Clinical Approach to Mood Disorders

Question 1

What objective measure is used to screen for depressive disorders?

Answer 1

PHQ-9

Question 2

What subtype of major depressive disorder occurs during or after pregnancy?

Answer 2

Major depressive disorder with peripartum onset

Question 3

How does diagnosis criteria for persistent depressive disorder differ in children and adults?

Answer 3

Adults require at least two years of symptoms, whereas children only need one year of symptoms

Question 4

This mood disorder requires only 3 symptoms for diagnosis, but they must persist for at least two years.

Answer 4

Persistent Depressive Disorder

Question 5

True/False. A family history of bipolar disorder increases the risk of developing bipolar disorder.

Answer 5

True

Question 6

Hypomania of less than four days, with no psychosis or impairment, characterizes what mood disorder?

Answer 6

Bipolar Type 2

Question 7

What is the most severe subtype of Major Depressive Disorder?

Answer 7

Major Depressive Disorder with melancholic features (poor sleep, issues with ADLs, etc.)

Question 8

A patient comes to the ER with a 10 day history of mania. They admit to hearing voices and believe someone is chasing after them. The attending admits the patient to the psychiatric unit. What is a possible diagnosis?

Answer 8

Bipolar Type 1 - 7+ days of mania, with psychosis and hospitalization, likely impaired functioning

Question 9

How many DIG FAST symptoms must be present for a manic episode?

Answer 9

3+ symptoms - hypomania is characterized by the same symptoms, but less severe

Question 10

What symptoms are associated with Major Depressive Disorder?

Answer 10

Sleep Changes
Interest Loss
Guilt
Energy Loss/Fatigue
Cognitive Impairment
Appetite Loss
Psychomotor/Agitation
Suicidal Ideations

Question 11

What is cyclothymic disorder?

Answer 11

A mood disorder characterized by episodes that range from mild depression to hypomania. Cyclothymic disorder may progress to Bipolar Type 2

Question 12

What symptoms characterize a manic state?

Answer 12

Distractability, Inhibition, Grandiosity, Flight of Ideas, Activity Increase, Sleep Disturbances, Talkative

Question 13

Which type of bipolar disorder is considered more severe?

Answer 13

Bipolar Type 1

Question 14

True/False. Bipolar Type 2 diagnosis requires a history of at least one manic episode.

Answer 14

False - Diagnosis requires at least one major depressive episode and one hypomanic episode, but NO history of manic or mixed episodes.

Question 15

True/False. For a diagnosis of Bipolar Type 1, a manic episode must be preceded or followed by a hypomanic or major depressive episode.

Answer 15

True

Question 16

What criteria must be met for a diagnosis of Major Depressive Disorder?

Answer 16

At least 5 of the following symptoms occur for 2+ weeks (sleep changes, interest loss, guilt, energy loss, concentration issues, weight changes, agitation, suicidal ideations)

At least one symptom of depressed mood or loss of interest

Episode is not attributable to substance use or psychotic disorder

No history of mania

Question 17

What psychiatric disorders may mimic mania?

Answer 17

Generalized anxiety disorder, panic disorder, PTSD, ADHD, personality disorders, intermittent explosive disorder

Question 18

What criteria automatically institute a diagnosis of Bipolar Type 1?

Answer 18

Psychotic symptoms, hospitalization, impaired functioning

Question 19

What is persistent depressive disorder?

Answer 19

A mild type of depression that requires only 3+ symptoms for at least 2 years

Question 20

What atypical symptoms may present with Major Depressive Disorder?

Answer 20

Hypersomnia, increased eating, leaden paralysis

Question 21

A mass in the left frontal lobe is most likely to exhibit what type of symptoms (depressive/manic)?

Answer 21

Depressive symptoms

Question 22

A mass in the right frontal lobe is most likely to exhibit what type of symptoms (depressive/manic)?

Answer 22

Manic symptoms

Question 23

True/False. The risk of suicide increases in patients with bipolar disorder.

Answer 23

False - Suicidality and self-harm are generally absent in patients with bipolar disorder. Suicides are generally accidental and the result of psychotic symptoms (ex: belief one can fly and jumping from building)