Mood Disorders and Differential diagnosis
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| What is this? | A mood d/o is characterized by one or more major depressive episodes (MDE) | I) one manic or mixed (meet criteria for mania and MDE) episode (usually requiring hospitalization) II) At least one MDE and on hypomanic episode | (blank)
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| DSM IV criteria for diagnosis? | 1) Depressed mood or anhedonia (lost interest) 2) 5 symptoms from SIG E CAPS list 3) for a 2 WEEK PERIOD | Manic episode is 1 week or more of persistently elevated, expansive or irritable mood plus 3 DIG FAST symptoms. Psychotic symptoms common in mania | (blank)
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| Symptoms of episode | SIG E CAPS: Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicide | DIG FAST: Distractability, Insomnia, Grandiosity, Flight of ideas, Activities/psychomotor Agitation, Sexual indiscretions, Talkativeness/pressured speech | (blank)
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| Who gets this? | Females in mid-20s; in elderly incidence increases with age; chronic illness and stress increases risk. 15% will die due to suicide | M:F is 1:1, fam hx increases risk, onset 20s, frequency of mood episodes increases with age, 10-15% die suicide | (blank)
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| What do they tell you? | Depressed mood/anhedonia + SIG E CAPS | DIG FAST. Excessive engagement in pleasurable activities, reckless behavior, and/or psychotic features ***antidepressant meds may trigger mania | (blank)
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| What are the different types within the disorder? | 1) Psychotic features: delusions/hallucinations 2) Postpartum: 1 mon; 10% risk, high recurrence; psychosis 3) Atypical: wt gain, hypersomnia 4) Seasonal: Depr commonly in winter; responds light therapy 5) Double depression: MDE in dysthmia | 1) Bipolar I (mania or mixed episode) 2) Bipolar II (MDE + hypomania) 3) Rapid cycling: greater than 4 episodes/year (MDE, manic, mixed or hypomanic) 4) Cyclothymic: less severe alternating hypomania and moderate depression >2yrs | (blank)
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| What is used for treatment? | 1) Meds: effective 50-70%; 2-6w to work; treat >6mon 2) ECT 6-12Xs for refractory or psychotic depression (SE- anterograde amnesia, HA, confusion) 3) Psychotherapy + meds 4) Phototherapy for seasonal | 1) Mania: antipsychotics and mood stabilizers 2) Depression: mood stabilizers +/- antidepressant (don't want to trigger mania); ECT can be used in refractory cases | (blank)
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| Mood d/o due to medical condition | Hypothyroid, Parkinson, CNS, neoplasms, stroke (esp ACA), dementias, parathyroid d/o | (blank) | (blank)
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| Substance-induced mood d/o | illicit drugs, alcohol, antiHTNs, steroids, OCPs | (blank) | (blank)
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| Adjustment d/o with depressed mood | symptoms resembling MDE within 3 months of identifiable stressor | (blank) | (blank)
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| Normal bereavement | After loved one lost | No severe impariment/suicidality; resolves in year but varies | may lead to major depressive d/o requiring Rx
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| Dysthmia | milder, chronic depressed mood present most of time for >2yrs | often treatment resistant | (blank)
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