Final Review - Mood Disorder I. Depression a. Symptoms i....

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Mood Disorder I. Depression a. Symptoms i. Affective Symptoms 1. Depressed mood, feelings of sadness, dejection, excessive and prolonged mourning 2. Anxiety frequently accompanies 3. Regular mourning rarely continues beyond 3 months ii. Cognitive Symptoms 1. Pessimistic belief 2. Self-accusations of incompetence and self-denigration 3. Suicide (8x higher than general population) iii. Behavioral Symptoms 1. Social withdrawal 2. Lowered work productivity 3. Lower energy is the dominant symptom 4. Anhedonia 5. Psychometric retardation iv. Physiological Symptoms 1. Appetite and weight changes 2. Constipation 3. Sleep disturbance 4. Disruption of the normal menstrual cycle 5. Aversion to sexual activity v. Symptoms are same in children and adolescents as adults, although prominence of symptoms may change with age 1. Common in kids: somatic complaints, irritability, and social withdrawal 2. Common in adolescents and adults: psychometric retardation, hypersomnia, and delusions II. Mania a. Symptoms i. Affective 1. Elevated, expansive, or irritable mood 2. Energy, enthusiasm, and self-assertion ii. Cognitive Symptoms 1. Flightiness, pressured thoughts, lack of focus and attention, and poor judgment iii. Behavioral Symptoms 1. Excessive and impulsive sexual activity iv. Two Levels of mania 1. Hypomania—milder form a. High in mood and overactive behavior b. Judgment poor, but delusions rare 2. Mania—more disruptive behavior
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v. Physiological Symptoms 1. Decreased need for sleep (most prominent) III. Classifications of Mood Disorders a. Depressive Disorders i. MDD ii. Dysthymic 1. Symptoms are not as severe as MDE or MDD, but last for years 2. Symptoms are present almost everyday for 2 years in adults, 1 year in children and adolescents 3. Higher in women than men iii. Depressive disorder NOS iv. Depressive Episode 1. Pt experiences a major depressive episode 2. Symptoms present for 2 wks 3. The earlier the age of onset, the more likely the recurrence b. Bipolar Disorders i. Bipolar 1 1. Single manic episode with depression ii. Bipolar 2 1. Recurrent MDE with hypomania iii. Associated with artistic talent iv. No gender difference v. If symptoms include hypomanic episode and depressed mood that do not meet the criteria for MDE and present for at least 2 years, it is cyclothymic disorder (one year in kids) vi. Mania vs. hypomania 1. Maniac ep lasts at least one week 2. Hypomanic ep lasts for four days IV.Course Specifiers a. Specifiers are used to more precisely describe MDE b. Course Specifiers i. Indicate the cyclic, seasonal, postarpartum, or longitudinal pattern 1. Rapid cycling BP: manic/depressive episodes have occurred four or more times during the previous 12 months 2. Postpartum: depression/mania in women within 4 weeks of childbirth 3. Seasonal Affective Disorder: sunlight change disrupts hormonal levels a. Light therapy V. Treatment of Mood Disorders a. Biological i. Catecholamine hypothesis 1. Control neurotransmitters ii. Medication 1. Antidepressants a. TCAs i. Block reuptake of norepinephrine b. HCAs
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c. MAOI’s
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Final Review - Mood Disorder I. Depression a. Symptoms i....

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