CMN 552 EXAM 1 QUESTIONS WITH VERIFIED
ANSWERS
What two neurotransmitters are most implicated in the pathophysiology of mood
disorders?
norepinephrine and serotonin
How are dopamine levels affected in depression and mania?
Dopamine activity may be reduced in depression and increased in mania
How does depression affect sleep neurophysiology?
Loss of deep (slow-wave) sleep
Increase in nocturnal arousal.
The latter is reflected by four types of disturbance: (1) an increase in nocturnal awakenings, (2) a
reduction in total sleep time, (3) increased phasic rapid eye movement (REM) sleep, and (4)
increased core body temperature. T
What is the most common abnormality found in structural and functional brain imaging in
depressive disorders?
Increased frequency of abnormal hyperintensities in subcortical regions, such as periventricular
regions, the basal ganglia, and the thalamus
What cognitive distortions are commonly seen in depressed patients?
(1) views about the self —a negative self-precept, (2) about the environment—a tendency to
experience the world as hostile and demanding, and (3) about the future—the expectation of
suffering and failure
What is learned helplessness?
the hopelessness and passive resignation an animal or human learns when unable to avoid
repeated aversive events
What "specifiers" are used to describe patients with various mood disorders?
Table 8.1-7
What factors are associated with a poor prognosis for patients with mood disorders?
MDD: The percentage of patients recovering after repeated hospitalization decreases with
passing time. Generally, as a patient experiences more and more depressive episodes, the time
between the episodes decreases, and the severity of each episode increases.
Bipolar I: Have a poorer prognosis than do patients with major depressive disorder. About 40 to
,50 percent of patients with bipolar I disorder may have a second manic episode within 2 years of
the first episode. poor occupational status, alcohol dependence, psychotic features, depressive
features, interepisode depressive features, and male gender were all factors that contributed a
poor prognosis. Short duration of manic episodes, advanced age of onset, few suicidal thoughts,
and few coexisting psychiatric or medical problems predict a better outcome.
Bipolar II: The course and prognosis of bipolar II disorder indicate that the diagnosis is stable
because there is a high likelihood that patients with bipolar II disorder will have the same
diagnosis up to 5 years later. Bipolar II disorder is a chronic disease that warrants long-term
treatment strategies.
What is endogenous depression?
depression with no apparent cause
What characteristics would the clinician see if a patient presented with atypical features in
a depressed patient?
Catatonic features
Postpartum onset
Rapid cycling
Seasonal features
Significant weight gain
Hypersomnia
Leaden paralysis
What diagnostic criteria are required for a patient to receive a diagnosis of Major
Depressive Disorder?
*Five (or more) of the following symptoms have been present during the same 2-week period
and represent a change from previous functioning; at least one of the symptoms is either (1)
depressed mood or (2) loss of interest or pleasure.
Depressed most of the day, nearly every day as indicated by subjective report (e.g., feels sad,
empty, hopeless) or observation made by others (e.g., appears tearful)
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly
every day (as indicated by subjective account or observation)
Significant weight loss when not dieting or weight gain (e.g., change of more than 5% of body
weight in a month), or decrease or increase in appetite nearly every day
Insomnia or hypersomnia nearly every day
Psychomotor agitation or retardation nearly every day (observable by others, not merely
subjective feelings of restlessness or being slowed down)
, Fatigue or loss of energy nearly every day
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly
every day (not merely self-reproach or guilt about being sick).
Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by
subjective account or as observed by others)
Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific
plan, or a suicide attempt or a specific plan for committing suicide
The symptoms cause clinically significant distress or impairment in social, occupational, or other
important areas of functioning.
The episode is not attributable to the physiological effects of a substance or to another medical
condition.
The occurrence of the major depressive episode is not better explained by schizoaffective
disorder, schizophrenia, schizophreniform disorder, delusional disorde
What are some common sleep disturbances experienced by patients with MDD?
Insomnia, hypersomnia.
What psychomotor changes would the clinician see when interviewing a patient with
MDD?
Psychomotor retardation is the most common.
Psychomotor agitation is also seen, especially in older patients.
Agitation: Hair pulling, hand-wringing.
Stooped posture; no spontaneous movements; and a downcast, averted gaze.
Symptoms of psychomotor retardation may appear identical to patients with catatonic
schizophrenia.
What is the prevalence of MDD? How do sex and age of the patient impact these rates?
Prevalence of 5-17%.
Twofold greater prevalence of major depressive disorder in women than in men.
The mean age of onset for major depressive disorder is about 40 years, with 50 percent of all
patients having an onset between the ages of 20 and 50 years.
What is the risk of suicide for patients with MDD?
ANSWERS
What two neurotransmitters are most implicated in the pathophysiology of mood
disorders?
norepinephrine and serotonin
How are dopamine levels affected in depression and mania?
Dopamine activity may be reduced in depression and increased in mania
How does depression affect sleep neurophysiology?
Loss of deep (slow-wave) sleep
Increase in nocturnal arousal.
The latter is reflected by four types of disturbance: (1) an increase in nocturnal awakenings, (2) a
reduction in total sleep time, (3) increased phasic rapid eye movement (REM) sleep, and (4)
increased core body temperature. T
What is the most common abnormality found in structural and functional brain imaging in
depressive disorders?
Increased frequency of abnormal hyperintensities in subcortical regions, such as periventricular
regions, the basal ganglia, and the thalamus
What cognitive distortions are commonly seen in depressed patients?
(1) views about the self —a negative self-precept, (2) about the environment—a tendency to
experience the world as hostile and demanding, and (3) about the future—the expectation of
suffering and failure
What is learned helplessness?
the hopelessness and passive resignation an animal or human learns when unable to avoid
repeated aversive events
What "specifiers" are used to describe patients with various mood disorders?
Table 8.1-7
What factors are associated with a poor prognosis for patients with mood disorders?
MDD: The percentage of patients recovering after repeated hospitalization decreases with
passing time. Generally, as a patient experiences more and more depressive episodes, the time
between the episodes decreases, and the severity of each episode increases.
Bipolar I: Have a poorer prognosis than do patients with major depressive disorder. About 40 to
,50 percent of patients with bipolar I disorder may have a second manic episode within 2 years of
the first episode. poor occupational status, alcohol dependence, psychotic features, depressive
features, interepisode depressive features, and male gender were all factors that contributed a
poor prognosis. Short duration of manic episodes, advanced age of onset, few suicidal thoughts,
and few coexisting psychiatric or medical problems predict a better outcome.
Bipolar II: The course and prognosis of bipolar II disorder indicate that the diagnosis is stable
because there is a high likelihood that patients with bipolar II disorder will have the same
diagnosis up to 5 years later. Bipolar II disorder is a chronic disease that warrants long-term
treatment strategies.
What is endogenous depression?
depression with no apparent cause
What characteristics would the clinician see if a patient presented with atypical features in
a depressed patient?
Catatonic features
Postpartum onset
Rapid cycling
Seasonal features
Significant weight gain
Hypersomnia
Leaden paralysis
What diagnostic criteria are required for a patient to receive a diagnosis of Major
Depressive Disorder?
*Five (or more) of the following symptoms have been present during the same 2-week period
and represent a change from previous functioning; at least one of the symptoms is either (1)
depressed mood or (2) loss of interest or pleasure.
Depressed most of the day, nearly every day as indicated by subjective report (e.g., feels sad,
empty, hopeless) or observation made by others (e.g., appears tearful)
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly
every day (as indicated by subjective account or observation)
Significant weight loss when not dieting or weight gain (e.g., change of more than 5% of body
weight in a month), or decrease or increase in appetite nearly every day
Insomnia or hypersomnia nearly every day
Psychomotor agitation or retardation nearly every day (observable by others, not merely
subjective feelings of restlessness or being slowed down)
, Fatigue or loss of energy nearly every day
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly
every day (not merely self-reproach or guilt about being sick).
Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by
subjective account or as observed by others)
Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific
plan, or a suicide attempt or a specific plan for committing suicide
The symptoms cause clinically significant distress or impairment in social, occupational, or other
important areas of functioning.
The episode is not attributable to the physiological effects of a substance or to another medical
condition.
The occurrence of the major depressive episode is not better explained by schizoaffective
disorder, schizophrenia, schizophreniform disorder, delusional disorde
What are some common sleep disturbances experienced by patients with MDD?
Insomnia, hypersomnia.
What psychomotor changes would the clinician see when interviewing a patient with
MDD?
Psychomotor retardation is the most common.
Psychomotor agitation is also seen, especially in older patients.
Agitation: Hair pulling, hand-wringing.
Stooped posture; no spontaneous movements; and a downcast, averted gaze.
Symptoms of psychomotor retardation may appear identical to patients with catatonic
schizophrenia.
What is the prevalence of MDD? How do sex and age of the patient impact these rates?
Prevalence of 5-17%.
Twofold greater prevalence of major depressive disorder in women than in men.
The mean age of onset for major depressive disorder is about 40 years, with 50 percent of all
patients having an onset between the ages of 20 and 50 years.
What is the risk of suicide for patients with MDD?
