Depressive And Bipolar Disorders

Question 1

Illness marked primarily by disturbances in mood, I.e. a persistent emotional state

-Moods can be elevated or depressed

Answer 1

Mood disorder

Question 2

Although the primary symptom of a mood disorder is mood change, symptoms almost always occur in which other 3 types of behavior?

Answer 2

Sleep, appetite, and cognition

Question 3

Characterized by depressed mood, diminished interest/pleasure, and at least 5% change in body weight

Answer 3

Major Depression

Question 4

66% of patients contemplate suicide, with 10-15% completing it

Answer 4

Major Depression

Question 5

The peak incidence of major depression is in the

-Shows cultural differences in expression

Answer 5

Depression

Question 6

May be present as the first episode of eventual bipolar or schizophrenic disorders

Answer 6

Depressions

Question 7

The heritability for major depression appears to be

Answer 7

40%

Question 8

Medical disorders such as drug intoxications and withdrawals, tumors, infections, cerebrovascular and cardiovascular events, etc are part of the differential diagnosis for

Answer 8

Major Depression

Question 9

First episode occurs before 40 in 50% of patients

Answer 9

Major Depression

Question 10

What percentage of patients with initial diagnosis of major depression go on to have a manic episode?

Answer 10

5-10%

Question 11

Dysfunctionalthoughtpatternsandbeliefsabout oneself, the environment and the future may lead painful affects, dysfunctional behaviors and expectation of failure. This in turn can predispose to

Answer 11

Depression

Question 12

A loss of interpersonal connections and efficacy can lead to and perpetuate

Answer 12

Depression

Question 13

Characterized by loss of pleasure in all or almost all activities or lack of reactivity to pleasurable activities

Answer 13

Major depression with melancholic features

Question 14

Major depression with melancholic features must also have

Answer 14

Depression worse in the AM

Question 15

Characterized by mood reactivity AND significant weight gain or increase and appetite, hypersonic, or leaden paralysis

Answer 15

Major depression with atypical features

Question 16

Characterized by mood congruence (self punishment or guilt), and delusions or hallucinations

Answer 16

Major Depressive Disorder w/ Psychotic features

Question 17

Symptoms occur during pregnancy or in the 4 weeks following delivery w/ or w/o psychosis

Answer 17

Major depressive disorder w/ peri partum onset

Question 18

Major depression with peri partum onset may be ore common in the first pregnancy, w/ psychotic features more likely with the

Answer 18

Second episode

Question 19

Depressed mood most of the day for more days than not for at least 2 years

Answer 19

Persistent Depressive Disorder

Question 20

Is never without symptoms over the 2 year period for more than two months

Answer 20

Persistent Depressive Disorder

Question 21

Persistent depressive disorder have a 12 month prevalence of

Answer 21

1-2% for chronic depression

Question 22

There is no clear genetic difference between PDD and

Answer 22

Major Depression

Question 23

About 50% of patients with Persistent Depressive Disorder have symptoms before

Answer 23

25 y/o

Question 24

15% of patients with persistent depressive disorder progress to

Answer 24

Bipolar II

Question 25

Marked affective liability, irritability, or interpersonal conflict present in the final week before the onset of menses -Improve within a few days after onset of menses

Answer 25

Premenstrual Dysphoric Depressive Disorder

Question 26

Risk factors include stress, previous trauma, and seasonal changes

Answer 26

Premenstrual Dysphoric Depressive Disorder

Question 27

We want to monitor caffeine, sugar, and sodium with? -Also calcium and B6

Answer 27

Premenstrual Dysphoric Depressive Disorder

Question 28

Differential includes substance intoxication and withdrawal, primary depression, or primary depressive disorder due to another medical condition

Answer 28

Substance/medication induced depressive disorder

Question 29

Prominent and persistent depressed mood or decreased interest that dominates the clinical picture -Direct pathophysiological effect of another medical condition

Answer 29

Depressive disorder due to another medical condition

Question 30

Clear associations with CVA, Huntington’s, Parkinson’s, TBI, Cushing’s, and hypothyroidism

Answer 30

Depressive disorder due to medical condition

Question 31

Cyclothymia is included in the category of

Answer 31

Bipolar and related disorders

Question 32

Must meet criteria for manic episode which is preceded by hypomania or major depressive episodes

Answer 32

Bipolar Type 1

Question 33

Are depressed for up to 1/3 of their lives

Answer 33

Bipolar Patients

Question 34

Elevated, expansive, or irritable mood and persistently increased goal directed activity or energy lasting at least 1 week

Answer 34

Manic Episode

Question 35

The difference between hypomania and mania is degree of intensity of symptoms and impairment. Hypomania must last at least

Answer 35

4 Days

Question 36

Behavior that is not characteristic of the individual and is observable by others but does not cause marked impairment

Answer 36

Hypomanic Episode

Question 37

Presence of at least 4 mood episodes in the previous 12 months that meet criteria for manic, hypomanic or depressive episodes

Answer 37

Bipolar/related disorders w/ rapid cycling

Question 38

Shows a period of partial/full remission of at least 2 months

Answer 38

Bipolar/related disorders w/ rapid cycling q

Question 39

Has bipolar features but also delusions and hallucinations

Answer 39

Bipolar w/ psychotic features

Question 40

Bipolar w/ stupor, catalepsy, waxy flexibility, mutism, and posturing

Answer 40

Bipolar w/ catatonia

Question 41

Equal prevalence in men and women, and 83% of cases are classified as severe

Answer 41

Bipolar 1 disorder

Question 42

The mean age of onset for bipolar is

Answer 42

18

Question 43

What percentage of bipolar 1 patients have depression as the first episode?

Answer 43

67-75%

Question 44

Can last for 3 months, and 90% of patients have more than one episode and time between episodes can decrease

Answer 44

Bipolar 1

Question 45

Young age of onset, alcohol dependence, psychotic features, and lack of interepisode remission are poor prognosticators for

Answer 45

Bipolar 1

Question 46

Is differentiated based on the fact that there is a history of hypomanic, but not manic episodes

Answer 46

Bipolar 2

Question 47

5-15% will ultimately develop a manic episode -Age of onset is mid 20’s

Answer 47

Bipolar 2

Question 48

Bipolar 2 shows a decline in

Answer 48

Occupational/cognitive abilities

Question 49

Bipolar 2 has a poorer prognosis if there is

Answer 49

Rapid Cycling

Question 50

Late age of onset, higher education, and marriage are good prognosticators for

Answer 50

Bipolar 2

Question 51

There is mixed data on gender prevalence, but 10-20% of post partum women may experience a

Answer 51

Hypomanic Episode

Question 52

Is the lethality of suicide attempts higher in type 1 or type 2 bipolar?

Answer 52

Bipolar 2

Question 53

A chronic fluctuating disorder of at least 2 years duration marked by many periods with hypomanic symptoms that don’t meet bipolar criteria and many periods of depressive symptoms that don’t meet criteria for MDD

Answer 53

Cyclothymia disorder

Question 54

Different from bipolar 2 in that the depression is not major depression

Answer 54

Cyclothymia

Question 55

With cyclothymia, the longest time period that a patient is free of mood swings is

Answer 55

2 months

Question 56

50-75% of patients with cyclothymia have an age of onset between

Answer 56

15 and 25

Question 57

What percentage of cyclothymia patients have a positive FH for bipolar disorder?

Answer 57

About 30%

Question 58

Much more sensitive to be switched to hypomania/mania with antidepressants

Answer 58

Cyclothymia Patients

Question 59

Differential always includes Bipolar 1 or 2, substance use disorders, ADD/ADHD and personality disorders

Answer 59

Cyclothymia Disorder