Twice as common in females as male
MDD criteria 5 or more of the following symptoms
1. Depressed mood
2. Sleep Changes
3. Interest loss
... [Show More] (anhedonia)
4. Guilt (worthlessness)
5. Energy loss
6. Concentration Reduction
7. Appetite Change
8. Psychomotor change
9. Suicide ideation/thoughts
a. i.e. SIGECAPS
b. Must last for 2 weeks or more
c. Must not be caused by other condition
i. Including substance use
d. Treatments include
i. Psychotherapy
ii. Medications (SSRI, SNRI, MAOis, TCAs)
iii. ECT for refractory (Electroconvulsive therapy)
Mania – 3 or more of the following
1. Distractability
2. Irresponsibility/irritability/impulsiveness
3. Grandiose
4. Flight of Ideas
5. Activity increase
6. Sleep decrease
7. Talkative
a. DIGFAST
b. For at least 1 week for an episode
c. Must cause significant impairment
d. Not attributable to substances
Hypomania – 3 or more of DIGFAST
1. For at least 4 days
2. No significant impairment – able to function
Bipolar 1 - Requires 1 episode of mania, and may include episodes of depression and hypomania
Bipolar 2 – Requires at least one episode of hypomania and an episode of major depression
Treatment include mood stabilizers (lithium/valproate first line. Also lamotrigine, quetiapine, and
atypical antipsychotics for acute mania)
Cyclothymic disorder – alternates between hypomania and depression. Suffer some symptoms of
DIGFAST, but not for 4 days. Also suffers criteria of SIGECAPS, but not enough to diagnose .
1. Symptoms present for 2 years or more
2. Treat with CBT and lithium, atypical antipsychotics
Persistent depressive disorder (aka dysthymic d/o).
1. Decreased mood and SIGECAPS symptoms without meeting full MDD criteria for 2+ years;
described as baseline sadness; still enjoy some things
2. Treat with CBT first and then SSRIs
Adjustment disorder
1. Mood/anxiety symptoms < 3 months after a stressor, typically resolving within 6 months
2. Treat with supportive therapy and meds for symptoms (insomnia, nausea etc)
Week 4
GAD
1. 5-10% lifetime prevalence. 2:1 women vs men
2. Definition: excessive worrying and anxiety for > 6 monhts
a. Worry about school/grades, job, money, relationships, events, life
b. Pathophys: Disrupted functional connectivity of the amygdala and its processing of fear
and anxiety
3. Dx criteria: at least 3 of the following
a. Restlessness
b. Tires easily
c. Problems concentrating
d. Irritability
e. Muscle tension
f. Problems with sleep
i. Symptoms must interfere with daily functioning
4. Treatment:
a. Psychotherapy: CBT
b. Pharmacotherapy: SSRI, SNRI, buspirone, short-term benzos
c. AMYGDALA problem
Specific phobias
1. >10% lifetime prevalence; 2:1 women vs men
2. Definition: irrational fear of a specific object, place, situation, or concept for 6+ months
a. Fear out of proportion to immenent threat
b. Fear interferes with functioning in society
c. Exposure induces immediate fear; removal reduces anxiety
d. Fear might have developed from related trauma (fear of water post near-drowning)
e. SOCIAL PHOBIA: fear of embarrassment in public situation
f. Agoraphobia: fear of public places due to lack of ability to escape; fear of unsafe
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