Depressive Disorder
What is the most common psychological disorder?
Major Depressive Disorder
Generalized excessive emotional state of fear and apprehension, associated with arousal
GAD: generalized anxiety disorder is excessive and persistent worry (chronic)
How do the 3 types of bipolar disorder differ?
Bipolar I: Severe manic episodes followed by extreme depression- cyclical mood swings
Bipolar II: cyclical mood swings with hypomanic episodes
Cyclothymic disorder: least severe mood swings
What populations are at highest risk for suicide?
10-14 yr olds and 20-34 yr olds
What are the risk factors for developing an eating disorder
Personality traits: perfectionism, athlete
Family hx of dieting obsession, obesity, drug or alcohol abuse
20% of women with type 1 DM may have eating disorder
What are some clinical manifestations of MDD?
It can be a single episode or intermittently throughout life
Severely depressed mood, loss of interest in activities
Decreased energy, sleep disturbances
What are the sxs of an anxiety disorder?
sleep disorders, GI problems, HA, bruxism (grinding teeth in sleep), tachycaridia, dyspnea, dizziness
What is the prognosis of bipolar disorder?
Chronic and recurring, half of those who are diagnosed deny any problems
What are some causes of suicidal behavior?
Biochemical, clinical, genetic and social factors
Describe the differences between the 3 eating disorders
Anorexia Nervosa: self induced malnutrition, calorie restriction, POOR prognosis, increases risk of suicide, denies hunger, dehydration-swelling cycles, refeeding syndrome
Bulimia Nervosa:episodic binge eating and then purging and/or excessive exercise, appears normal or overweight, BEST prognosis
Binge-Eating disorder: binging or compulsive overeating, rapidly eating large amount until uncomfortably full, appears obese
What is the diagnostic criteria for MDD?
What is the diagnostic criteria for someone with anxiety?
Sxs present for more than 1 month
GAD: sxs have to be present for more than 3 months
What would lead to a diagnosis of schizophrenia?
2 or more of the following sxs 1x a month: hallucinations, delusions, disorganized speech, grossly disorganized/catatonic behavior
What are the warnings and red flags of suicidal behavior?
Loss of interest socially, changes in mood, sleep, appetite, substance use, signs of depression
Red Flags: saying goodbye, giving away possessions, making final arrangements, buying gun or collecting medications
What is the pathogenesis of eating disorders? How are they treated?
Low energy availability (LEA)
Prevention is first line of defense, treatment with meds and CBT and nutritional therapy
How is SAD (seasonal affective disorder) different from MDD?
SAD occurs in a seasonal pattern, increases with less daylight and improves as daylight increases
Could be linked to hypersensitivity of melatonin
What are the types of symptoms present in PTSD?
3 types of sxs
Intrusion: re experiencing trauma, nightmares
Avoidance: social withdrawal, becoming numb to feelings
Hyperarousal: anxiety, being on guard, panic attacks
Bipolar: chronic and recurrent, deny they have any problems
Schizophrenia: up to 50% have good outcomes, complete recovery is rare, 20% make suicide attempts (6% succeed)
QPR (Question, Persuade, Refer)
Question the person, persuade them to get help, refer for help
Remind them medications often take 3-4 weeks to take effect
What can PTs do to prevent an eating disorder?
Education!!!
Screen athletes and others- female athlete triad
Use worksheets/charts to improve self awareness
Council against excessive exercise and promote healthy body image acceptence
How can PTs help patients with depressive disorders?
Screen every patient with PHQ-2, document in chart, screen for CV RF
Offer encouragement and point out improed sxs or function
Physical activity can PREVENT and TREAT mild/moderate depression!!!
How does the prognosis of anxiety differ from PTSD?
Anxiety: has a good prognosis, treatment is very effective but depression can complicate progress
PTSD: begins within 6 months of trauma and usually resolves within 12 months, depending on support and treatment
What can PTs do to help manage patients with bipolar and schizophrenia?
Aerobic exercise can improve severity of symptoms!!
Yoga, deep breathing, support group
Antipsychotic meds are NECESSARY to manage symptoms but we need to watch for side effects: dehydration, HA, confusion, movement disorders: parkinson disorders
All of them
Which eating disorder has the worst prognosis? Which is the best?
Anorexia Nervosa- worst
Bulimia Nervosa- best
Binge-Eating- 80% recovery byt high relapse risk