Term
| Why must we study gender difference? |
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Definition
- impede empathic grasp of condition of the other group
- diagnostic error
- obscures differences in treatment responsiveness and outcome
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Term
| Mental disorders that are more prone in women |
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Definition
depression
panic disorder
GAD
PTSD
eating disorder |
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Term
| Common features with psyc disorders in women |
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Definition
- higher gender ratios
- all are episodic
- all cluster in reproductive years
- all mediated by monoamine neurotransmitters (CNS, PNS, Gut)
- all are influenced by stress
- early trauma
- current stress
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Term
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Definition
- different stressors and resources unequally distributed
- more intimate relationships violence as oppose to population based violence
- degree of social integration/availability of support
- less degree of control/autonomy
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Term
| Effect of female sex hormones on glucocorticoid levels |
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Definition
-
sex hormones may block glucocorticoid feedback levels, leading to persistently high glucocorticoid levels (as seen in depression, PTSD)
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sex hormones cross cell membranes and affect protein synthesis in brain areas involved in stress response
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Term
| Role of CRH in depression |
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Definition
- activate locus coruleus
- center of adrenergic activity mediating, vigilance, anxiety, decreased exploratory behavior
- decrease sleep
- cause anorexia
- GI motility changes
- CRH upreg. by estrogen
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Term
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Definition
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Term
| When during the reproductive cycle are women most susceptible to depression? |
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Definition
| periods of steep change in hormone levels (mood, anxiety, somatic symptoms) |
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Term
| Symptoms of premenstrual dysphoric disorder |
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Definition
- depressed mood, hopelessness, self depricating thoughts
- marked anxiety, tension
- marked affective lability
- persisted and marked anger or irritability or increased interpersonal conflicts
- decrease interest in activities
- difficulty concentrating
- lethargy
- change in appetite
- hypersomnia, insomnia
- feeling overwhelmed
- physical symptoms
- breast tenderness
- headaches
- bloating
Unlike MDD, this only lasts 3-10 days |
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Term
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Definition
| if you give SSRI for 10 days, this should stabilize synaptic serotonin, preventing estrogen from breaking down monoamines |
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Term
| Different post partum mood disorder |
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Definition
post partum blues
post partum depression
post partum psychosis |
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Term
| Symptoms of postpartum blues |
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Definition
- tearfulness
- irritability
- insomnia
- mood lability
- dysphoria
- anxiety
- insomnia
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Term
| Progression of post partum blues |
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Definition
- onset of symptoms in first week
- peaks 3-5 days after delivery
- resolves within 10-14 days
- severeness correlates with risk for PPD
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Term
| Symptoms of PPD are similar to what other disorder? |
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Definition
| major depressive disorder (comorbid anxiety symptoms common) |
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Term
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Definition
| first three months, but can have insidious onset (more than six months) |
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Term
| Symptoms specific to postpartum depression |
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Definition
- ambivalent or negative feelings toward infant
- self doubt concerning ability to care for the child
- obsessive compulsive symptoms (intrusive fears with compensitory rituals)
- suicidal ideation
- attempts rare, but higher than during pregnancy
- having young children is independent protective factor
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Term
| Factors that could predispose one to PPD |
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Definition
- different sensitivity to normal fluctuations in gonadal steroids
- thyroiditis
- Sheehan's syndrome
- anemia
- nutritional deficiencies
- isolation
- victimization by violence
- social role of new mother
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Term
| Effect of PPD on children |
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Definition
| significant intelectual defect if mother depressed in first year of life |
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Term
| Who should be screened for PPD |
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Definition
- adolescents
- women with prior depression, premenstrual dysphoria, social risk factors
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Term
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Definition
- follow up with ob/gyn and peds
- high freq of neurovegatitive symptoms
- change in sleep, energy, apetite, libido
- use Edinburgh postnatal depression scale (EPDS)
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Term
| Phases of treatment in perinatal depression |
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Definition
- prenatally take folate
- first trimester- concern for fetal morphology
- second- concern for growth
- third- birth complications, mother, baby
- first post partum trimester- lactation, parenting
Remember, light treatment helps, and we generally do not have to stop all psyc. drugs unless they are antiepileptic. Electroconvulsive therapy may be the best treatment with minimal fetal risk. |
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