Flashcards in Mood Disorders Deck (46):
'Source of truth'
Mood vs. affect
Mood: subjective (larger order experience -climate)
Affect: objective (moment by moment feelings - weather)
2+ weeks of: at least one of:
-Anhedonia (signature symptom
Depressed mood 3 description:
2 types of depression:
1. Neuro-vegetative (biological)
2. Cognitive affective symptoms
-loss of self esteem and worthlessness
What more likely to have suicidal ideation?
-Phase of recovery - so apathetic when depressed, but when treating can increase motivation to complete suicide
What is a criteria of severe depression?
Psychotic symptoms in severe depression: 6 kinds of delusions:
Delusions: guilt, persecution, poverty, hyper contrasts, catastrophe, nihilism
Why psychotic depression important to Dx or know?
Treatment is different:
How long will you be depressed with moderate depression if untreated?
Postpartum depression, how many and when?
10% women during
Depression in older adults factors?
Irritable more than sad
What neurological conditions associated with depression?
Stroke: frontal lobe
What meds can trigger depression?
Mono amine depletion
GABA-Ergic drugs: benzos, alcohol
Psychiatric co-morbidities include these 3 and need parallel treatment
What isn't depression:
-demoralization (loss of competence but still has hedonics)
-delirium (hypo active)
Genes and depression heritability?
Depression only emotion?
-Brain structure changes
-Functional neurotransmitter changes
Interpersonal factors in childhood depression
1. Parental loss + poor parenting
2. chronic depressed mother
3. Cumulative disadvantages
4. Childhood sexual abuse
what is Protective for depression in childhood?
Interpersonal factors in adult that is protective?
Confiding in others
Environmental factors for depression?
What environmental factors protective for depression?
How to treat mild/mod depression?
-CBT (introduce alterity)
-lifestyle: sleep, diet, less alcohol)
What kinds of pharmacological treatments for depression?
**How long to treat pharma for depression for?
6-12 weeks full dose
Maintain for 6-12 months post recovery in 1st episode.
If someone is better from 1st episode depression with pharma, how to do treat?
Treat for 6-12 months after at treatment dose.
ECT useful for?
Bipolar or mania
Poor oral intake
Risk factors for bipolar:
Organic CNS disease
Season (spring/summer: mania)
Circadian rhythm disruption
Symptoms of mania? 1a and 1b?
1a: elevated mood
1b: irritable mood
Subjective less need for sleep
Flight of ideas: thoughts moving too fast but still associated connections
Increased sexual activity
What is bipolar I in spectrum disorder?
At least 1 episode of mania. +/- depressive
What is bipolar II in spectrum disorder?
Depressive episode + hypo-manic episode
What is cyclothymia?
Dysphoric + hypo mania
Ppl who are not psychotic when manic are what when depressed
Mania Dx conventions?
Hypo mania: >2-4 days
Rapid cycling: >4episodes per year
Mixed state 1-2 weeks
Clinical pattern of bipolar:
Starts in Adolescence: brief, mild
-median duration 4.5-7 months
-2x depressive episodes of unipolar pts
Mania or depression
3x longer in depression than manic
Bipolar vs. depression, who gets more episodes of depression
Bipolar: 2x more likely to get depressive episode.
DDx for bipolar?
2. ORganic: orbito-frontal
3. Drug induced psychosis: cocaine, cannabis etc.
How to treat bipolar?
-SGAs-second Gen, anti
If suicidal bipolar, how to treat?
Primary indication for clozapine?
Treatment resistant schizophrenia
Chronic low mood
Slightly happier than normal all the time.