MOOD DISORDERS AND SUICIDE MANAGEMENT

Question 1

Which disorder is associated with low moods without abnormally high periods

Answer 1

major depressive disorder, persistent depressive disorder, prenenstral dysphoric disorder, disruotive mood dyregulation disorder

Question 2

MDD / unipolar depression ethiology

Answer 2

at least ine major depressive episode wiithout a history of mania or hypomania

Question 3

MDE diagnosis

Answer 3

occurs for atleast 2 weeks and there is 5 or more one of which must be depressed mood or anhedonia.

others:
(3) Change in appetite/significant weight change
(4) Insomnia/hypersomnia
(5) Loss of energy
(6) PPsychomotor changes
(7) Feeling guilty/worthless
(8) Decreased concentration
(9) Thoughts of death/suicidal ideation

Question 4

MDD with melancholic features

Answer 4

• Severe anhedonia (Loss of pleasure in all, or almost all, activities)
• Lack of mood reactivity (does not feel much better, even temporarily, when
  something good happens)
• Profound despondency, despair
• Depression that is regularly worst in the morning
• Early-morning awakening (at least 2 hours before usual wakening)
• Significant anorexia or weight loss
• Excessive or inappropriate guilt

Question 5

MDD with atypical features

Answer 5

Mood reactivity (i.e., Mood brightens in response to
actual or potential positive events).
* Significant weight gain or increase in appetite
* Hypersomnia
* Leaden paralysis (i.e., heavy, leaden feelings in arms
and legs)

Question 6

MDD with psychotic features

Answer 6

Delusions or hallucinations are present at anytime in the
episode. Can be with mood-congruent features or mood-incongruent features

Question 7

MDD with mood-congruent psychotic features

Answer 7

During depressive
episodes, the content of all delusions and hallucinations is
consistent with the typical theme of depression.
SAD RELATED HALLUSIONS

Question 8

with mood incongruent physchotic features

Answer 8

During depressive
episodes, the content of all delusions and hallucinations is NOT
consistent with the typical theme of depression.
POSITIVE HALLUCINATIONS

Question 9

MDD with catatonia

Answer 9

Used for depressive episodes characterized by
psychomotor symptoms such as:
― Mutism (no, or very little, verbal response)
― Immobility
― Waxy flexibility (slight, even resistance to positioning
by the examiner)
― Stereotypies (repetitive, abnormally frequent, non
goal directed movements)
― Other odd posturing

LIKE A LIVING CORPSE

Question 10

MDD WITH PERIPARTUM ONSET

Answer 10

Mood develop during pregnancy or 4 weeks post partum

Question 11

MDD with seasonal pattern

Answer 11

consist relationship between time of the year and mood episodes

Question 12

persistent depressive disorder

Answer 12

Chronic depressed mood for >2 years
➢ The depressed mood can be in the form of:
* A long-lasting MDE
or
* Dysthymia: Chronic depressed mood plus ≥2 of the following symptoms:
▪ Poor appetite or overeating
▪ Insomnia/hypersomnia
▪ Low energy
▪ Low self-esteem
▪ Trouble concentrating or making decisions
▪ Feelings of hopelessness

Question 13

PDD with persistent MDE

Answer 13

Depression is characterized by a prolonged MDE

Question 14

PDD with pure dysthymic syndrome

Answer 14

Depression is characterized by prolonged dysthymia (see previous slide) but
no MDE occurs

Question 15

PDD with intermittent MDE

Answer 15

Depression is characterized by dysthymic periods and MDEs

Question 16

Premenstraual dysphoric disorder

Answer 16

― Mood lability, irritability, dysphoria, and anxiety symptoms
― Anhedonia, problems concentrating, lethargy, appetite and sleep
change, physical symptoms (e.g., breast tenderness, weight gain)

Question 17

PMDD REUQIREMENTS

Answer 17

present before mensies, improve after, minizes post mensises

Question 18

DISRUPTIVE MOOD DYSREGULATION DISORDER

Answer 18

Severe temper outbursts at least 3 times/week
* Sad, irritable or angry mood almost every day
* Reaction is disproportionate to situation
* Symptoms are present in multiple settings

Question 19

DMDD TIMELINE

Answer 19

Child must be at least 6 years old
* Symptoms must begin before age 10
* NOT DIAGNOSED AFTER AGE 18

Question 20

DISORDERS ASSOICATED WITH HIGH MOODS

Answer 20

Bipolar I disorder
* Bipolar II disorder
* Cyclothymic disorder

Question 21

BIPOLAR 1 / MANIC DEPRESSIONN

Answer 21

Must have one manic episode

Question 22

manic episodes symptoms

Answer 22

Abnormally elevated mood (or irritability) AND increased activity or
energy PLUS at least 3 additional symptoms:
‒ Inflated self-esteem/grandiosity
‒ Decreased need for sleep
‒ Pressured speech
‒ Flight of ideas (and/or racing thoughts)
‒ Distractibility
‒ Increased goal-directed activity or psychomotor agitation (purposeless
activity)
‒ Excessive involvement in “risky” activities

Question 23

BP1 requiements

Answer 23

hospitalization, funcational imparement

Question 24

Bipolar 2

Answer 24

one major depressive episode wotj one hypomania episode

Question 25

hypomania

Answer 25

do NOT have congitive functioning, no psychosis and do not require hospitalization

Question 26

CYCLOTHYIC DISORDER

Answer 26

MORE THAN 2 YEARD MOVE BETWEEN HYPOMANIA AND DEPRESSIVE SYMPTOMS YOU DO NOT HAVE MANIA OR MDE

Question 27

questions to ask someones who is thinking about suicide

Answer 27

‒ Do you ever feel that life isn’t worth living? ‒ Do you feel that you might be better off dead? ‒ Have you ever thought about taking your own life?

Question 28

how to evaluate the severity of the suicide intent

Answer 28

Suicide plan ‒ Presence, specificity, and lethality of plan ‒ Availability of means * Preparations for death ‒ Have you taken steps towards taking your own life? ▪ Stockpiling pills, acquiring gun ▪ Making a will, getting affairs in order, giving possessions away, suicide note, saying goodbyes * Prior attempts (self and family)