DEPRESSION AND BPD

Question 1

It stands for a complex of disturbed feelings (called mood, or affective, disorder)-which may include aspects of despair, hopelessness, sense of worthlessness, and thoughts of selfharm- associated with decreased energy and libido, loss of interest in personal affairs, impaired concentration, various abnormalities of behavior and appearance, and prominent physical complaints

Answer 1

DEPRESSION

Question 2

As a purely phenomenological observation, an
abnormally elevated mood, or ______ is about one-third
as frequent as depression

Answer 2

mania,

Question 3

_____ and ______ disorder are the names given to milder forms of mania and bipolar disorder, respectively.

Answer 3

Hypomania

cyclothymic

Question 4

The DSM classifications also acknowledge the existence of a __________ in which attributes of depression and schizophrenia are combined

Answer 4

mixed schizoaffective state

Question 5

__________is a particularly frequent somatic manifestation of depression

Answer 5

Chronic pain

Question 6

_______used for the treatment of multiple sclerosis
and hepatitis, and the _______ may also evoke
a depressive reaction

Answer 6

beta-interferons

phenothiazines

Question 7

depressed mood may
also emerge during the tapering-off period of _______
medication or during their initial use (a hypomanic
state is more common).

Answer 7

corticosteroid

Question 8

Patients with psychotic depression with hallucinations and delusions usually have ______infarcts

Answer 8

right temporoparietal infarcts

Question 9

With regard t o emotional reactions in degenerative
brain diseases, Parkinson disease is complicated by a
depressive reaction in approximately _____

Answer 9

one-quarter of

cases

Question 10

Another hazard in Parkinson and
in Lewy-body disease is the tendency for L-dopa itself
to provoke a depression in a limited number of patients,
sometimes with ________, ________, _____

Answer 10

suicidal tendencies, paranoid ideation,

and psychotic episodes.

Question 11

The main risk

for depression during pregnancy is a______

Answer 11

history of previous

depressions.

Question 12

the essential diagnostic criteria of
endogenous depression ("major depressive syndrome")
consist of a dysphoric mood or loss of interest or pleasure in all usual activities (including sexual activity) in combination with at least four of the following seven symptoms:

1.
2.
3.
4.
5.
6.
7.

Answer 12

(1) disturbance of appetite and change in weight;
(2) sleep disorder; (3) psychomotor retardation or agitation;
(4) decreased energy and fatigue; (5) self-reproach,
feelings of worthlessness or guilt; (6) indecisiveness,
complaints of memory loss and difficulty in concentrating;
and (7) thoughts of death or suicide or actual suicide
attempts.

Question 13

T or F

In Depressive psychosis

The delusions are generally congruent with the
patient’s mood and are not as fixed or bizarre as those of
schizophrenia or paranoia

Answer 13

T

Question 14

In Depressive psychosis

_______, when they occur, are usually
transitory, vocal, and vaguely accusatory; their presence
should always raise the possibility of an associated structural
brain disease, drug intoxication, or alcoholic auditory
hallucinosis.

Answer 14

Hallucinations

Question 15

the illness takes the form of a depressive stupor;
the patient becomes mute, indifferent to nutritional needs,
and neglectful even of bowel and bladder functions (anergic
depression). The condition in this extreme form is a
_________

Answer 15

catatonic depression

Question 16

________is a disorder of mood consisting of
prolonged episodes of depression, interrupted by, or
coexistent with episodes of mania

Answer 16

Bipolar disease

Question 17

bipolar psychosis has been divided into two subtypes: the ________ in which only an endogenous depressive illness occurs, and a ______, in which one or more bouts of mania occur with or without depression

Answer 17

unipolar group,

bipolar group

Question 18

There has been an arbitrary
further subdivision of bipolar I to denote at least one episode
of _______, and bipolar II when the process entails
an episode of _______.

Answer 18

full mania

hypomania

Question 19

In addition, there are _______, in which
symptoms of both depression and mania occur within a
single episode of the illness.

A so-called _________
form of bipolar disease has also been recognized in which four or more circumscribed episodes occur in a year

Answer 19

mixed affective states

“rapid-cycling”

Question 20

The __________ is, in most ways, the opposite of the
depressed state, being characterized by a flight of ideas,
motor and speech hyperactivity, and an increased appetite and sex urgE

Answer 20

manic state

Question 21

The
manic individual appears to possess great drive and
confidence yet lacks the ability to ______

Answer 21

carry out plans.

Question 22

In its most advanced form, a condition
described as __________” the patient becomes
totally incoherent and altogether disorganized in behavior.
At this stage visual and auditory hallucinations and
paranoid delusions may be rampant

Answer 22

“delirious mania,

Question 23

______ describes a milder degree of the disorder
but this term is also used loosely to depict behavior in
a normally functioning individual who is unusually
energetic and active

Answer 23

Hypomania

Question 24

First attacks of either depression or mania last an
average of _________ if untreated, although the duration
varies greatly.

Answer 24

6 months

Question 25

Variables that are predictive

of an unfavorable outcome in Mania are high degrees of ________, ___________, ________

Answer 25

anxiety, strongly positive family history of a similar psychiatric illness, and presence of depression-provoking circumstances

Question 26

Hypometabolism in the________ cortex is among the

most consistent findings in depression

Answer 26

left frontal

Question 27

Also prominent in many studies
are metabolic changes in the _______ and ________ related parts of the medial limbic system, and
the hippocampus

Answer 27

cingulate and orbitofrontal

cortices,

Question 28

On histologic level, several studies have shown a
depletion of and changes in the _____________ in both depression
and stress,

Answer 28

pyramidal neurons of

the CA3 region of the hippocampus

Question 29

depressed
patients and their first-degree relatives, as well as healthy
individuals, develop a depressed mood after dietary
depletion of the monoamine precursor tryptophan and
concentrations of 3-methoxy-4-hydroxyphenylglycol
(MHPG), a metabolite of ________

Answer 29

norepinephrine

Question 30

5-hydroxyindoleacetic
acid (5-HIAA), a deaminated metabolite of _______, is
reduced in the cerebrospinal fluid of depressed patients

Answer 30

serotonin

Question 31

It had been found
several decades ago that the parenteral administration of
1 to 2 mg of dexamethasone _______ serum cortisol
secretion while the patient was ill with endogenous
depression, but did so after recovery

Answer 31

failed to suppress

Question 32

The failure of dexamethasone suppression has been
attributed to hyperactivity in the hypothalamic pituitary
axis and a corresponding increase in secretion
of ________, _______ and ______

Answer 32

corticotropin-releasing hormone, adrenocorticotropic

hormone (ACTH), and glucocorticoids

Question 33

Among patients with primary depressive
disorders, ____________ were
found to have occurred more frequently in the months
preceding the onset of depression than in matched control
groups.

Answer 33

life events of a stressful nature

Question 34

I n the management o f bipolar and depressive disease, sixmain categories of drugs are in general use-
1
2
3
4
5
6

Answer 34

the tricyclic antidepressants, 
 "atypical" or nontricyclic group of compounds, 
the MAO inhibitors, 
serotonin agonists
(reuptake inhibitors), 
antiepileptic drugs, 
and lithium

Question 35

____________ has a
tendency to produce insomnia and weight loss, making
it particularly useful in the treatment of depressions that
are characterized by overeating and hypersomnia

Answer 35

Fluoxetine

Question 36

Patients with anorexia, insomnia, and high
levels of anxiety may do better with a more sedating
medication, such as _______

Answer 36

amitriptyline

Question 37

The tricyclic antidepressants comprise amitriptyline,
imipramine, desipramine, doxepin, clomipramine, and
trimipramine, and the closely related drugs nortriptyline
and protriptyline. Among this group, most psychiatrists
start with________ or _______ because of their
relative safety.

Answer 37

imipramine or amitriptyline

Question 38

The therapeutic effect of tricyclic medication
is generally not evident for _______ after treatment
has been initiated, and it is important that this be
explained to the patient and family.

Answer 38

2 to 4 weeks

Question 39

Caution should be exercised in elderly patients with
cardiac disorders of all types because of the possibility of
causing heart block or arrhythmia. For such patients, the
serotonin drugs or one of a newer group of nontricyclic
antidepressant drugs-________ and _______-may
be preferable, but the latter causes orthostatic hypotension and sedation in doses required for consistent antidepression effects.

Answer 39

bupropion and trazodone

Question 40

If one of the SSRI or tricyclic and related drugs,
given in full doses for _________ does not produce
the desired effect, or, as often happens, if the patient is
intolerant of the given drug, another one from an alternative group, e.g., an MAO inhibitor, may be tried.

Answer 40

4 to 6 weeks,