Term
| What is the definition of mood? |
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Definition
| A pervasive emotional state that influences one's view of self, others, and the environment |
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Term
| Technically, what emotions is mood concerned with? What isn't it? |
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Definition
Happy vs. sad
Not concerned with anxiety or anger |
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Term
| What disorder is the first in the burdern of disease? Sixth? |
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Definition
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Term
| Low levels of these molecules is associated with depression: |
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Definition
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Term
| High levels of NE and serotonin are associated with this condition: |
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Definition
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Term
| Broadly, what is the mechanism of antidepressants? |
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Definition
| Increasing transmission of NE or serotonin |
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Term
| What alterations happen in the HPA axis during depression? |
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Definition
| Hyperactivation --> cortisol secretion |
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Term
| What kind of endocrine disturbance is associated with depression? What is the treatment? |
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Definition
Hypothyroidism
Thyroid augmentation |
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Term
| What changes take place to sleep during depression? |
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Definition
Decreased total sleep time
Decreased REM latency
Increased total REM sleep |
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Term
| What changes occur to the brain on imaging during depression? |
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Definition
Decrased frontal lobe, hippocampal volume
Decreased frontal lobe metabolic activity
Increased metabolic activity in the HPA axis |
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Term
| What psychosocial factors can put someone at increased risk for depression? |
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Definition
Early life losses
Acute life stress
Negative cognitive factors |
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Term
| What is the definition of a major depressive episode? |
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Definition
Two weeks of depressed mood/diminished interest or peasure
3-4 vegetative symptoms:
-Weight loss
-Increased appetitie
-Insomina
-Psychomotor retardation
-Fatigue
-Feelings of worthlessness
-Suicidal thoughts |
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Term
| What causes sadness to not be considered a major depressive episode? |
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Definition
Not attributable to substance abuse/medical illness
Can't happen in the context of normal bereavement |
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Term
| What are some of the subtypes of major depression? |
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Definition
Melancholia (persistent anhedonia)
Postpartum (w/in 4 weeks of having child)
Catatonic (motor problems)
Psychotic (psychosis only while depressed)
Seasonal |
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Term
| What is one of the most important questions you can ask someone who comes in for depression? |
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Definition
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Term
| What is the definition of a manic episode? |
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Definition
| A distinct period of at least one week during which there is an abnormally and persistently elevated, expansive, or irritable mood |
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Term
| What are the diagnostic symptoms of a manic episode? |
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Definition
-Flight of ideas/distractable
-Increased involvement in goal-directed activities
-High-risk behavior
-Decreased need for sleep
-Loud,rapid, intrusive speech |
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Term
| What are the subtypes of manic episodes? |
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Definition
Mixed
Psychotic
Rapid cycling
Hypomanic |
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Term
| What is the definition of a mixed manic episode? |
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Definition
| Simultaneously manic and depressed; they switch between them rapidly |
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Term
| What is the definition of a psychotic manic episode? |
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Definition
Psychosis in the context of mania
Hard to distinguish between this of schizophrenia |
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Term
| What is the definition of rapid cycling mania? |
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Definition
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Term
| What is the definition of a hypomanic episode? |
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Definition
Similar to mania, but:
Shorter duration
No significant impairment in function
No psychosis
No hospital admission |
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Term
| What is the definition of major depressive disorder? |
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Definition
| One or more major depressive episodes without a manic/hypomanic episode |
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Term
| When is the onset of major depressive disorder? |
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Definition
Peak onset is in the 20's
You can have it set in when you're very old or young, though |
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Term
| How rapid is the onset of major depressive disorder? |
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Definition
Either sudden or gradual
Sudden: couple of days; usually following 6 months of a major stressor
Gradual: months of sublclinical symptoms |
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Term
| What is the normal course for major depressive disorder? How many episodes is average? |
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Definition
50% will have another episode
50% recover within 6 months
4 is the average number of episodes |
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Term
| What is the lifetime suicide risk for someone with major depressive disorder? |
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Definition
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Term
| What are the major complications/co-morbidities of major depressive disorder? |
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Definition
Depressive pseudodementia
Substance abuse
Anxiety disorders |
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Term
| What is the lifetime risk for depression for men? Women? |
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Definition
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Term
| What's the point prevalence of depression in men? Women? |
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Definition
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Term
| What's the inheritance of major depressive disorder? |
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Definition
It's genetic.
Monozygotic: 50-75% concurrence |
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Term
| What is the treatment for major depressive disorder? |
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Definition
Antidepressants: tricyclics, MAOIs
Psychotherapy: CBT, IPT
Always combine them - they're more effective
ECT: for severe, unresponsive depression |
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Term
| If someone is on antidepressants, how long of a course should they be on? |
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Definition
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Term
| What are the contraindications to ECT? |
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Definition
Intracranial masses
Dementia
Severe personality disorder
Anesthesia risk |
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Term
| What are the side effects of ECT? |
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Definition
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Term
| What percent of patients with major depressive disorder will become psychotic? |
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Definition
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Term
| What is the treatment of major depressive disorder with psychotic features? |
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Definition
1st line: antidepressants, antipsychotics
2nd line: ECT |
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Term
| What is the definition of dysthymic disorder? |
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Definition
At least 2 years of depressedmood
2 or more vegetative symptoms
Doesn't meet criteria for major depressive episode for 2 years |
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Term
| What's the risk for dysthymic disorder? |
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Definition
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Term
| What is the treatment for dysthymic disorder? |
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Definition
Antidepressants
Psychotherapy |
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Term
| What's the definition of bipolar I disorder? |
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Definition
| At least one manic episode with OR without a depressive episode |
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Term
| What's the onset and course of bipolar I disorder? |
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Definition
Peak onset: 20s
Age range of onset: teens - 60's
Pace of onset: Rapidly
Course: recurrent Less common in 20's, increases in frequency until peaking in 50's, decreases thereafter |
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Term
| What are the complications from bipolar I disorder? |
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Definition
10-15% lifetime suicide risk
Substance abuse |
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Term
| What is the epidemiology of bipolar I disorder? |
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Definition
1% lifetime prevalence
VERY GENETIC |
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Term
| What is the treatment for bipolar I disorder? |
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Definition
1st line:
Antipsychotic
Lithium
Valproic acids
When they're manic, DON'T GIVE THEM ANTIDEPRESSANTS |
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Term
| What is the definition of bipolar II disorder? |
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Definition
| At least one hypomanic episode with at least one depressive episode |
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Term
| What is the prevalence of bipolar II disorder? |
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Definition
2-3%
Same treatment as bipolar I disorder |
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Term
| What is cyclothymic disorder? Who gets this? |
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Definition
Chronic fluctuating mood not meeting criteria for manic or major depressive episodes
Young adults |
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Term
| What disease is cyclothymic disorder very similar to? |
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Definition
BipolarI or II; it progresses to these two 50% ofthe time
Treatmentis the same |
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Term
| What is the definition of substance induced mood disorder? |
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Definition
| Prominent and persistent mood disturbance related to intoxication or withdrawal from a substance |
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Term
What substance most commonly causes substance induced mood disorder?
What others cause problems |
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Definition
Alcohol
Amphetamine
Cocaine
Steroids |
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Term
| What is the definition of a mood disorder due to a general medical condition? |
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Definition
| Prominent and persistent mood disturbance (depressed/elevated) related to the direct physciological effects of an illenss |
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Term
| What is the definition of adjustment disorder with depressed mood? |
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Definition
Depression within 3 months of onset of a stressor
Resolving of symptoms within 6 months of the removal of the stressor
Symptoms don't meet dcriteria for other things. |
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