Mood (Affective) Disorders
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| 1. According to Leonhard: | |
| A. Bipolar includes only mania |
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| B. Bipolar I is hypomanic episodes |
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| C. Bipolar II is manic episodes |
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| D. Bipolar III is unipolar illness with bipolar disorder in 1st degree relatives |
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| E. Unipolar illness can include one episode of mania, but is predominantly depressive |
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| 2. In the discussion between endogenous vs. reactive depression: | |
| A. In psychotic depression, a continuum theory is most likely |
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| B. Paykel (1971) found 6 groups of depressive patients |
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| C. Cyclothymia never becomes major affective disorder |
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| D. Dysthymia and major depressive episodes can occur and are called 'double depression' |
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| E. Cyclothymia is common in relatives of patients with major depressive illness |
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| 3. The following are specific to a diagnosis of mania (not hypomania) in ICD-10: | |
| A. Flight of ideas |
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| B. Increased sexual energy |
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| C. Inflated self esteem or grandiosity |
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| D. Overfamiliarity |
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| E. Reckless or irresponsible behaviour |
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| 4. The following are true of Bipolar Affective disorder: | |
| A. One year prevalence of 1 % |
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| B. Mean age of onset is 21 years |
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| C. Rates are higher in rural areas |
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| D. It is more common in females |
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| E. Marriage has no association with BAD |
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| 5. Regarding the aetiology of Bipolar Affective disorder: | |
| A. The 'genetic loading' for mood disorder is greater in unipolar depressives than in manic depressives |
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| B. The long arm of Chromosome 11 has been implicated |
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| C. The gene for tyrosine hydroxylase is on chromosome 11 |
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| D. The long arm of the X chromosome has been implicated |
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| E. There is an excess of life events preceding depression, but not mania |
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| 6. Regarding treatment of bipolar affective disorder: | |
| A. About 50 % of rapid-cycling patients are lithium resistant |
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| B. About 75 % of bipolar affective patients (non-rapid-cycling) will respond to lithium |
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| C. The response rate for carbamazepine is the same as that for lithium |
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| D. Valproate may have a role in mixed affective disorder |
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| E. Clozapine has no role in treatment of BAD |
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| 7. The following are true of depressive illness: | |
| A. Depression has a lifetime prevalence of about 6 % |
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| B. 25 % of men and 35 % of women have experienced depressive symptoms by the age of 65 |
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| C. Depressive symptoms have a point prevalence of about 15 % |
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| D. The one-month prevalence is about 2 % |
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| E. Women suffer twice as commonly as men |
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| 8. Regarding the demographics of depression: | |
| A. The mean age of onset is 27 years |
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| B. Women have the peak age of onset in their 40s, while men have the peak onset in their 30s |
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| C. Lower social groups have a higher incidence of depression |
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| D. There is clear ethnic variation in the UK |
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| E. There is an association between smoking and depression |
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| 9. The following are recognized risk factors for depression: | |
| A. Divorce |
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| B. Living in industrialized countries |
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| C. Urban habitation |
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| D. Obsessional personality traits |
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| E. Neuroticism |
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| 10. Regarding the aetiology of depression: | |
| A. An autosomal dominant transmission is suggested by the uniform morbidity risk among parents, children, and siblings |
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| B. There is no association with parental discord |
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| C. Parental factors include lack of care and overprotection |
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| D. 25 % of depressive episodes are precipitated by life events |
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| E. The risk of depression is increased sixfold in the six months following threatening life events |
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| 11. Brown and Harris found the following to be vulnerability factors for depression: | |
| A. Three or more children under the age of 15 at home |
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| B. Alcoholic husband |
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| C. Loss of mother before the age of 11 |
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| D. Wide social support network |
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| E. Neurotic personality traits |
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| 12. Regarding the psychological theories of depression: | |
| A. Freud said that depression was due to envy |
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| B. Abraham proposed that failure to develop relationships other than the primary love object resulted in depression |
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| C. The concept of 'learned helplessness' was proposed by Wolpe |
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| D. Klein said that if the depressive position was not negotiated, then depression would be more likely in later life |
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| E. 'Ambivalence' occurs when feelings of love and hostility are present at the same time |
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| 13. In Beck's cognitive theory: | |
| A. 'Arbitary inference' occurs when conclusions are based on only one incident |
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| B. 'All-or-nothing' thinking is known as 'dichotomous reasoning' |
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| C. 'Overgeneralization' are conclusions that are formed in the absence of evidence |
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| D. A 'stress-diathesis' model is used |
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| E. 'Selective abstraction' occurs when a person abstracts from the whole situation and focuses on a single incident |
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| 14. The following biochemical changes have been observed in depressed patients: | |
| A. Decreased platelet 5-HT uptake |
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| B. Decreased 5-HT2 receptor binding in platelets |
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| C. Increased prolactin response to clomipramine |
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| D. Decreased growth hormone release in response to clonidine |
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| E. Reduced beta-adrenergic receptors in suicide victims |
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| 15. The following statements are true: | |
| A. Bipolar I is characterized by hypomanic episodes only |
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| B. Bipolar II is characterized by manic episodes and hypomanic episodes |
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| C. The term 'melancholia' in DSM-IV is equivalent to somatic symptoms in ICD-10 |
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| D. 'Endogenous' depression is characterized by somatic symptoms |
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| E. 'Reactive' depression is characterized by anxiety, irritability, and phobias |
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| 16. Cyclothymia: | |
| A. Is more common in males |
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| B. Has a prevalence of around 5 % |
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| C. Has its onset usually between the ages of 15 and 25 |
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| D. Results in a diagnosis of bipolar disorder in around a third of patients |
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| E. Antimanic drugs are usually ineffective |
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| 17. Dysthymia: | |
| A. Usually presents after the age of 25 |
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| B. Is associated with chronic medical illness |
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| C. Is more common in women, and the unemployed |
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| D. 20 % of patients will develop bipolar disorder |
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| E. Treatment does not involve antidepressant drugs |
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| 18. Bipolar affective disorder is associated with: | |
| A. Alcoholism |
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| B. Schizoaffective disorder |
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| C. Obsessive compulsive disorder |
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| D. Anxiety states |
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| E. Cyclothymic personality |
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| 19. Bipolar affective disorder: | |
| A. Is more common in males |
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| B. Has a lifetime risk of about 1 % |
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| C. Usually presents in the early 20s |
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| D. Is more common in urban areas |
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| E. Has been associated with higher rates in higher social classes |
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| 20. Regarding the aetiology of bipolar disorder: | |
| A. Monozygotic concordance is around 55 % |
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| B. The risk in 1st degree relatives is about 25 % |
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| C. Chromosome 11 has been implicated |
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| D. Chromosome Y has been implicated |
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| E. Excess life events can precipitate manic episodes |
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| 21. Rapid cycling mania: | |
| A. Was described by Kendler |
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| B. Has equal incidence in males and females |
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| C. Is associated with good response to lithium |
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| D. Valproate can be effective |
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| E. Is associated with a worse prognosis |
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| 22. Regarding other presentations of depressive illness: | |
| A. Agitated depression is more common in the elderly |
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| B. Retardation predicts a poor response to ECT |
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| C. Masked depression is more common with mild/ moderate illness |
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| D. Brief recurrent depression has no link with the menstrual cycle |
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| E. Atypical depression may be characterized by hypersomnia, and overeating |
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| 23. Regarding the demographics of depression: | |
| A. It has an equal sex ratio |
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| B. Lifetime prevalence is about 6 % |
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| C. One month prevalence is 2 % per 100 people |
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| D. Highest 1 year prevalence is in the 45-65 age group |
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| E. Lifetime prevalence increases with age |
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| 24. Depression is more common in: | |
| A. Lower social class |
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| B. Urban areas |
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| C. Industrialized countries |
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| D. Those who are cohabiting |
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| E. The unemployed |
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| 25. The following are reported risk factors for depressive illness: | |
| A. Neurotic personality |
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| B. Childhood abuse |
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| C. Loss of father before the age of 11 |
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| D. Three or more children at home above the age of 15 |
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| E. Low self esteem |
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| 26. The following are true of psychoanalytical theories of depression: | |
| A. Depression is a defence against mania |
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| B. Depression occurs when love and hostility are present at the same time |
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| C. Regression can occur |
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| D. Failure to negotiate the 'depressive position' of childhood |
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| E. Learned helplessness was described by Joseph Wolpe |
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| 27. The following drugs are associated with depression: | |
| A. Propanolol |
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| B. Methyldopa |
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| C. Reserpine |
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| D. Steroids |
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| E. Valproate |
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| 28. The following are true in depression: | |
| A. There is increased plasma tryptophan concentration |
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| B. There is reduced levels of 5-HIAA in the CSF of suicide victims |
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| C. The prolactin response to Clomipramine is reduced |
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| D. The prolactin response to L-Tryptophan is mediated by 5-HT receptors |
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| E. CSF HVA levels are reduced |
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| 29. The following are true in depression: | |
| A. There is a reduced response to CRH |
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| B. There is reduced GH release in response to Clonidine |
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| C. Somatostatin levels are raised |
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| D. Cortisol levels are suppressed by Dexamethasone |
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| E. There is a blunted TSH response to TRH |
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| 30. The following are true of sleep in depression: | |
| A. EEG shows increased stage 3 and 4 sleep |
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| B. Increase in REM sleep towards the end of the night |
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| C. Decreased latency to REM sleep |
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| D. Antidepressant drugs decrease REM sleep time |
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| E. EEG changes always resolve in depressed patients |
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| 31. The following have been observed in depression: | |
| A. Enlarged lateral ventricles |
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| B. Loss of temporal lobe volume |
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| C. Reduction in the size of the caudate nucleus |
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| D. Increased blood flow in the basal ganglia |
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| E. Decreased blood flow in the cingulate cortex |
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| 32. In bipolar disorder: | |
| A. Depression is the most common first presentation |
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| B. The first manic episode is usually before the age of 30 |
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| C. Manic episodes last longer than depressive episodes |
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| D. The median length of a manic phase is 3 months |
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| E. The frequency of episodes increases in the first 10 years |
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| 33. In depression: | |
| A. 10 % will have chronic, unremitting course |
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| B. 25 % have a recurrence within a year |
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| C. 10 % will eventually have a manic episode |
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| D. Mood incongruent delusions indicate a better prognosis |
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| E. Recurrence is associated with late age of onset |
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| 34. The following are risk factors for bipolar disorder, after a depressive episode: | |
| A. Psychotic symptoms |
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| B. Postpartum depression |
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| C. Older age at onset |
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| D. Psychomotor agitation and hyperactivity |
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| E. Feelings of guilt |
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