mood disorder mcq

13. All of the following are indicators of good response to lithium except
A. Family history of bipolar disorder
B. Good baseline functioning
C. No rapid cycling
D. mixed episode



yes best answer for this question and thank you for explanation

drmahir70 wrote:13. All of the following are indicators of good response to lithium except
A. Family history of bipolar disorder
B. Good baseline functioning
C. No rapid cycling
D. mixed episode

Answer: D



Explanation:

PSYCHOLOGICAL PREDICTORS:
Predictors of a good response to lithium prophylaxis include:
- Initial good response to lithium during the first 6-12 months of treatment (most reliable predictor of a favourable response to lithium)
- Classical pattern of elated manic episodes
- Positive familial history of bipolar disorders (especially those known to be responsive to lithium)
- Absence of comorbid personality disorders
- Bipolar type I disorders
- Melancholic features during depressive episodes
- MDI pattern in the illness course
- Early onset of lithium treatment.

Predictors of a poor response to lithium prophylaxis include:
- Mixed episodes (most reliable predictors of poor response to lithium)
- Rapid cycling bipolar disorders
- Comorbid alcohol and/or drug abuse
- Mood disorders with incongruent psychotic features
- Early onset bipolar disorder before the age of 18
- Discontinuation of lithium treatment
- High number of previous affective episodes in the illness course before lithium initiation and DMI pattern.


ENVIRONMENTAL PREDICTORS:
Being single was found to be the only predictor of a poor response to lithium treatment in prophylaxis.


BIOLOGICAL PREDICTORS:
Predictors of a good response to lithium prophylaxis include:
- High RBC/plasma-lithium ratio (one of the most controversial predictors of a favourable response to lithium in the literature)
- Higher platelet serotonin-induced calcium mobilization
- High rate of red blood cell membrane phospholipids, especially of phosphatidylcholine, and a phospholipid implicated in lithium intracellular transport.
- Brain lithium concentrations above 0.2 mEq/L when measured by 7Li-MRS
- Decreased cerebral intracellular pH and white matter hyper intensity at (31)P-MRS
- High intensity of loudness dependence auditory-evoked potentials (LDAEP)

Predictors of a poor response to lithium prophylaxis include:
- Epileptiform anomalies with diffuse theta waves on electroencephalography
- Decreased cerebral phosphocreatine levels at (31)P-MRS


GENETIC PREDICTORS:
Predictors of a good response to lithium prophylaxis include:
- Lower-inositol-monophosphatase (IMPase-2) mRNA expression
- Higher frequency of phospholipase C isoenzyme gamma1 (PLCG1)-5 repeat allele genes

Predictors of a poor response to lithium prophylaxis include:
- homozygotic forms of the short allele of the serotonin transporter gene (5-HTT),
- presence of the A/A subtype of tryptophan hydroxylase (TPH) gene
- high frequency of human leukocyte antigens type A3 (HLA-A3)

. All of the following immunologic abnormalities are found in depression
except
A. Decreased natural killer cells
B. Decreased interleukin 2
C. Decreased absolute neutrophil count
D. Decreased T-cell replication
E. Increased monocyte activity

drmahir70 wrote:. All of the following immunologic abnormalities are found in depression
except
A. Decreased natural killer cells
B. Decreased interleukin 2
C. Decreased absolute neutrophil count
D. Decreased T-cell replication
E. Increased monocyte activity

I think C.

Regarding Choice C, D & E: Two meta-analytic reviews of immune findings in major depression confirmed the presence of leucocytosis, neutrophilia and lymphopaenia in these patients (Herbert and Cohen, 1993; Zorrilla et al., 2001).

Regarding Choice A: Studies comparing NK cell activity in depressed patients and psychiatric controls or healthy controls have revealed a significant decrease in NK-cell activity in the depressed group. This finding has been considered among the most reliable examples of immune alteration in patients with major depression (Herbert and Cohen, 1993; Stein et al., 1991).

Regarding Choice B: Anisman et al. (1999) noted an increase in the production of IL-1b, notably in dysthymic patients, and a decrease in the production of IL-2.
Weizman et al. (1994) found a decrease in the production of IL-1, IL-2 and IL-3.

Admin wrote:

drmahir70 wrote:. All of the following immunologic abnormalities are found in depression
except
A. Decreased natural killer cells
B. Decreased interleukin 2
C. Decreased absolute neutrophil count
D. Decreased T-cell replication
E. Increased monocyte activity

I think C.

Regarding Choice C, D & E: Two meta-analytic reviews of immune findings in major depression confirmed the presence of leucocytosis, neutrophilia and lymphopaenia in these patients (Herbert and Cohen, 1993; Zorrilla et al., 2001).

Regarding Choice A: Studies comparing NK cell activity in depressed patients and psychiatric controls or healthy controls have revealed a significant decrease in NK-cell activity in the depressed group. This finding has been considered among the most reliable examples of immune alteration in patients with major depression (Herbert and Cohen, 1993; Stein et al., 1991).

Regarding Choice B: Anisman et al. (1999) noted an increase in the production of IL-1b, notably in dysthymic patients, and a decrease in the production of IL-2.
Weizman et al. (1994) found a decrease in the production of IL-1, IL-2 and IL-3.

yes best answer is c