Psychiatry: Depression

Question 1

What Sleep changes are seen in Major Depressive Disorder (MDD)

Answer 1

Insomnia

Hypersomnia

Decreased REM Latency

Question 2

What Hormone is elevated in depression

Answer 2

Cortisol

Question 3

What is another name for Depression-related cognitive impairment

Answer 3

Pseudodementia

Question 4

Describe Depression-Related Cognitive Impairment

Answer 4

Difficulty thinking/concentrating and/or making decisions

Rapid onset/progression

High suicide risk

Question 5

How do you diagnose Major Depressive Disorder (MDD)

Answer 5

At least 5 of 9 features of SIG E CAPS for 2 weeks

Question 6

What does the first S in SIG E CAPS stand for

Answer 6

Sleep Disturbance

Question 7

What does the I in SIG E CAPS stand for

Answer 7

Lack of Interest

Question 8

What does the G in SIG E CAPS stand for

Answer 8

Guilt

Question 9

What does the E in SIG E CAPS stand for

Answer 9

Energy loss and fatigue

Question 10

What does the C in SIG E CAPS stand for

Answer 10

Concentration problems

Question 11

What does the A in SIG E CAPS stand for

Answer 11

Appetite changes/weight changes

Question 12

What does the P in SIG E CAPS stand for

Answer 12

Psychomotor symptoms

Question 13

What does the second S in SIG E CAPS stand for

Answer 13

Suicidal Ideation

Question 14

How do psychotic features present in MDD

Answer 14

always with mood symptoms
-if no mood symptoms with psychosis it is Schizoaffective

Question 15

What is Persistent Depressive Disorder (Dysthmic Disorder)

Answer 15

Low grade depression lasting at least 2 years

never symptom free for more than 2 months

Question 16

What do you need to diagnose Persistent Depressive Disorder (dysthmic disorder)

Answer 16

at least 2 of the following
-Hopelessness
-Decreased appetite
-Sleep problems
-low energy
-low concentration
-low self esteem

Question 17

What are the subtypes of MDD

Answer 17

Atypical
Melancholic
Catatonic
Psychotic
Mixed Features
Anxious
Seasonal

Question 18

What is unique about Atypical Depression

Answer 18

Mood reactivity
-able to react to pleasurable stimuli

Question 19

How does Atypical Depression Present

Answer 19

Mood reactivity

Eating/sleeping all the time

Heavy or Leaden feelings in limbs

Sensitive to Rejection

Question 20

How is Atypical Depression usually Treated

Answer 20

SSRI

Question 21

What is seasonal depression

Answer 21

Worsening depression in fall and winter

Question 22

How is Season depression treated

Answer 22

Phototherapy
-in addition to others

Question 23

What are the treatment options for MDD

Answer 23

Psychotherapy

Antidepressants

ECT

Hospitalize if high suicide risk

Question 24

How long do you need to use antidepressants to access efficacy

Answer 24

4 to 6 weeks

Question 25

How does ECT work

Answer 25

General Anesthesia Electricity administered Serizures

Question 26

Can ECT be used in pregnancy

Answer 26

Yes

Question 27

What is ECT reserved for

Answer 27

Severe Depression -persistent suicidal intent -Depression with psychosis -Catatonia -Food refusal

Question 28

What is a complication of ECT

Answer 28

Amnesia

Question 29

What is Retrograde Amnesia

Answer 29

Memories before procedure are lost

Question 30

What is Anterograde Amnesia

Answer 30

Memories for a few weeks after procedure are lost

Question 31

What medication is held before ECT

Answer 31

Lithium -can worsen memory impairment

Question 32

What Medication is avoided in patients undergoing ECT

Answer 32

Benzodiazepines -anticonvulsant drugs

Question 33

What are the Risk Factors of Suicide

Answer 33

SAD PERSON

Question 34

What does the first S in SAD PERSON stand for

Answer 34

Sex (Male)

Question 35

What does the A in SAD PERSON stand for

Answer 35

Age -young adults -elderly

Question 36

What does the D in SAD PERSON stand for

Answer 36

Depression

Question 37

What does the P in SAD PERSON stand for

Answer 37

Prior attempt

Question 38

What does the E in SAD PERSON stand for

Answer 38

Ethanol or drug use

Question 39

What does the R in SAD PERSON stand for

Answer 39

Rational thinking loss -psychosis

Question 40

What does the second S in SAD PERSON stand for

Answer 40

Sickness -medical illness

Question 41

What does the O in SAD PERSON stand for

Answer 41

Organized plan

Question 42

What does the N in SAD PERSON stand for

Answer 42

No spouse -lack of social support

Question 43

What score on the SAD PERSON scale is considered low risk of suicde

Answer 43

0-4

Question 44

What score on the SAD PERSON scale is considered Medium Risk

Answer 44

5-6

Question 45

What score on the SAD PERSON scale is considered High risk

Answer 45

7-10

Question 46

How to assess suicide risk

Answer 46

Ideation Plan Intent High risk if all 3 are present

Question 47

What must be present to Involuntarily hospitalize a suicidal patient

Answer 47

Imminent risk of harm

Question 48

What is Catatonia

Answer 48

Behavioral syndrome with an inability to move normally

Question 49

What conditions commonly have Catatonia

Answer 49

Depression Bipolar Schizophrenia

Question 50

What are the treatment options for Catatonia

Answer 50

Benzodiazepines ECT

Question 51

What is the first line treatment for Catatonia

Answer 51

Benzodiazepines

Question 52

What drug class is avoided in Catatonia

Answer 52

Antipsychotics

Question 53

What is stupor or Mutism in Catatonia

Answer 53

Decreased alertness to speech

Question 54

What is Negativism in Catatonia

Answer 54

resistant to instructions

Question 55

What is Catalepsy in catatonia

Answer 55

Remain in fixed position

Question 56

What is Posturing iN Catatonia

Answer 56

Resistant to movement

Question 57

What is Echolalia in Catatonia

Answer 57

Meaningless repetition of another person's words

Question 58

What is Echopraxia in Catatonia

Answer 58

Meaningless imitation of movements of others

Question 59

How long does Typical Acute Grief last

Answer 59

Resolves within 6 months

Question 60

What is complex Grief

Answer 60

Lasting >6 months interferes with functioning