Mood disorders

Question 1

MDD- Eti

Answer 1

• 12 month prevalence 8%
• Rate increasing
• Highest among 24-44 yrs
• 2-3x more common in females

Question 2

MDD- DSM V criteria

Answer 2

• 5+ sx during 2 week period, change from previous fxn
• 1 of sx is depressed mood, loss of interest
• Depressed/ irritable mood
• Anhedonia
• Sig. wt loss/ gain, change in appetite
• insomnia, hypersomnia
• psychomotor agitation/ retardation
• Fatigue, loss of energy
• Worthlessness, guilt
• Can’t think, concentrate, indecisive
• Recurrent thoughts of death, suicide
• Not better accounted for by bereavement, general medical condition, direct physiological effect of substance

Question 3

MDD- Course

Answer 3

• Episodes last 3-6 months

- Chronic and recurrent

Question 4

MDD- Tx

Answer 4

• SSRIs, SNRI, MAOIs, Tricyclicts
• Electroconvulsive therapy
• Psychotherapy, CBT

Question 5

MDD- Complications

Answer 5

• 15% commit suicide

- more likely to die

Question 6

Dysthymic disorder- DSM V

Answer 6

• Depressed mood most of day, more days than not for 2 years
• Children = 1 year
• Plus: Poor appetite, overeating
• Insomnia/ hypersomnia
• Low energy
• Low self esteem
• Poor concentration, difficulty making decisions
• Hopelessness
• Has never been w/o sx for > 2 months
• No major episode during first 2 years

Question 7

Dysthymic disorder- Eti

Answer 7

• 3.2% population
• Before 45
• biological relationship + personality features

Question 8

Dysthymic disorder- Tx

Answer 8

• SSRIs, TCA & MAOIs x 6-12 months

- Psychotherapy

Question 9

Dysthymic disorder- Outcomes

Answer 9

• 10% develop MDD

- Interpersonal issues, cluster C personality dx

Question 10

Bipolar Disorders- DSM V

Answer 10

• Distinct, abnormal persistently elevated/ irritable mood lasting > 1 week
• 3+ sx
• Grandiosity
• Decreased need for sleep
• More talkative, pressure to keep talking
• Flight of ideas
• Distractibility
• Increased goal directed activity
• Excessive involvement in pleasure without concern for consequences

Question 11

Bipolar I

Answer 11

Recurrent, major depressive episodes with manic episodes

Question 12

Bipolar II

Answer 12

Recurrent MDD with hypomanic episodes

Question 13

Bipolar disorder- Eti

Answer 13

• Female, am hx, upper socioeconomic class

-

Question 14

Bipolar disorder- Tx

Answer 14

Avoid TCAs

• Depression- SSRIs
• Mania: Litium
• Maintenance- Lithium, valproic acid, carbamazepine

Question 15

Adjustment disorder- Sx

Answer 15

• Anxiety or depression in rxn to stress
• subsequent symptoms elicited by lesser magnitude
• Impairment in function
• Marked distress in excess to expeted
• Alcohol as tx
• Restlessness, irritability, fatigue, startle rxn
• Guilt, shame, fear, rage

Question 16

Adjustment disorder- Tx

Answer 16

• CBT, psychotherapy

- SSRIs

Question 17

Seasonal affective disorder

Answer 17

• Depressive episode at specific time of year
• Fall winter
• Higher latitudes, younger people, females
• Hypersomnia, anergia, craving sweets

Question 18

Seasonal affective disorder- Tx

Answer 18

• Light therapy

- SSRIs