Putinta- Affective Disorders Flashcards by Madeline Wing

___ out of 9 symptoms for 2 weeks or more for MDD

5/9

How well did you know this?

Not at all

Perfectly

symptoms to diagnose MDD

SIGECAPS
(sleep, interest, guilt, energy, concentration, appetite, psychomotor, suicide)

How well did you know this?

Not at all

Perfectly

to be MDD (major depressive disorder)

How well did you know this?

Not at all

Perfectly

“functional depression” most common type

atypical

How well did you know this?

Not at all

Perfectly

Retained emotional reactivity!!! (actually enjoy hanging out with their friends)
Leaden paralysis (feel heavy all the time)

Atypical depression

How well did you know this?

Not at all

Perfectly

typical depression from the 40s-50s
reduced appetite, weight loss, insomnia, guilt, poor memory, loss of emotional reactivity (responds well to ECT)

melancholic depression

How well did you know this?

Not at all

Perfectly

Alzheimer’s vs depressive pseudodementia

lack of effort w/ depressive

How well did you know this?

Not at all

Perfectly

1 thing contributing to the amount of years of quality of life lost to disability

major depressive disorder

How well did you know this?

Not at all

Perfectly

gold standard for MDD treatment

cognitive behavioral therapy

How well did you know this?

Not at all

Perfectly

first line medicine for MDD

SSRIs (sertraline, fluoxetine, paroxetine)

How well did you know this?

Not at all

Perfectly

what is effective in MDD treatment, but w/ risk of increasing BP due to NE

SNRIs

How well did you know this?

Not at all

Perfectly

not first line but good meds but require serum levels b/c have very narrow therapeutic windows

TCAs (Amitriptyline)

How well did you know this?

Not at all

Perfectly

rule of 2’s

persistent depressive disorder

How well did you know this?

Not at all

Perfectly

always depressed but not as depressed as someone with MDD

persistent depressive disorder

How well did you know this?

Not at all

Perfectly

_____ and ____ are criteria for MDD but NOT for persistent depressive disorder

anhedonia (loss of interest in activities)
suicidal thoughts

How well did you know this?

Not at all

Perfectly

Without extreme symptoms of MDD (suicidality and anhedonia)
The “rule of twos” – At least TWO symptoms of depression for TWO years with no less than TWO months consecutively without symptoms
Without psychosis

persistent depressive disorder

How well did you know this?

Not at all

Perfectly

this is a cyclical pattern and have sx’s of bloating and breast tenderness or weight gain, irritable, depressed, anxious, pick fights with partner, increased pain sensations during the week leading up to menstrual cycle
absence of suicidal ideation
(5 sx’s week prior to menses)

premenstrual dysphoric disorder

How well did you know this?

Not at all

Perfectly

A period of elevated, expansive, or irritable mood lasting at least ONE week

manic episode

How well did you know this?

Not at all

Perfectly

DIGFAST sx’s of manic episode (need 3/7 to diagnose)

distractibility
increased goal-directed activity (that doesnt make sense with their daily life)
grandiosity
flight of ideas
agitation
sleep (decreased need)
talkativeness

How well did you know this?

Not at all

Perfectly

to help diagnose manic episode

How well did you know this?

Not at all

Perfectly

psychotic symptoms
single episode of mania defines illness, may have a major depressive episode, but not required

bipolar 1 disorder

How well did you know this?

Not at all

Perfectly

very highly heritable disorders (2)

bipolar 1 disorder
schizophrenia

How well did you know this?

Not at all

Perfectly

pt has inflated self-esteem (grandiose), decreased need for sleep, but will sleep for 2-3 hrs a night, talkative but not pressured, more appropriate goal directed activity (staying up all night cleaning the room or studying), may spend more money than they need to, but they aren’t putting themselves in bankruptcy like in bipolar 1

hypomanic episode

How well did you know this?

Not at all

Perfectly

A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day
no psychosis

hypomanic episode

How well did you know this?

Not at all

Perfectly

The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization

hypomanic episode

being more productive than normal (definite change from baseline, but usually positive)

hypomania

Criteria have been met for at least one hypomanic and at least one major depressive episode

bipolar 2 disorder

Major depressive episode is REQUIRED in bipolar ___ disorder, but is not required in bipolar ____disorder

required in bipolar 2, but not in bipolar 1

hyperthyroidism malignancy affecting R orbital frontal cortex levothyroxine steroids stimulants opiates

DDx of bipolar disorder

2 or 3 sxs of depression instead of 5 for MDD 2 or 3 sxs of hypomania instead of 4

cyclothymic disorder

For at least a two year period, there have been episodes of hypomanic and depressive experiences which do not meet the full DSM-5 diagnostic criteria for hypomania or major depressive disorder

cyclothymic disorder

Same rule of 2’s – Two years of symptoms, at least Two symptoms of either hypomania or depression for more than half the time, no more than TWO months of absence of symptoms Never associated with psychosis 2-3 sxs of depression 2-3 sx's of hypomania

cyclothymic disorder

to treat bipolar disorder

mood stabilizers (valproate, lithium)

top 5 risk factors for suicide

hx of previous attempt older adults substance abuse violent behavior male

caucasian, native americans chronic illness healthcare professionals

risk factors for suicide

The physician’s good clinical judgment is the most important variable in identify the patient at risk for _____

suicide

Psychiatric diagnosis with highest suicide rate is _____

anorexia nervosa

if patient is suicidal, what to recommend

hospitalization

Big stressful life event that happens and it temporarily disrupts your normal functioning (have sx's w/in 3 months of stressor that lasts no longer than 6 months)

Adjustment disorder

how to treat adjustment disorder if you decide to

cognitive behavioral therapy

Characterized by physiologic and psychological symptoms of fear without external cause or threat. sx's persistent (often 6 months) interferes w/ functioning and/or cause distress

Anxiety disorders

time frame for depression in adults vs children diagnosis

2 yrs for adults 1 yr for children

time frame for anxiety in adults vs children diagnosis

6 months for adults 3 months for children

hypothesis of the cause of this includes decreases serotonin and GABA and increased NE and glutamate

anxiety

caffeine stimulants hyperthyroidism anemia hypo/hyperglycemia

DDx for anxiety

Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance)

generalized anxiety disorder

May occur with panic attacks. If fear of subsequent panic attacks is absent, and constant worry is present, correct diagnosis is ____

generalized anxiety disorder w/ panic

attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur

panic attack

4 or more of these sx's

panic disorder

fear of having panic attack in a place and not able to get out of there in a timely manner

agoraphobia

If social anxiety situations is what triggers panic, than it is not _______

panic disorder

Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood) lasting for 6 months or more

specific phobia

Clowns, crossing bridges, public transportation, blood draw, spiders

specific phobia

Feel comfortable in smaller groups of people and get increasingly uncomfortable the larger the group gets Very common anxiety disorder

social anxiety disorder

mean age of onset is 13 yrs for this anxiety disorder

social anxiety disorder

first line therapy for anxiety disorders

CBT

first line meds for anxiety disorder

SSRIs

second-line pharmacotherapy and may be quite effective, though increased norepinephrine may cause worsening anxiety in some patients (venlafaxine and duloxetine)

SNRIs

is highly effective in social anxiety disorder and in helping with somatic symptoms of various anxiety disorders Crosses the blood-brain barrier and has some calming effect, as well beta blocker

propranolol

Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways (experiencing it, witnessing it, hearing about it)

PTSD

meet criteria for ONE month; sx's last >1 month

PTSD

symptoms last >2 day to <4 weeks (re-experiencing, hyperarousal, numbing, avoidance)

Acute Stress Disorder

gold standard for PTSD treatment

CBT

Recurrent and persistent thoughts, urges or images that are experienced, at some time during the disturbance, as intrusive, unwanted, and that in most individuals cause marked anxiety or distress. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some thought or action (i.e., by performing a compulsion)

obsessions (OCD)

repetitive behaviors that are always numbered

compulsions (OCD)

The obsessions or compulsions are time consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

OCD

no time criteria for ___

OCD

Anxiety relieved to some extent by compulsions – escalating sense of tension released by compulsions Insight usually present – almost have startling degrees of insight, but cannot avoid engaging in compulsions

OCD

main management in OCD

CBT (exposure response prevention therapy)

Lack of capacity to control aggressive impulses Presents as verbal aggression, on average 2 times per week for three months, OR three behavioral outbursts destroying property within 12 months

intermittent explosive disorder

Recurrent failure to refrain from impulsive fire setting Heightened tension before firesetting and relief on fire setting Fire setting is not in context of anger, vengeance, or attempting to improve living conditions (intentionally setting fire for insurance money)

pyromania

Recurrent urges to steal objects with no monetary value Heightened tension before committing theft with relief after committing theft

kleptomania

no FDA approved treatment for these disorders

impulse control disorders

Putinta- Affective Disorders Flashcards

(75 cards)