mood disorders

Question 1

t or f: 1 in 10 women suffer from depression after giving birth

Answer 1

false, 1 in 20

Question 2

what is MDD?

Answer 2

major depressive disorder

Question 3

define anhedonia

Answer 3

lack of pleasure or interest in previously enjoyable/rewarding activities

Question 4

MDE requires 5 or more of 9 symptoms for most days/every day, what are they?

Answer 4

• depressive mood
• anhedonia
• significant weight loss/gain (appetite increase/decrease)
• insomnia/hypersomnia
• psychomotor agitation (increased motor movement ie tapping, fidgeting) or retardation (unusual slow performance at activites ie brushing teeth)
• fatigue/loss of energy
• worthless/guilty feelings
• inability to concentrate/indecisiveness
• recurring thoughts of death/suicide/attempts

Question 5

Mood disturbances must be present for one week + in mania/ 4 + days in hypermania, with 3 of 7 symptoms present, name them.

Answer 5

• inflated self esteem/grandiosity
• increased goal-directed activity/psychomotor agitation
• reduced need for sleep
• racing thoughts/flight of ideas
• distractibility
• increased talkativeness
• excessive involvement in risky behaviours

Question 6

hypomanic vs manic episodes

Answer 6

hypomanic: shorter, not always accompanied by impairment in functioning
manic: at least 1 week, significant impairment in functioning

Question 7

what are the two major types of unipolar disorders

Answer 7

MDD and PDD (persistant depressive disorder)

Question 8

Symptoms required for PDD

Answer 8

at least two, cannot be without symptoms for more than 2 months:
- poor appetite/overeating
- insomnia/hypersomnia
- low energy/fatigue
- low self esteem
- poor concentration/difficulty making decisions
- hoplessness

Question 9

What are the tree major types of BDs?

Answer 9

• Bipolar l Disorder (BD l): single or recurrent manic episode
• Bipolar ll Disorder: single (or recurrent) hypomanic episodes and depressive episodes
• Cyclothymic disorder: numerous/alternating periods of hypomania and depression lasting at least two years, must have symptoms at least half the time

Question 10

t or f: 1 in 5 americans meet criteria for MDD

Answer 10

true

Question 11

what is the 12-month prevalence

Answer 11

the proportion of people who meet criteria for a disorder during a 12-month period

Question 12

what is SES

Answer 12

socioeconomic status, lower SES=higher rate of MDD

Question 13

t or f: ppl with bipolar disorder usually only suffer from bipolar and no other disorders

Answer 13

false, approximately 65% of people with BD meet diagnostic criteria for at least one additional psychiatric disorder, most commonly anxiety disorders and substance use disorders

Question 14

what ethnic group/race tends to be more diagnosed and treated than others?

Answer 14

european americans, hispanic and african american are more likely to remain ill or be under-diagnosed

Question 15

t or f: bipolar diagnoses in adolescence makes for easier time with the illness over time

Answer 15

false, those diagnosed with BD prior to adulthood experience a more pernicious course of illness relative to those with adult onset, including more episode recurrence, higher rates of suicidality, and profound social, occupational, and economic repercussions

Question 16

t or f: MDD is mainly a genetic disorder and gene play the main role in onset of disease

Answer 16

false, enviro and some genetic factors both are to blame

Question 17

what was noticed in fMRI scans when MDD patients were shown a negative stimuli (ie pic of angry face)?

Answer 17

they had greater activation in brain regions involved in stress response and reduced activation in brain regions involved in positively motivated behaviours

Question 18

what is early adversity

Answer 18

chronic stressful event(s) that may be biological or psychological (ie poverty, abuse, neglect) in childhood

Question 19

attributional styles

Answer 19

tendency by which someone infers cause/meaning behind behaviours/events

Question 20

t or f: People with a pessimistic attributional style tend to make internal (versus external), global (versus specific), and stable (versus unstable) attributions to negative events, serving as a vulnerability to developing MDD

Answer 20

true

Question 21

t or f: BD is not at all heritable

Answer 21

false, it is extremely heritable as it is a genetic vulnerability

Question 22

t or f: regions of the brain thought to be involved in emotional processing and regulation are activated differently in people with BD

Answer 22

true

Question 23

t or f: standardized stimuli (eg. facial expression of anger) is more effective in inducing strong emotions in ppl with BD than personally engaging stimuli (eg memories)

Answer 23

false

Question 24

t or f: ppl with BD have less manic symptoms after life events involving attainment of desired goals

Answer 24

false, they have more lol, they have hypersensitivity to rewards

Question 25

what is the social zeitgeber theory

Answer 25

zeitgeber=time giver enviro cues, ex meal time w other ppl, help bio rhythms/circadian rhythm messing it up can increase BD symptoms/trigger relapse episode

Question 26

what are some treatments for MDD

Answer 26

- antidepressant medications, target neurotransmitter implicated w depression -electroconvulsive therapy (ECT, induce seizure) - transcranial magnetic stimulation (TMS) - deep brain stimulation (plant electrolode in brain) -psychosocial treatment (behavioural/cog/interpersonal therapy)

Question 27

what is the earliest anti depressant medication?

Answer 27

- monoamine oxidase inhibitors (MAOIs) - inhibits monoamine oxidase, enzyme deactivates dopamine, norepinephrine, and serotonin - have bad side effects: high blood pressure if taken with antihistamines or food s w amino acid tyramine

Question 28

what are the different types of antidepressants

Answer 28

- MAOIs - Tricyclics (blocks reabsorption of norepinephrine, serotonin, dopamine at synapses=increased availability, can be cardiotoxic) - Selective Serotonin reuptake inhibitors (SSRI ex fluoxetine) - Serotonin and norepinephrine reuptake inhibitors (SNRIs ex duloxetine) last two have less side effects

Question 29

treatment for BD

Answer 29

- pharmacotherapy - lithium first choice (reduction of excitatory (dopamine and glutamate) neurotransmission, and increasing of inhibitory (GABA) neurotransmission) - SSRIs and SNRIs can induce mania - anticonvulsant medications (carbamazepine, valproate) - interpersonal and social rhythm therapy (IPSRT)

Question 30

Recently, Zeb has lost his passion for sports. Invitations to play with his friends just don’t excite him. This loss of interest is an example of which symptom of a major depressive episode? anhedonia. flat affect. suicidal ideation. loss of appetite. hypersomnia

Answer 30

anhedonia

Question 31

Psychomotor ______refers to an increase in activity that is marked by restlessness and fidgeting, pacing, or tapping of the feet. agitation. enhancement. augmentation. frenzy. retardation

Answer 31

agitation

Question 32

How can you best distinguish between a manic episode and a hypomanic episode? By the duration and level of impairment.. By looking at whether or not the symptoms have an identifiable trigger or came “out of the blue.”. By the presence or absence of depressive symptoms.. By the age at which the person experiences symptoms.. By determining whether the symptoms are a side effect of a medication.

Answer 32

By the duration and level of impairment..

Question 33

Dr. Scarcliff is seeing a patient with symptoms of euphoria and grandiosity. What question should he ask to determine if the correct diagnosis is bipolar I or bipolar II disorder? Has this patient had the symptoms for more or less than two weeks?. Does there seem to be any recent history of a major depressive episode?. Is this patient experiencing a manic episode or a hypomanic episode?. Has this patient suffered from these symptoms in the past?. Is there any indication that this patient is currently taking recreational substances?

Answer 33

Is this patient experiencing a manic episode or a hypomanic episode?.

Question 34

The way in which a person infers the cause or meaning of behaviors or events around them is called their ______style. causational. attributional. personal-bias. ruminative. thinking.

Answer 34

attributional

Question 35

Karla takes antidepressants but has been advised that she should stay away from “anything that has tyramine” such as wine, soy sauce, and aged cheese. What kind of drugs does Karla take? a tricyclic antidepressant (TCA). neuroleptic mood stabilizer (NMS. a tetracyclic antidepressant (TTCA). a monoamine oxidase inhibitor (MAOI). a selective serotonin reuptake inhibitor (SSRI).

Answer 35

a monoamine oxidase inhibitor (MAOI)

Question 36

When someone with bipolar disorder is prescribed lithium, the expected changes include: - an increase of dopamine and glutamate and a decrease of GABA neurotransmitters.. - a decrease adrenaline and an increase in noradrenaline hormones.. - the release of both agonist and antagonist enzymes in synaptic clefts.. - a decrease of dopamine and glutamate and increase of GABA neurotransmitters. - an increase in adrenaline and a decrease in the noradrenaline hormones.

Answer 36

a decrease of dopamine and glutamate and increase of GABA neurotransmitters.

Question 37

what is needed in a mania diagnosis

Answer 37

- euphoria and 3 other symptoms - irritable mood and 4 other symptoms

Question 38

what hormone drops during depression and increases during mania?

Answer 38

norepinephrine (sns)

Question 39

what are monoamines examples and how are they relevant to depression

Answer 39

- dopamine, serotonin, and norepinephrine - Monoamine theory for depression: it is caused by depletion of these

Question 40

how do SSRI's work in relation to synapses and action potential

Answer 40

- it inhibits re-uptake of serotonin, serotonin stays in synapse

Question 41

why do you have to be careful with pharmaceutical treatments

Answer 41

- ppl can have comorbidity (two or more diseases at once)