Mood Disorders Flashcards Preview

Jason's MD3 Psychiatry Rot > Mood Disorders > Flashcards

Flashcards in Mood Disorders Deck (46):
1

Feelings?

Compelling
'Source of truth'
binding

2

Mood vs. affect

Mood: subjective (larger order experience -climate)

Affect: objective (moment by moment feelings - weather)

3

Depression Dx?

2+ weeks of: at least one of:

-Depressed mood
-Anhedonia (signature symptom

4

Depressed mood 3 description:

Quality
Reactivity
Diurnal pattern

5

2 types of depression:

1. Neuro-vegetative (biological)
-psychomotor retardation

2. Cognitive affective symptoms
-guilt
-loss of self esteem and worthlessness

6

What more likely to have suicidal ideation?

-Severe depression
-Insomnia
-Worthlessness
-Guilt
-Phase of recovery - so apathetic when depressed, but when treating can increase motivation to complete suicide

7

What is a criteria of severe depression?

Psychotic symptoms

8

Psychotic symptoms in severe depression: 6 kinds of delusions:

Delusions: guilt, persecution, poverty, hyper contrasts, catastrophe, nihilism

9

Why psychotic depression important to Dx or know?

Treatment is different:

Antipsychotic
Antidepressants
ECT

10

How long will you be depressed with moderate depression if untreated?

9 months

11

Postpartum depression, how many and when?

10% women during
4-12 weeks
50% recurrence

12

Depression in older adults factors?

Loss
Organic
Somatic complains
Irritable more than sad

13

What neurological conditions associated with depression?

Parkinson's
Stroke: frontal lobe

Orbits-frontal dementia

14

What meds can trigger depression?

Corticosteroids
Mono amine depletion
GABA-Ergic drugs: benzos, alcohol
Chemo
OC (rare)
Interferon

15

Psychiatric co-morbidities include these 3 and need parallel treatment

Alcohol/drug abuse
Anxiety
Personality

16

What isn't depression:

-Grief
-anxiety
-demoralization (loss of competence but still has hedonics)
-adjustment disorder
-delirium (hypo active)
-normal sadness

17

Genes and depression heritability?

40-70%

18

Depression only emotion?

-Brain structure changes
-Functional neurotransmitter changes

19

Interpersonal factors in childhood depression

1. Parental loss + poor parenting
2. chronic depressed mother
3. Cumulative disadvantages
4. Childhood sexual abuse

20

what is Protective for depression in childhood?

Good relationship
Higher IQ

21

Interpersonal factors in adult that is protective?

Married
Confiding in others

22

Environmental factors for depression?

Precipitating
Loss
Humiliation
Entrapment
Danger

23

What environmental factors protective for depression?

Employment/Financial, status
Fresh starts
social capital

24

How to treat mild/mod depression?

Psycho-social
-problem solving
-CBT (introduce alterity)
-exercise
-confiding other
-couple therapy
-lifestyle: sleep, diet, less alcohol)

25

What kinds of pharmacological treatments for depression?

SSRIs
SNRIs
Mirtazipine
TCAs
Lithium
T3
SGAs

26

**How long to treat pharma for depression for?

6-12 weeks full dose
Maintain for 6-12 months post recovery in 1st episode.

27

If someone is better from 1st episode depression with pharma, how to do treat?

Treat for 6-12 months after at treatment dose.

28

ECT useful for?

Melancholic
Psychotic
Puerperal
Bipolar or mania
Prominent suicidality
Poor oral intake

29

Risk factors for bipolar:

Genetic
Head injury
Organic CNS disease
AIDS
Season (spring/summer: mania)
Circadian rhythm disruption
Life events

30

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
Talkativeness
Distractibility
Risky behavioural
Increased sexual activity

31

What is bipolar I in spectrum disorder?

At least 1 episode of mania. +/- depressive

32

What is bipolar II in spectrum disorder?

Depressive episode + hypo-manic episode

33

What is cyclothymia?

Dysphoric + hypo mania

34

Ppl who are not psychotic when manic are what when depressed

Not psychotic

35

Mania Dx conventions?

Mania: >1week
Hypo mania: >2-4 days
Rapid cycling: >4episodes per year
Mixed state 1-2 weeks

36

Clinical pattern of bipolar:

Starts in Adolescence: brief, mild
-median duration 4.5-7 months
-kindling
-2x depressive episodes of unipolar pts

37

Mania or depression

3x longer in depression than manic

38

Bipolar vs. depression, who gets more episodes of depression

Bipolar: 2x more likely to get depressive episode.

39

DDx for bipolar?

1. Schizophrenia
2. ORganic: orbito-frontal
3. Drug induced psychosis: cocaine, cannabis etc.

40

How to treat bipolar?

-Mood stabilizers
-lithium
-SGAs-second Gen, anti
-antidepressants
-ECT

41

If suicidal bipolar, how to treat?

Clozapine and
Lithium

42

Primary indication for clozapine?

Treatment resistant schizophrenia

43

Dysthymia is?

Chronic low mood

44

Cyclothymia?

Mild mania
Mild depression

45

Hyperthymia?

Slightly happier than normal all the time.

46

What is an emotion

a Complex action:
facial expression
Postural
Visceral
Thoughts