Mood Disorders and Psychotherapy Flashcards
(29 cards)
Presentation of bereavement
2 months
crying spells, sleep problems, trouble concentrating at work
does NOT include gross disorganization or suicidality
depression vs normal grief
normal grief < 2 months, suicidal thoughts are rare, mild cognitive disorder 2months, mild cog disorder >1yr treated with antidepressants, mood stabilizers, ECT
medical causes of manic episode
metabolic (hyperthyroid)
neuro (temporal lobe seizure, MS)
neoplasms
HIV infection
medication or substance induced mania
antidepressants sympathomimetics dopamine corticosteroids L dopa bronchodilators
rapid cycling definition
4+ mood episodes in 1 year (major depressive, mixed, manic, etc)
bipolar I age of onset
before 30
what has highest genetic link of all major psych disorders?
bipolar I
40-70% monozygotic twins, 5-25% dizygotic
first degree relatives 8-18x more likely to develop BP1
how long does untreated mania last?
3 months
what % of individuals after 1 manic episode will have another within 5 years?
90%
which has worse px? MDD or bipolar disorder?
BP
25-50% attempt suicide, 15% die by suicide. higher rates than MDD :(
what, if taken between episodes, decreases risk of relapse of BP?
lithium ppx
ECT in BP vs MDD?
works well in treatment of manic episodes
requires more treatments than for depression
especially effective for refractory or life threatening acute mania or depression
bipolar II more common in which gender?
women
dysthymic disorder
chronic mild depression w/o discrete episodes
rarely need hospitalization
depressed mood for majority of time most days for at least 2 years (in children or adolescents for at least 1 year)
not w/o sx for > 2 months at a time
no major depressive episode
cyclothymic disorder
2 years of hypomanic and depressive sx
never sx free for >2 months during those 2 years
may coexist with borderline personality disorder
onset age 15-25
M=F
seasonal affective disorder
at least 2 consecutive years of two major depressive episodes during the same season
postpartum major depression onset
within 4 weeks of delivery
adjustment disorder
sx begin within 3 months after event and end within 6 months after a stressful life event
adjustment disorder more common in which gender
2x as common in women
age of onset for adjustment disorder
adolescents
treatment of adjustment disorder
supportive psychotherapy is most effective
also group therapy or pharma if sx (insomnia, anxiety, depression)
Systemic desensitization
Exposure to increasing doses of an anxiety provoking stimulus
Negative reinforcement
Encouraging a behavior by removing aversive stimulus. Not punishment
Flooding and implosion
Confronted by real (flooding) or imagined (implosion) assets rovoiing stimulus and not allowed to withdraw from it until pt calm and in control
Used commonly for phobias
