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Adjustment Disorder
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Bipolar Disorders
Epidemiology Onset Prognosis COURSE & PROGNOSIS: With DDx, always think: Bipolar I Disorder Bipolar II Disorder MANIC EPISODE Hypomanic Episode Mixed Features DEPRESSIVE EPISODES: Mental state Exam Depression Mania Appearance & Behaviour: generalised psychomotor retardation is the most common Sx (although ψ-motor agitation is seen, esp. in elderly 🡪 agitation…
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Depression (kids)
Presentation MDD symptoms How symptoms may present in a child Depressed mood Irritable, temper outburst, cranky, unhappy, miserable Anhedonia/lack of interest Loss of interest in pleasurable activities (eg does not want to see friends, do usual activities) Somatic symptoms Stomach ache, headache, musculoskeletal pain, fatigue Sleep disturbance Change in sleep…
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Major Depressive Disorder (MDD)
EPIDEMIOLOGY Prognosis having a longer duration of depression before initiation of Tx → these pts may benefit from long-term antidepressant Tx Risk factors DSM-IV-TR for Major Depressive Episode (SADAFACES) S – sleep (insomnia esp. terminal or hypersomnia) A – anhedonia (loss of interest/pleasure in all activities most of the day)…
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Mood Disorders
ELEVATED MOOD DEPRESSED MOOD expansivenessflight of ideasdecreased sleepheightened self-esteemgrandiose ideas loss of energy & interestguilt feelingsdifficulty concentratingloss of appetite thoughts of death/suicide MOOD DISORDER FEATURES Major Depressive Disorder (Unipolar depression) only major depressive episodes (at least 2/52) Bipolar disorder both manic & depressive episodes or if mania alone (mania alone also…
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Suicide Risk screening
So how do you ask about suicide? Explore ambivalence: reasons to die vs. reasons to live RISK LEVEL/INTERVENTION RISK FACTORS FOR SUICIDE: “SADPERSONS” If have untreated depression 🡪 10-15% risk of suicide If have psychosis 🡪 15% risk of suicide 🡪 risk is greatest once they are discharged, the delusions…