25 terms

Mood Disorders

For Abnormal Midterm
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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?