Flashcards in Mood Disorders Deck (22):
Sustained, distressing mood state which alters functioning and causes clinically significant impairment
2 weeks or more of depressed mood and/or loss of interest with additional symptoms like sleep problems, appetite changes, fatigue, thoughts of death/suicide
Major depressive episode
Depressed mood for most of the time for at least 2 years with additional symptoms like sleep problems, appetite changes, fatigue, hopelessness, low self esteem
Distinct period of at least one week of a persistently elevated, expansive, or irritable mood with three or more additional symptoms like: decreased need for sleep, inflated self esteem, pressured speech, flight of ideas
Sufficiently severe to cause marked impairment, including psychotic symptoms
Distinct period of at least 4 consecutive days of a persistently elevated, expansive or irritable mood and abnormally and persistently increased activity with three or more additional symptoms like inflated self esteem, decreased need for sleep, pressured speech, racing thoughts/flight of ideas, increased goal directed activity
Not severe enough to cause marked impairment in functioning or necessitate hospitalization
- Diagnosis only requires one episode of mania
- Most patients have major depression and manic episodes
- Hallucinations and delusions possible
Bipolar I Disorder
What does rapid cycling involve?
More than 4 episodes of a mood disturbance in 12 months
Men or women: More likely to have bipolar I disorder?
Age of onset of Bipolar I disorder?
What can precipitate episodes of bipolar I disorder?
Sleep wake cycle disruptions (travel across time zones, call, infants)
Disorders that have comorbidity with Bipolar I
Anxiety disorders, any substance use, conduct disorder (childhood), adult antisocial behavior
Which relatives of patients have increased risk of all mood disorders?
First degree relatives
Which loci are identified as linked to bipolar disorder?
13q32 and 22q11-13
- Must have a history of both a hypomanic episode and a major depressive episode
- Rapid cycling is more common
Bipolar II Disorder
Men or women: More likely to have bipolar II disorder?
Patients are more likely to be fully functional between episodes: Bipolar I or II?
Greater than 2 years of both hypomanic episodes and dysthymic episodes
Criteria for both a manic episode and major depressive episode are present for one week
Which neurotransmitter is involved in mania?
Dopamine antagonists are effective in treatment of mania
Which endocrine axes can be involved in bipolar spectrum disorders?
- Thyroid axis (hyperthryoidism)
- Male hypothalamic pituitary gonadal axis (exogenous testosterones can cause 'roid rage and manic symptoms)
Illnesses that cause manic or hypomanic symptoms:
- Neurologic disorders
- Infections - neurosyphilis
- Neoplasm - tumors
- Endocrine disorders
- Inflammatory diseases