Mood disorders

Question 1

Depression diagnosis

Answer 1

The DSM-5 outlines a list of symptoms of which five or more must be experienced in the same two-week period (including at least one of the first two listed) to make a diagnosis of depression:

* Persistent low mood
* Anhedonia
* Weight loss or gain
* Retardation of thought and action
* Fatigue
* Feelings of worthlessness or guilt
* Diminished ability to concentration
* Recurrent suicidal ideation.

Question 2

Primary features of unipolar depression?

Answer 2

Low mood, reduced energy, anhedonia

Question 3

Secondary features of unipolar depression?

Answer 3

Weight and appetite changes, reduced concentration, insomnia, hopelessness, suicidal ideation, reduced interest and motivation, low self esteem

Question 4

Bipolar affective disorder

Answer 4

Classically, periods of prolonged and profound depression alternate with periods of excessively elevated and/or irritable mood, known as mania.

Question 5

Type 1 bipolar

Answer 5

Full-blown mania or mixed mania and depression

Question 6

Type 2 bipolar

Answer 6

Recurrent depression and hypomania without episodes of either mania or mixed states.

Question 7

ICD 10 bipolar disorder diagnosis needs In

Answer 7

At least 2 mood episodes before bipolar diagnosis can be considered, with complete recovery in between the episodes.

Question 8

DSM bipolar disorder diagnosis

Answer 8

Can be diagnosed even with single manic episode.

Question 9

Bipolar diagnosis durations for each depressive episode, mania and hypomania

Answer 9

Depressive episode must be present at least for 2 weeks; mania for 7 days (lesser if hospitalized) ; hypomania for 4 days and mixed episodes for 2 weeks before they can be diagnosed using ICD 10.

Question 10

How is bipolar different in elderly

Answer 10

Shorter periods of interepisodic remissions and more frequent episodes which are considerable longer.

Question 11

Natural course of mood episodes

Answer 11

Mania lasts for 4 months while depression for 6 months.

Question 12

Type 2 bipolar primary feature

Answer 12

Elated/irritable mood & increased activity

Question 13

Type 2 bipolar secondary feature

Answer 13

Grandiosity, racing thoughts, decreased need for sleep, etc

Question 14

Type 2 bipolar impairment

Answer 14

Change in functioning that is uncharacteristic of the person when not symptomatic. Observable by others

Question 15

Type 2 bipolar durational criterion

Answer 15

> 4 days

Question 16

Type 1 bipolar durational criterion

Answer 16

> 7 days

Question 17

Type 1 bipolar impairment

Answer 17

Impairment in functioning

Question 18

Type 1 bipolar secondary feature

Answer 18

Grandiosity, racing thoughts, decreased need for sleep, etc

Question 19

Type 1 bipolar primary feature

Answer 19

Elated/irritable mood & increased activity

Question 20

Mania

Answer 20

A distinct period of abnormally and persistently elevated, expansive, or irritable mood, with 3 (or more) characteristic symptoms of mania.

Question 21

Features of mania

Answer 21

Elevated mood (usually out of keeping with circumstances)

Increased energy, which may manifest as Over activity, reduced need for sleep, racing thoughts Pressured speech and flight of ideas

Increased self-esteem- Grandiosity, Overoptimistic ideation, over familiarity, Reduced social inhibition

Reduced attention/increased distractibility

Tendency to engage in behaviour that could have serious consequences like overspending, preoccupation with extravagant schemes

Question 22

Psychotic symptoms accompany

Answer 22

Mania

Question 23

Psychotic symptoms

Answer 23

Delusions and hallucinations

Question 24

Hypomania/hypo manic episode

Answer 24

By definition, not severe enough to interfere with social or occupational functioning, require admission to hospital, or include psychotic features.

Question 25

Symptoms of hypomania

Answer 25

Hypomania shares symptoms with mania, but these are evident to a lesser degree.

It includes mildly elevated, expansive, or irritable mood, increased energy and activity, increased self-esteem, talkativeness, over familiarity, reduced need for sleep and difficulty in focusing on one task alone.

Question 26

Mixed states

Answer 26

Manic and depressive symptoms occur simultaneously. The occurrence of both manic/hypo manic and depressive symptoms in a single episode, present every day for at least 1 week (DSMIV) or 2 weeks (ICD-10)

Can rapidly swing between the 2 or symptoms of each can be present at the same time

Question 27

Rapid cycling

Answer 27

When at least four episodes of bipolar disorder occur within a period of one year, the condition is described as ‘rapid cycling’

Question 28

Factors associated with the rapid cycling include

Answer 28

The use of tricyclic anti-depressant, low thyroxin level, being a female patient, Bi Polar 2 pattern of illness and the presence of neurological disease.

Question 29

Postpartum onset refers to

Answer 29

Onset of mania, hypomania or depression with 4 weeks of childbirth.

Question 30

How many will attempt suicide (bipolar)?

Answer 30

50%