Advertisement Upgrade to remove ads

For Abnormal Midterm

Euphoric

More cheerful and elated than average. Possibly ecstatic. Typical of Bipolar I

Dysphoric

Unpleasant feelings like sadness/irritability

Episode Specifiers

-Chronic
-w/melancholic features
-w/atypical features
-w/catatonic features
-w/postpartum onset

Course Specifiers

-seasonal
-rapid cycling
-w/ or w/o full interepisode recovery

Major Depressive Episode Symptoms

-Must have 5 of 9 during two week period
-depressed, sad, weight loss, insomnia, hypersomnia, agitation, fatigue, feelings of worthlessness, diminished ability to think, recurrent thoughts of death, diminished interest in pleasurable activities
-Change in level of functioning
-Depressed Mood

Manic Episode

-Elevated or irritable mood for a week (or any length if hospitalization is necessary)
-3 or more symptoms to a significant degree
-Not "mixed"
-Marked impairment
-Not due to GMC or substance

Hypomanic Episode

-Elevated/irritable mood for 4 days
-3 or more symptoms to a significant degree
-Changes in functioning that are observable to others
-Not severe enough for hospitalization/marked impairment
-Not due to GMC or substance

Mixed Episode

-Criteria met for both manic and major depressive episode (except duration) for almost EVERY day for at least one week
-Marked impairment
-Not due to GMC/substance

Major Depressive Disorder

-296.xx
-Presence of 1 or more depressive episodes
-No history of manic/mixed/hypomanic
-Onset: mid-20's, and more often in women

Dual Depression

Meets criteria for dysthymia and major depressive disorder

Comorbidity and Depression

-25% of patients also have panic disorder
-Med conditions: hypothyrodism, malignancy, brain lesion, parkinsons, stroke
-Hard to diagnose personality disorders
-Substance abuse can have same symptoms

Depression and Sleep

-Reduced continuity
-Increased wakefulness
-Increased REM

Cross-cultural Symptoms of Depression

-dysphoria, lack of energy, and loss of interest

Culture Specific Symptoms of Depression

-Guilt (West)
-Headaches (Latino)
-Tiredness and imbalance (Asian countries)
**Some groups somaticize and others psychologize

Depression and Age

-Kids are irritable and somaticize
-Older adults may experience pseudo-dementia

Dysthymic Disorder Dx Criteria

-300.4
-Depressed mood present most of the time for 2 years in adults, 1 year in children
-2 out of 6 depression symptoms (overeating, no appetite, fatigue, lack of sleep, sleeping too much, poor self esteem, lack of interest, hopelessness)
-Not severe enough to be MDD

Dysthymic Specifiers

-Early onset (before 21)
-Late onset (after 21)
-Atypical features

Depression and Differential Dx

-MDD or Dysthymia?
-Substance abuse
-Dementia
-Mood disorder due to GMC
-Manic
-ADHD
-Could be personality disorder comorbidity

Bipolar I Disorder

-One or more manic episodes and maybe depressive episodes
*High suicide rate

Bipolar II Disorder

-One or more major depressive episodes and at least one hypomanic episode
*High suicide rate

Rapid Cyclers

-Less than 15%
-4 to 8 mood episodes in one year

Differential Dx of Bipolar

-I, II, or Cycolthymia
-Due to GMC
-Substance abuse
-Hypomanic, manic, major depressive
-ADHD

Comorbidity and Bipolar

-High level of comorbidity
-Anxiety disorders
-Substance use disorder
-ADHD
-Personality disorders

Cyclothymic Disorder

-Not as intense as bipolar
-Dramatic/recurrent mood shifts
-Hypomania with mild depressive episodes
-Chronic (2yrs +)
-They may feel productive but others call them moody

Charlie Sheen Differential Dx

-Manic episode
-Bipolar I
-Mixed episode
-Substance abuse
-GMC?

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again

Example:

Reload the page to try again!

Reload

Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

Star this term

You can study starred terms together

NEW! Voice Recording

Create Set