Mood Disorders - Hill Flashcards Preview

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Flashcards in Mood Disorders - Hill Deck (22):
1

How to diagnose a major depressive episode

2 weeks -- 5+ of the following, including 1 of the first 2...
- Depressed mood for most of the day, almost every day
- Marked diminished interest/pleasure in anything
- Weight loss or weight gain
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or energy loss
- Worthlessness or excessive guilt
- Poor thinking or concentration
- Recurrent thoughts of death or suicide

SIG E CAPS (see first aid)

2

How to diagnose a manic episode

1+ week -- 3+ of the following, w/ mood disturbance and high energy...
- Distractability (low concentration)
- Irresponsibility (pleasure w/o consequences)
- Grandiosity (high self esteem)
- Flight of ideas (racing thoughts)
- Activity/agitation
- Sleep less
- Talkative or pressured speech

DIG FAST (see first aid)

3

Major depressive episodes and manic episodes are both ___ for the patient

Very disturbing/distressing/impairing

4

Hypomanic episode

Less severe manic episode, 4+ days, no major impairment in social or occupational functioning, no psychosis, no need for hospitalization

5

Major depressive disorder - how to diagnose

Treatment?

Major depressive episodes lasting 6-12 months WITHOUT any manic, hypomanic, or mixed episodes

CBT, SSRIs

6

Dysthymic disorder - how to diagnose

Depressed mood (milder than major depressive episode) for at least 2 years, where breaks in symptoms are no longer than 2 months. Never met criteria for manic episode, hypomanic episode, or mixed episode.

CHASE -- concentration loss, hopelessness, appetite loss, self-esteem loss, energy loss

7

Bipolar 1 disorder

1+ manic or mixed episode, with or without a hypomanic or depressive episode. Mood returns to normal between episodes.

8

Bipolar 2 disorder

1+ major depressive episode + 1+ hypomanic episode, WITHOUT any manic or mixed episodes

9

Treatment for bipolar disorders

Lithium
Valproic acid

10

Cyclothymic disorder



Treatment

Dysthymic disorder w/ intermittent REPEATED hypomanic and depressive (NOT major) periods. At least 2 years. No major depressive, manic, or mixed episodes

Lithium, Valproic acid; psychotherapy

11

What NOT to give to a bipolar or cyclothymic person? Why?

Antidepressants -- can precipitate manic symptoms

12

Symptoms of anxiety (psych and somatic)

Psych: Apprehension, worry, sense of doom/panic, hypervigilence, difficulty concentrating, derealization

Somatic: Sympathetic symptoms

13

Anxiety

Inappropriate fear/worry + physical manifestations that are incongruent with the magnitude of the perceived stressor

14

Panic disorder - define

(1) Recurrent panic attacks
(2) 1+ month of concern, worry, or behavioral changes about additional attacks

15

Panic attack

Under 25 minutes, peaking in 10 minutes, 4+ of the following...

PANICS - palpitations, paresthesias, abdominal distress, nausea, intense fears of dying or losing control, chest pain, chills, choking, sweating, shaking, SOB

16

Generalized anxiety disorder

Excessive anxiety and worry for at least 6 months, most of the time, about a variety of events or activities. Symptoms include...
- Restlessness or feeling on edge
- Easily fatigued
- Difficulty concentrating
- Irritable
- Muscle tension
- Sleep disturbance

17

OCD

Obsessions = persistent, recurrent thoughts and impulses that are intrusive. Patient attempts to ignore them.

Compulsions = Repetitive behaviors or mental acts that try to prevent or reduce the distress OR prevent a dreaded event

Spends AT LEAST 1 hour per day doing them

18

How is OCD different that OC personality disorder?

OCD - ego-dystonic, patient finds it stressful

OC personality - ego-syntonic, more about order, perfectionism, values/beliefs

19

Main obsessions in OCD

Contamination, safety/harm, unwanted acts of aggression, unacceptable sexual/religious thought, symmetry/exactness

20

Main compulsions in OCD

Cleaning, checking/ordering/arranging, counting, repeating routine activities, mental rituals

21

PTSD - qualifications

What do they tend to do?

(1) Person experienced/witnessed the event
(2) Person's response involved intense fear, helplessness, or horror

1+ month of...
- Persistently re-living it
- Persistently avoiding stimuli related to it
- Persistent hyper-vigilance and increased arousal

22

PTSD - treatment

SSRIs, CBT