question

when they become too long term or too extreme

answer

Depression and elation are normal human emotions. When do they become a 'disorder'?

question

a primary disturbance in the internal emotional state, causing distress and problems in functioning

answer

Mood disorders are characterized by what?

question

depression, bipolar disorder (I and II), dysthymia, cyclothymia

answer

What are some primary mood disorder that we learned about?

question

a medical condition, substance abuse, or withdrawal, etc.

answer

What are secondary mood disorders due to?

question

10% in males and 20% in females

answer

What is the lifetime prevalence of unipolar disorders (e.g. Depression)?

question

unipolar

answer

Depression is a _________ disorder.

question

females

answer

Is depression seen more in males or females?

question

40 years old

answer

What is the mean age of onset in unipolar disorders (Depression)?

question

1% in both males and females

answer

What is the lifetime prevalence of bipolar disorders (manic)?

question

30 years old

answer

What is the mean age of onset in bipolar disorders (Manic)?

question

It is seen the same in both sexes

answer

Is mania seen more in males or females?

question

single and divorced people

answer

There is a higher risk for both unipolar and bipolar disorders if family history is present. Bipolar disorder is more prevalent among ________ and ____________ people.

question

17%

answer

Major depressive disorder has highest lifetime prevalence (_____%) than any other psychiatric disorder.

question

men, BUT women have a higher rate of occurrence of manic episodes (mania lasts longer in men, but they do not experience as many manic episodes as women)

answer

Is mania more likely in women or men?

question

60

answer

______% of depressed patients have suicidal ideation

question

15

answer

_____% of depressed patients die by suicide

question

true!

answer

T or F: Unipolar and Bipolar disorders have no correlation with ethnicity, education, marital status or income.

question

depression

answer

If you have major depressive disorder or unipolar depression, you must have only _________.

question

depression

answer

If you have bipolar disorder, you have mania/hypomania WITH _________.

question

True!

answer

T or F: There is no simple 'manic' condition (i.e. mania alone, unipolar mania) since depression symptoms eventually occur.

question

True!

answer

T or F: A depressed person can just be depressed, whereas a manic person cannot just be manic, they will be depressed too.

question

bipolar

answer

Depression in mania is ________.

question

An episode of mania that does not meet full DSM-IV-R criteria for a manic episode (less than 7 days and no hospitalization)

answer

What is hypomania?

question

a less severe form of bipolar disorder

answer

What is cyclothymia?

question

a less severe form of major depression (Eeyore)

answer

What is dysthymia?

question

MANIC!

answer

If a person has a manic episode and requires hospitalization, they are _______.

question

Ajax (you probably don't have to know this but just in case)

answer

Depression (and Bipolar Disorder) has been around a long time; the Greek king _______ gets depressed and commits suicide during the siege of Troy (1200 BCE).

question

A. Major depressive episode must last AT LEAST TWO WEEKS and have five or more of the following symptoms (look at next notecard) B. Symptoms do not meet criteria for mixed episode (see later) C. Symptoms cause clinically significant distress or impairment of functioning (social, etc) D. Symptoms are not due to a medical condition (someone upset due to their cancer) E. Symptoms are not better accounted for by bereavement

answer

What is the criterion for Depression according to the DSM-IV-R?

question

1) depressed mood most of day, nearly every day 2) diminished interest in all or almost all activities most of the day, nearly everyday 3) significant weight loss when not dieting, or weight gain (>5% change in body weight in less than a month) 4) insomnia or hypersomnia 5) psychomotor agitation or retardation 6) fatigue or loss of energy 7) feelings of worthlessness or excessive guilt 8) diminished ability to think or concentrate 9) recurrent thoughts of death/suicidal ideation (4-9 add 'nearly every day')

answer

What are the symptoms that are part of criteria A?

question

bereavement

answer

If a patient just loses a spouse, it is usually due to _______________, not depression.

question

Bipolar

answer

People who are manic with very little depression still have __________ disorder.

question

NE, 5-HT and sometimes DA

answer

Drugs for treatment of depression typically interact with _______ and sometimes ______ (all are decreased in depression)

question

tricyclic antidepressants, SSRI's, and MAO inhibitors

answer

What are some drugs that treat depression?

question

Tricyclic antidepressants

answer

What drug to treat depression was first used in the 1950's but is now largely replaced by SSRI's but is still used for patients who are not responsive to SSRI's?

question

SSRI's

answer

What drug to treat depression are widely used now (the 'go-to' guys) and inhibit 5-HT reuptake which in turn prolongs 5-HT activity in the synapse?

question

SSRI's

answer

What are paxyl and zelexa examples of?

question

MAO inhibitors

answer

What drug to treat depression block the degradation of transmitters and thus prolong their action?

question

glucose, amygdala The amygdala is a big area in the brain for emotions and fear, etc.

answer

PET scans show abnormally high _________ metabolism in the __________.

question

hippocampus-->HUGE FOR MEMORY FORMATION

answer

The ___________ is smaller in depressed patients and will atrophy greater as depression continues.

question

glucocorticoids

answer

Higher levels of __________ correlates with stress and depression.

question

anti-inflammatory agents released by the adrenal cortex

answer

What are glucocorticoids and where are they released?

question

TSH

answer

If you give depressed patients TRH, some (5-10%) will release too much ______ and some (20-30%) will release too little ______.

question

40-60%

answer

You see elevated HPA (glucocorticoids) activity in ____% of depressed patients

question

tests for depression in patients--> you give dexamethasone to a patient and if patient is normal, HPA activity (circulating glucocorticoids) will decrease for 24 hours. With depressed patients, dexamethasone will NOT decrease HPA activity.

answer

What is the dexamethasone (Decadron) suppression test?

question

an artificial steroid

answer

What is dexamethasone?

question

hypothalamus-->pituitary-->adrenal this axis responds to stress and seems to have changes in depressed patients

answer

What is the HPA axis?

question

increased, decreased

answer

CSF somatostatin levels are __________ in mania and ____________ in depression.

question

inhibits release of somatotropin, glucagon, and insulin produced in the pancreas

answer

What does somatostatin do?

question

TRH, TSH

answer

Hypothalamus releases ______ which stimulates pituitary to release ______ which stimulates thyroid gland to release T3 and T4

question

10-25%

answer

If one parent has a mood disorder, their child has ______% chance of developing one.

question

20-50%

answer

If both parents have a mood disorder, their child has _______% chance of developing one.

question

50-70%

answer

Twin studies suggest genetics account for _______% of etiology of mood disorders.

question

True

answer

T or F: Stressful life events generally precede the first appearance of a mood disorder, not the subsequent episodes.

question

losing a parent before age 11

answer

What is the life event most often associated with depression?

question

dogs who were previously exposed to inescapable shock had difficulty learning to avoid escapable shock in a new situation it is the antithesis of our greatest heroes finding a way to beat the odds, finding a new strategy, etc.

answer

What is learned helplessness?

question

For recurrent, episodes are separated by at least 2 months

answer

What's the difference between major depressive disorder (single episode) and major depressive disorder (recurrent)?

question

depressed mood, low self esteem, loss of enjoyment of pleasurable activities (anhedonia), feelings of worthlessness, hopelessness, loser, uselessness, insomnia, and anxiety

answer

What are some clinical features of depression?

question

80%

answer

_________ of depressed people have insomnia.

question

90%

answer

_________ of depressed people have anxiety.

question

50%

answer

____% of patients show symptoms of depression before a major 'episode' is identified.

question

6-13 months

answer

An untreated episode will last ______________ typically until relief of symptoms

question

3 months

answer

A treated episode will last ___________ until relief of symptoms

question

true!

answer

T or F: Early drug treatment cessation will most often result in a recurrence of symptoms.

question

5-10%

answer

_______ of depressed patients will experience a manic episode

question

True

answer

T or F: Depression is generally chronic and patients tend to relapse.

question

50%

answer

Approximately _____ of depressed patients do not seem aware, or deny, that they have depression.

question

50% 50% 50%!

answer

If asked about a percentage, say 50% and you will probably be right

question

hypochondriac

answer

'Masked' depression patients often see the doctor for vague physical symptoms, and thus are sometimes misdiagnosed as ____________.

question

a depressed person will show other symptoms inconsistent with hypochondriasis (weight loss, etc.)

answer

How do you tell the difference between a hypochondriac and depressed person?

question

Hypothyroidism, hypogonadism, metabolic disturbances, infectious processes, age-related (Alzheimer's, etc.), adverse reactions to medications, alcohol abuse, Lyme disease, Wilson's disease, Huntington's, Parkinson's, stroke, hyperthyroidism, cancer of pancreas, MS, etc.

answer

What are some differential diagnosis for Depression?

question

1/3

answer

As many as _______ of individuals with a serious medical condition experience depression.

question

Melancholic depression

answer

What is the depression where you see a loss of pleasure in most or all activities, failure of reactivity to pleasurable stimuli, a quality of depressed mood more pronounced that that of grief or loss, a worsening of symptoms in the morning hours, early morning waking, psychomotor retardation, excessive weight loss, or excessive guilt?

question

Anorexia Nervosa

answer

What should excessive weight loss not be confused with in depressed patients?

question

mood reactivity (mood improves in response to something good, also known as paradoxical anhedonia), hypersomnia, leaden paralysis (a sensation of heaviness in limbs), significant social impairement as a consequence of hypersensitivity to perceived interpersonal rejection, significant weight gain or increased appetite (comfort eating--reverse vegetative signs), fatigue superimposed on a history of somatic anxiety and phobias, crave carbohydrates, might involve thyroid dysregulation, higher prevalence in women, MAO-I's more effective than SSRI's or TCA's

answer

What are some symptoms of atypical depression?

question

insomnia and not eating

answer

What are some examples of vegetative signs?

question

women

answer

Do you see atypical depression more in men or women?

question

MAO-I's (better than SSRI's or TCA's)

answer

What is the most effective treatment for atypical depression?

question

Catatonic depression

answer

What is the rare and severe form of major depression involving disturbances of motor behavior and other symptoms where person is mute and almost stuporous, and either remains immobile or exhibits purposeless or even bizarre movements?

question

Post-partum depression

answer

What is the intense, sustained and sometimes disabling depression experienced by women after giving birth?

question

Seasonal Affective Disorder

answer

What is the type of depression where you see depressive symptoms during the winter months only?

question

increased sleep, increased appetite, especially for carbs, decreased energy, morning sickness, difficulty in waking up

answer

What are some of the symptoms for Seasonal Affective Disorder?

question

abnormal melatonin metabolism

answer

What is Seasonal Affective Disorder caused by?

question

false: it can occur in the summer but it is less common (symptoms in the summer are similar to major depression but can be either melancholic or atypical)

answer

T or F: Seasonal Affective Disorder can only occur in the Winter.

question

sunlamps, possible melatonin tables, anti-depressants (SSRI's), negative air ionization

answer

What can you use to treat Seasonal Affective Disorder?

question

1. Depressive episodes must occur at a particular time of the year 2. Remissions or mania/hypomania must also occur at a characteristic time of year 3. These patterns must have lasted two years with no nonseasonal major depressive episodes during that same period 4. These seasonal depressive episodes outnumber other depressive episodes throughout the patient's lifetime

answer

What is the DSM-IV-R criteria for seasonal affective disorder?

question

Vascular Depression, Minor depressive disorder, Mixed anxiety-depressive disorder, Recurrent brief depressive disorder, Premenstrual dysphoric disorder, Postpartum depression, Motility psychosis, Anxiety-blissfulness psychosis, Hysteroid dysphoria

answer

What are some other types of depression?

question

the prefrontal lobe is damaged due to ischemic events resulting in age related depression that is often unresponsive to antidepressants

answer

What is damaged in vascular depression and why?

question

repetitive transcranial magnetic stimulation (rTMS) rTMS has also been used for Parkinson's, tinnitus, dystonia, etc.

answer

What has been effective in treating vascular depression?

question

Minor Depressive Disorder

answer

What type of depression has the same criteria as Major Depressive Disorder just less severe?

question

Minor Depressive Disorder

answer

What type of depression could by synonymous with dysthymia but is not well defined yet?

question

Mixed Anxiety-Depressive Disorder

answer

In what type of depression do you see persistent and recurring depressed mood for at least 1 month with symptoms of anxiety (sleep disturbances, irritability, worry, etc.)?

question

Mixed Anxiety-Depressive Disorder

answer

What type of depression is most prevalent in 'general medical settings' (anxiety about a medical condition) where chronic fatigue is a common complaint?

question

Mixed Anxiety Disorder

answer

In what type of depression does an individual have some anxiety and some depression but one didn't cause the other?

question

Recurrent Brief Depressive Disorder

answer

What is the type of depression where you have short (<2 weeks) episodes of depression that occurs over and over again that meet all the criteria of major depressive disorder?

question

young adults

answer

Recurrent Brief Depressive Disorder is most common in what age group?

question

2 days to 2 weeks, 12 months

answer

Depressive periods must last _____ to ______, and occur once a month for ____ months, not relating to menstrual cycle.

question

True

answer

True or false: In recurrent brief depressive disorder, there are no major depressive, manic, or hypomanic episodes.

question

Premenstrual Dysphoric* Disorder Dysphoria: opposite of euphoria (i.e. anger, sadness, rage, despair)

answer

What type of depression does a person have when their mood, behavior and physical symptoms are occurring at a specific time during the menstrual cycle?

question

5%

answer

Premenstrual Dysphoric Disorder occurs in ____% of women.

question

Post Partum

answer

Women with Premenstrual Dysphoric Disorder are at a greater risk for __________ depression.

question

crying spells, verbal outbursts, tantrums

answer

You typically see mood lability in women with Premenstrual Dysphoric Disorder. What are some examples of mood lability?

question

mood lability

answer

crying spells, verbal outbursts, tantrums are all examples of ______ __________.

question

Dysphoria

answer

What is the opposite of euphoria (anger, sadness, rage, despair)?

question

Postpartum Depression

answer

What type of depression affects women right after childbirth but can also affect men?

question

Postpartum blues ('baby blues'), Major Depressive Episode, and Brief Psychotic Disorder with postpartum onset?

answer

What are the 3 possible types of Postpartum Depression?

question

Postpartum blues (30-50% of women)

answer

What is the type of Postpartum Depression that has an onset within a few days of birth and the symptoms can last approximately 2 weeks?

question

1/3 to 1/2 or 30-50% of women

answer

As many as ____ to ____ of women experience Postpartum blues.

question

Major Depressive Episode (5-10% of women)

answer

What is the type of Postpartum Depression that starts within one month of delivery and can last a year?

question

Brief psychotic disorder with postpartum onset

answer

What is the type of Postpartum Depression that has psychotic symptoms and occurs within 2-3 weeks after birth, lasting up to ?

question

looking like a catatonic stupor; resolves rapidly and no deterioration of personality

answer

What does akinetic mean?

question

can resemble manic or catatonic excitement, also resolves rapidly

answer

What does hyperkinetic mean?

question

akinetic and hyperkinetic

answer

In motility psychosis, an individual can switch between being ______ and ______.

question

True However, the duration of the episode in Motility Psychosis is SHORTER than in Schizophrenia

answer

T or F: Motility Psychosis might be a type of brief psychotic disorder but probably fits better in Schizophrenia.

question

akinetic and hyperkinetic

answer

What are the two forms of motility psychosis?

question

True!

answer

T or F: In contrast to the catatonic type of Schizophrenia, akinetic motility psychosis has a rapidly resolving and favorable course that does not lead to personality deterioration.

question

Brief Psychotic Disorder

answer

Motility psychosis is probably a variant of ___________.

question

Anxiety-Blissfulness Psychosis (they have anxiety/depression/and psychosis and then suddenly they just don't anymore)

answer

What type of Depression is known as a 'periodic state of overwhelming anxiety and paranoia, may be accompanied by hypochondriasis, other depressive symptoms, and hallucinations'?

question

blissful

answer

During the _________ state in Anxiety-Blissfulness Psychosis, patients show expansive behavior and grandiose ideas of how to make people and the world happy.

question

Hysteroid Dysphoria 1) giddy responses to romantic opportunities and strong dysphoria (angry/depressive/suicidal) response to romantic disappointment 2) impaired anticipatory pleasure 3) craving for chocolate and sweets

answer

In what type of depression do you have reverse vegetative signs? What 3 symptoms do you also see in this depression?

question

impaired anticipatory pleasure

answer

An individual is standing in line to get on a rollercoaster and as the person gets closer and closer to the front of the line, he/she is not getting more and more excited. What is this an example of?

question

90%

answer

Depressed persons are at increased risk for suicide. Over ____% of suicides had been diagnosed with depression or other mental disorder.

question

1) previous attempt at suicide 2) >45 years old 3) alcohol dependence 4) history of violent behavior 5) male

answer

Factors which increase the risk of suicide include what?

question

4 times, 3-4 times

answer

Men are _____ times as likely to commit suicide, but women are ______ times more likely (than men) to attempt it.

question

Firearms for men, Pills for women

answer

_______ are the most common method for committing suicide (M=F) but _______ are the most likely method for attempting in women.

question

65 years old

answer

25% of suicides occur when a person is older than ______.

question

80%

answer

_____% of suicides saw their physician in the preceding 6 months (50% or more in the preceding month)

question

True when the patient feels better, he/she will have enough energy to do it

answer

T or F: Suicide attempts often occur as the patient begins to feel better.

question

Dentistry

answer

What profession has the highest suicide rate?

question

Bipolar Disorder

answer

What mood disorder is defined as having both manic and depressive episodes, or just manic episodes?

question

A distinct period of an abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week, or less if hospitalization is required (Criterion A)

answer

What is mania?

question

1 week! (must last a week or longer)

answer

Mania must last at least __________.

question

1 week! (must last less than a week)

answer

Hypomania cannot last longer than _______.

question

Bipolar I disorder and Bipolar II disorder

answer

What are the two classifications of Bipolar Disorder?

question

Bipolar II disorder

answer

What type of Bipolar disorder involves depressive episodes and hypomanic episodes (not full manic episodes)?

question

II

answer

Bipolar ____ disorder may be under-diagnosed as hypomanic persons may present as having high functioning behavior.

question

I

answer

What type of Bipolar disorder describes the classic bipolar disorder, meaning a full manic episode along with major depressive symptoms?

question

A. mood must last at least 1 week, or less if hospitalization is required B. 3 or more of the following: 1) inflated self-esteem or grandiosity 2) decreased need for sleep 3) more talkative than usual 4) flight of ideas 5) distractibility 6) psychomotor agitation or increase in goal-directed activity 7) excessive involvement in pleasurable activities having potential negative outcomes C. Symptoms do not meet criteria for mixed episode D. Symptoms cause clinically significant distress or impairment of functioning (social, etc) E. Symptoms are not due to a medical condition

answer

What is the DSM-IV-R Criteria for a Manic Episode?

question

A. mood must last throughout at least 4 days B. same as for Manic episode C. Episode is associated with a clear change in functioning that in uncharacteristic of the person when not symptomatic D. The disturbance in mood and the change in functioning are observable by others E. Episode is not severe enough to cause marked impairment in social or occupation functioning, or to be hospitalized-->THERE ARE NO PSYCHOTIC FEATURES F. not due to a medical condition

answer

What is the DSM-IV-R Criteria for a Hypomanic Episode?

question

depression

answer

In Bipolar I, 75% of males and 66% of females start with ____________.

question

10-20%

answer

In Bipolar I, _______% of patients experience ONLY manic episodes

question

90%

answer

____% of patients with a single manic episode will have another.

question

Worse

answer

Does Bipolar I have a better or worse prognosis than Major Depressive Disorder?

question

II

answer

Bipolar ____ is not well studied yet.

question

a chronic mood disorder in the depression spectrum that is also known as 'low grade depression' it has less severe symptoms than major depressive disorder but it often lasts longer patients complain 'that they have always been depressed' (i.e. not tied to specific life events) 3x more common in women

answer

What is Dysthymia?

question

less severe; lasts longer

answer

Dysthymia has ______ severe symptoms than Major Depressive Disorder but often lasts ________.

question

WOMEN! 3x more common

answer

Is Dysthymia more common in men or women?

question

Cyclothymia

answer

Hypothymia + Dysthymia = ?

question

A. a depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years (in children or adolescents, mood can be irritable and less than 1 year duration) B. Presence, while depressed, of two (or more) of the following: 1) poor appetite or overeating 2) insomnia or hypersomnia 3) low energy or fatigue 4) low self-esteem 5) poor concentration or difficulty making decisions 6) feelings of hopelessness

answer

What is the DSM-IV-R Criteria for Dysthymia?

question

a mild form of Bipolar Disorder; episodes of hypomania and mild depression; equal in men and women if twin has it, other twin has ___% chance of developing

answer

What is Cyclothymia?

question

EQUAL FOR BOTH

answer

Is cyclothymia seen more in men or women?

question

Cyclothymia

answer

A person has episodes of mild depression and hypomania. His condition is like a mild form of Bipolar Disorder. What would you diagnose them as having?

question

A. For at least 2 years, the presence of numerous periods of hypomanic symptoms, and depressive symptoms that do not meet criteria for a major depressive episode (duration must be 1 year for children and adolescents) B. During the 2 year period, the person has not been without the symptoms in (A) for 2 months at a time C. No major depressive episode, manic or mixed episode in the 2 year period Remainder is similar to Criterion for Dysthymia (no other medical condition, etc.)

answer

Criteria for Cyclothymia

question

Hospitilization if required (i.e. manic episode), pharmacology for initial treatment (lithium, anticonvulsants, antidepressants), continued treatment to manage condition, substance abuse treatment (if necessary)

answer

What are some possible treatments for Bipolar Disorder?

question

Lithium: effective stabilizer, around a long time, side effects include tremor, weight gain, GI issues; periodic blood tests required for potential liver and thyroid issues Anticonvulsants: may help in some cases such as valproic acid (Depakene) Antidepressants: may work although they might trigger manic episodes, and loss of libido is a side effect)

answer

What are some pharmacological treatments for Bipolar Disorder?

question

for OCD: stereotactic ablation of the anterior cingulum has been effective for drug-resistant OCD for depression: vagal nerve stimulation increases NE and 5-HT; also ECT used for treating depression that is refractive to medication for both OCD and depression: deep brain stimulation

answer

What are some surgical and other options for treating psychiatric disorders?

question

stereotactic ablation of the anterior cingulum for drug-resistant OCD

answer

What is a possible treatment for OCD that we learned?

question

vagal nerve stimulation (increases NE and 5-HT) and ECT

answer

What are some possible treatments for depression that we learned?

question

Electro-convulsive therapy It is fast, effective and safe with a long history of use in depression; very effective in treating depression that is refractive to medication 25-60 sec of current results in a generalized seizure; patient is pre-medicated with anesthetic and muscle relaxant typical course is 5-10 treatments over 2-3 weeks

answer

What is ECT?

Depression and Mood Disorders – Flashcards

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards