Neuro 2 - Ryan - Mood Disorders

Front 1

Define Mood vs. Affect

Back 1

Mood = what person feels ie what pt TELLS you they feel

Affect = how a pts. emotional state is perceived by someone else. ie what Dr. THINKS pt is feeling

Front 2

What are the Unipolar mood disorders? Bipolar? Which mood disorders are not one or the other?

Back 2

Unipolar = Major Depression, Dysthymic Disorder, Depressive Disorder NOS

Bipolar = Bipolar disorder I, Bipolar disorder II, Cyclothymic disorder

Other = Mood disorder due to general medical condition, substance-induced mood disorder, Adjustment disorder with depressed mood

Front 3

DSM criteria for Major Depressive Episode?

Back 3

2 week period of either depressed mood or anhedonia plus 5 of the following:

Significant weight loss, psychomotor retardation or agitation, fatigue, wirthlessness or guilt, dec. concentration or indecisiveness, suicidal ideation

Front 4

Whats the pneumonic for Major Depressive Episode?

Back 4

D-SIGECAPS

Depressed Mood
Sleep Disturbance
Interest Dec.
Guilt
Energy diminished
Conc. dec.
Appetite change
Psychomotor inc or dec.
Suicidal Ideation

Front 5

What disorders have as a feature Major Depressive Episodes (ie what our our differential Dx's in a pt with major depressive episodes?)

Back 5

Major depressive disorder, Bipolar disorder I or II, Double Depression, Mood disorder due to GMC, Substance-induced mood disorder, Adjustment disorder, Simple or complicated bereavement, Dementia with prominent apathy, Other mental disorders with depression as feature

Front 6

DSM criteria for Manic Episode?

Back 6

At least One week of:

Elevated, Expansive or Irritable mood (for at least 1 week) with 3 OR MORE (4 if only irritable mood):
Inflated self-esteem, Dec. need for sleep, more talkative or pressured speech, flight of ideas or racing thoughts, Distractability, Inc. goal-directed activity or psychomotor agitaion, Excessive involvement in pleasurable activities with a high potential for negative consequences (ex = gambling, sex-addiction)

Pneumonic = "DIG FAST"
Distractability
Insomnia
Grandiosity
Flight of Ideas
Activities
Speech
Thoughtlessness

Front 7

DSM Criteria for Hypomanic?

Back 7

At least 4 days of:

Elevated, Expansive or Irritable mood (for at least 1 week) with 3 OR MORE (4 if only irritable mood):
Inflated self-esteem, Dec. need for sleep, more talkative or pressured speech, flight of ideas or racing thoughts, Distractability, Inc. goal-directed activity or psychomotor agitaion, Excessive involvement in pleasurable activities with a high potential for negative consequences (ex = gambling, sex-addiction)

Pneumonic = "DIG FAST"
Distractability
Insomnia
Grandiosity
Flight of Ideas
Activities
Speech
Thoughtlessness

NOTE: HYPOMANIC EPISODES DO NOT CAUSE IMPAIRMENT IN SOCIAL/OCCUPATIONAL FUNCTIONIG AND DO NOT REQUIRE HOSPITALIZATION

Front 8

What disorders display Manic or hypomanic episodes?

Back 8

Bipolar I or II, Cyclothymic disorder, Mood disorder due to GMC, Substance-induced mood disorder, Major Depressive Episode with Prominent Irritability, Attention deficit/hyperactivity disorder, Other mental disorders with mania as a feature

Front 9

DSM criteria for a mixed episode?

Back 9

Criteria for both Manic and Major depressive Episode are met nearly every day for ONE WEEK = roller coaster

Mood disturbance causes significant social or occupational impairment, requires hospitalization, or has psychotic symptoms.

Front 10

T/F: In order to qualify for Major Depressive Disorder, One cannot have had a manic, hypomanic, or mixed episode

Back 10

TRUE

Front 11

Major Depressive Episodes can have single or recurrent episodes. How do we determine the severity of the case and what are the Course Specifiers?

Back 11

Severity = mild, moderate, severe, severe with psychotic features, partial or full remission

Course Specifiers = Chronic, Catatonic (neurogenic motor dysfunction ie rigidity, motor, spasticity), Atypical, Melancholic (nothing makes them happy), Post-Partum

Front 12

T/F: Number of previous episodes of Major Depressive Disorder increases the likelihood of future episodes

Back 12

TRUE

Front 13

Criteria for Dysthymic Disorder?

Back 13

2 year or more of Depressed mood - Has not met the criteria for Major Depressive Disorder

At least TWO:

Appetite change
Sleep change
Fatigue, loss of energy
Low self esteem
Poor concentration
Hopelessness

Pt is NOT WITHOUT symptoms for more than 2 weeks at a time.

Front 14

Define Double Depression

Back 14

Dysthymia + Major Depressive Disorder

Front 15

Define Depressive Disorder, NOS (=Not Otherwise Specified)

Back 15

= Disorders that do not meet the criteria for Major Depressive Disorder

Ex = Premenstrual dysmorphic disorder, Minor depressive disorder, recurrent brief depressive disorder, Postpsychotic depressive disorder, Major Depressive Disorder superimposed on a psychotic disorder

Front 16

Criteria for Bipolar I Disorder

Back 16

1 Manic or Mized episode OR
Manic + Depressive Episodes

May also have Hypomanic Episodes (but have to have 1 manic episode)
KNOW: MANIC episode has to last a WEEK to qualify

Front 17

A 65 year old pt has a week of grandiosity, flight of thoughts, Insomnia, Activities, is extremely talkative and is engaging in risque sexual behaviors. What is his condition most likely due to?

Back 17

Pt is probably suffering from Bipolar Disorder I, because of the Manic Episode that at this point has been occuring for a week. the CAUSE of this Bipolar disorder I is most likely due to a GMC, general medical condition, because he is 65+

Front 18

Criteria for Bipolar II?

Back 18

1 Hypomanic plus 1 Major depressive Disorder but NO manic or mixed episodes

(vs. Bipolar Disorder I = 1 Manic or mixed episode OR manic + Depressive episodes and can have hypomanic episodes but HAVE to have at least 1 manic episode)

Front 19

Good Graphical representation of the spectrum of disorders:

Back 19

Front 20

Define Cyclothymic Disorder

Back 20

Dysthymia + Intermittent Hypomanic Episodes over a period of 2+ years

(never meet criteria for Major depressive episode or manic episode over 2 years = these are the ultimate strivers that never made it to the top o the pack)

Front 21

A pt with Bipolar Disorder I gets symptoms when the first snow hits the ground and it doesn't let up until the first leaves begin to come back on the trees. Dx?

Back 21

This is Bipolar disorder I with a seasonal pattern specifer ie the symptoms are season-specific

Note - seasonal pattern specifier must have occured over the past 2 years for Dx

Front 22

A pt has sleep apnea and you dx them with Bipolar Disorder 2. Whats the cause of their Bipolar disorder II?

Back 22

COULD be due to their underlying general medical condition ie mood disorder due to GMC

Front 23

Pt is coming off heroin but the methadone clinic in town ran out. If they develop mood disorder whats you Dx?

Back 23

Substance-induced mood disorder

Front 24

A pt recently switched jobs, lost her house, and a tree fell in her car. She has symptoms of Depression. Dx?

Back 24

Adjustment disorder with depressed mood

Ie 3 identifiable stressors within 3 months

Front 25

If you Dx a pt with Adjustment disorder with depressed mood, How long do you tell the pt the symptoms will last?

Back 25

not more than 6 months once the stressor has been terminated