Mood Disorders

Question 1

Sustained, distressing mood state which alters functioning and causes clinically significant impairment

Answer 1

Mood disorder

Question 2

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

Answer 2

Major depressive episode

Question 3

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

Answer 3

Dysthymia

Question 4

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

Answer 4

Manic episode

Question 5

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

Answer 5

Hypomanic episode

Question 6

• Diagnosis only requires one episode of mania
• Most patients have major depression and manic episodes
• Hallucinations and delusions possible

Answer 6

Bipolar I Disorder

Question 7

What does rapid cycling involve?

Answer 7

More than 4 episodes of a mood disturbance in 12 months

Question 8

Men or women: More likely to have bipolar I disorder?

Answer 8

Equal prevalence

Question 9

Age of onset of Bipolar I disorder?

Answer 9

15-34

Question 10

What can precipitate episodes of bipolar I disorder?

Answer 10

Sleep wake cycle disruptions (travel across time zones, call, infants)

Psychosocial stress

Question 11

Disorders that have comorbidity with Bipolar I

Answer 11

Anxiety disorders, any substance use, conduct disorder (childhood), adult antisocial behavior

Question 12

Which relatives of patients have increased risk of all mood disorders?

Answer 12

First degree relatives

Question 13

Which loci are identified as linked to bipolar disorder?

Answer 13

13q32 and 22q11-13

Question 14

• Must have a history of both a hypomanic episode and a major depressive episode
• Rapid cycling is more common

Answer 14

Bipolar II Disorder

Question 15

Men or women: More likely to have bipolar II disorder?

Answer 15

Women (maybe)

Question 16

Patients are more likely to be fully functional between episodes: Bipolar I or II?

Answer 16

bipolar II

Question 17

Greater than 2 years of both hypomanic episodes and dysthymic episodes

Answer 17

Cyclothymia

Question 18

Criteria for both a manic episode and major depressive episode are present for one week

Answer 18

Mixed episode

Question 19

Which neurotransmitter is involved in mania?

Answer 19

Dopamine

Dopamine antagonists are effective in treatment of mania

Question 20

Which endocrine axes can be involved in bipolar spectrum disorders?

Answer 20

• Thyroid axis (hyperthryoidism)

- Male hypothalamic pituitary gonadal axis (exogenous testosterones can cause ‘roid rage and manic symptoms)

Question 21

Illnesses that cause manic or hypomanic symptoms:

Answer 21

• Neurologic disorders
• Infections - neurosyphilis
• Neoplasm - tumors
• Endocrine disorders
• Inflammatory diseases

Question 22

Substances and meds that cause manic or hypomanic systems:

Answer 22

• Psychostimulants (amphetamines, methylphenidate)
• CNS therapeutic drugs
• Systemic meds (anabolic steroids, corticosteroids, isoniazid, theophylline)