Mood Disorders and Suicide Flashcards
(55 cards)
when is the typical onset of Major depressive disorder
around 32 years old
when is the typical onset of bipolar disorder
around 25 years old
when is the typical onset of Dysthymia
around 30 years old
what are the biologic etiologies of Mood disorders
Neurotransmitters, Genetics, Hormonal
What are psychosocial etiologies of mood disorders
stressful life events, trauma or ACEs can trigger
can also be ‘familial’
Learned helplessness
Pessimism
Insult with genetic susceptibility
what primary areas of the brain are involved in depression
Amygdala (can enlarge)
Hippocampus (may be smaller)
what are other names for Major depression
unipolar depression or clinical depression
what is the presentation of MD
patient may be able to tell you they feel depressed
may present with variety of ‘negative symptoms’- SIG E CAPS
how is MD screened?
PHQ-9 (Patient health questionnaire-9)
or
MDI (major depression inventory)
a patient has a PHQ-9 of 12, what level of MD is this associated with
moderate depression - likely does not require treatment
a patient has a PHQ-9 of 25, what level of MD is this associated with
Severe MD and requires treatment
what is the scoring system for MDI
<20: no depression
20-24= mild depression
25-29 = moderate depression
30+ = severe depression
what is the prognosis of Major depressive episode
depressive episodes may last months to years
most abate within 6 months
most resolve spontaneously
20% will develop chronic depression
What diseases are associated with MD
hypothyroidism
Anemia
chronic obstructive airways disease
chronic pain
chronic kidney disease
cancer
cardiovascular diseases
neurologic disease (Parkinsons, stroke, dementia)
what medications are associated with MD
hormonal agents
antivirals
immunologic agents
antimigraine
retinoic acid derivatives
opioids
beta blockers
what is the first line treatment of MD
SSRI’s
should try for atleast 4-8 weeks before changing agents or increasing dose
continue for 4-6 months once symptoms resolve
what is an adjunctive treatment of MD
cognitive behavioral therapy (CBT)
what are side effects of SSRI
Sexual dysfunction, headache, GI upset, increased anxiety/ SI (early), insomnia
Metabolized by liver CYP450 (drug-drug interactions)
not considered safe in pregnancies
Risk for serotonin syndrome
what is a risk of MD treatment
Discontinuation syndrome
- flu-like symptoms, insomnia, Nausea, headache, irritability, vivid dreams
- few days after stopping and lasts about 2 weeks
- slow taper off to avoid this
what is the presentation of Serotonin syndrome
AMS, fever, abnormal vitals, agitation, diaphoresis, hyerreflexia, etc
how do you treat serotonin syndrome
stop the med!
can use benzos and typically resolves in 24 hours
what is another name for Persistent Depressive Disorder
Dysthymia
what is Dysthymia
chronic, persistent low mood (not episodic)
lows aren’t as low as MDD
what are the DSM-5 criteria for Dysthymia
mostly same symptoms as MDD
Only requires 2 of the 6 symptoms but must be present for 2 or more years and must be present pretty much continuously
