melancholic
2) Atypical 3) Catatonic 4) Psychotic |
|
|
Describe melancholic MDD
|
Anhedonia, early morning awakenings, psychomotor disturbance, excessive guilt, anorexia
|
|
|
Describe atypical MDD
|
Hypersomnia, hyperphagia, reacive mood, hypersensitivity to interpersonal rejection
|
|
|
Describe catatonic MDD
|
Catalepsy (immobility), purposeless motor activity, extreme negativism, bizarre postures, echolalia
|
|
|
Describe psychotic MDD
|
Characterized by the presence of delusions or hallucinations
|
|
|
What kind of drug is effective in treating atypical MDD?
|
MAOIs
|
|
|
How do you treat catatonic MDD?
|
With both antidepressants and antipsychotics
|
|
|
What is the DSM-IV criteria for bipolar I disorder?
|
Occurence of one manic or mixed episode; between manic episodes there may be other mood episodes but none are required for diagnosis
|
|
|
Can psychotic features be associated with bipolar I disorder?
|
Yes, always include bipolar I disorder as part of the differential in a psychotic patient
|
|
|
What pharmacotherapy is out there for treatment of bipolar disorder?
|
1) Lithium - mood stabilizier
2) Anticonvulsants - carbamazepine and valproic acid 3) Atypical antipsychotic - olanzapine |
|
|
What are other treatment modalities for bipolar disorder?
|
Psychotherapy and ECT
|
|
|
What is rapid cycling?
|
Defined by the occurrence of 4 or more mood episodes in 1 year (major depressive, manic, mixed, etc)
|
|
|
What are the side effects of lithium?
|
A whole list
|
|
|
What is the DSM-IV criteria for bipolar II disorder?
|
History of major depressive episode and at least one hypomanic episode
*if there has been a full manic episode even in the past, then the diagnosis is not bipolar II disorder, but bipolar I |
|
|
What is the DSM-IV criteria for dysthymic disorder?
|
1) Depressed mood for the majority of the time of most days for at least 2 years
2) C - concentration poor H - hopelessness A - appetite up or down S - sleep up or down E - energy S - self-esteem *person has not been without the above symptoms for > 2 months at a time; NEVER had a manic or hypomanic episode (would be bipolar disorder) |
|
|
Define double depression?
|
Patients with MDD with dysthymic disorder during residual periods
|
|
|
Can you have psychotic features with dysthymia?
|
Delusions or hallucinations are never in patients with dysthymia; consider another diagnosis
|
|
|
What is the mneumonic of dysthymic disorder?
|
2 years of depression
2 listed criteria Never asymptomatic for > 2 months |
|
|
What is the DSM-IV criteria for cyclothymic disorder?
|
Numerous periods with hypomanic symptoms and periods of depressive symptoms for at least 2 years, never symptom free for > 2 months during those 2 years
|
|
|
What personality disorder is associated with cyclothymic disorder?
|
Borderline personality disorder
|
