Affective disorder Flashcards
1
Q
Mood disorder
A
- Mental disorder involving altered mood as the core feature
- Refers to states of depression and of elevated mood → mania
- Commonest group of mental disorder
- Can be primary or secondary to other disorder → cancer, dementia, drug misuse
- Associated with anxiety symptoms and anxiety disorder
2
Q
Classification systems
A
- ICD 10 → international classification of Disease (WHO)
- DSM-5 → diagnostic and statistical Manual of Mental Disorders (American Psychiatric Association)
3
Q
Depression
A
- Symptom
- State of feeling, mood, range from normal experience to severe and life-threatening
- Often systemic → similarities to pain and fatigue and not just an absence of happiness
- Syndrome → cluster of signs and symptoms
- Recurrent illness → recurrent depressive disorder
4
Q
When does depression become abnormal
A
- No hard and fast rule
- Persistence of symptoms
- Pervasiveness of symptoms
- Degree of impairment
- Presence of specific signs and symptoms
5
Q
Presentation of depression
A
- Psychological
- Depression → diurnal variaiton
- Anxiety → inability to relax
- Perplexity → feeling overwhelmed
- Anhedonia → loss of interest
- Guilt
- Hopelessness
- Worthlessness
- Neurotic symptoms
- Agoraphonbia
- Hypochondriasis
- Obsessions and compulsions
- Panic attacks
- Ideas of reference
- Delusions and hallucinations → psychotic symptoms
- Physical
- Energy → fatigue
- Sleep
- Appetite → weight loss
- Libido
- Constipation
- Pain
- Psychomotor functioning → agitation/ retardation
- Social
- Loss of interest
- Irritability
- Apathy
- Withdrawal, loss of confidence, indecisive
- Loss of concentration, registration and memory
6
Q
Key definition
A
- Agitation → restless overactivity
- Anhedonia → loss of pleasure from experience
- Apathy → loss of interest in surroundings
- Anxiety → feeling of apprehension and fear
- Depression → feeling of sadness/ unhappiness
- Retardation → feeling of slowing motor responses including speech
- Stupor → state of extreme retardation with intact consciousness
7
Q
ICD-10 criteria for depression
A
- Last for at least 2 weeks
- No hypomania or manic episodes
- Not related to psychoactive substance use or organic mental disorder
- No psychotic symptoms or stupor → must rule out schizoprenia or other psychotic illness
8
Q
Somatic syndrome
A
- Marked loss of interest or pleasure in activities
- Lack of emotional reaction → events or activities that normally produce emotional response
- Waking 2 hours before normal time
- Depression worst in the morning
- Marked loss of appetite
- Weight loss (5% BM in a month)
- Marked loss of libido
9
Q
Criteria for mild, moderate and severe depression
A
- Depressed mood
- Loss of interest or pleasure
- Decreased energy or increased fatiguability
- Mild depression → 2
- Moderate depression → 2
- Severe → 3
- At least 4 of the following criteria
- Loss of confidence/ self-esteem
- Unreasonable guilty
- Recurrent thoughts of suicide
- Decreased concentration
- Agitation/ retardation
- Altered appetite
- Mild depression → 4
- Moderate depression → 6
- Severe depression → 8
10
Q
Post-natal depression
A
- Increased risk of admission 30 days following birth
- 75% experience ‘blues’ within 2 weeks
- 10% develop MDD within
- Not associated with hormonal changes go puerperium
11
Q
Differential diagnosis of depression
A
- Situational depression
- Seasonal Affective Disorder
- Dysthymia
- Cyclothymia
- Bipolar disorder
- Organic mental illness → stroke, tumour, dementia
- Hypothyroidism, Addison’s hyperparathyroidism
- Infection → influenza, mononucleosis hepatitis, HIV/AIDS,
- Drugs
12
Q
Management of depression
A
- Antidepressants
- Selective Serotonin Reuptake Inhibitor
- Tricyclic antidepressants (TCA)
- Monoamine Oxidase Inhibitors
- Atypicals
- Psychotherapy → CBT, IPT, individual dynamic therapy, family therapy
- Physical therapy → ECT, psychosurgery, Deep brain stimulation, vagal nerve stimulation
13
Q
Measurement tools
A
- SCID → Structured Clinical Interview for DSM disorder
- SCAN → Schedules for Clinical Assessment in Neuropsychiatry)
- HDRS → Hamilton Depression Rating Scale
- BDI-II → Beck Depression Inventory II
- HADS → Hospital Anxiety and Depression Scale
- PHQ-9 → Patient Health Questionnaire 9
14
Q
Mania
A
- State of feeling, mood, ranging from near-normal to severe and life-threatening
- Rarely a symptom
- Associated with grandiose ideas, disinhibition, loss of judgement
- Similar to the mental effects of taking stimulant drugs (amphetamines and cocaine)
- Pathological and inappropriate elevated mood
15
Q
Characteristics of mania
A
- Similar to classification of depression
- Persistent
- Pervasive
- Degree of impairment
- Presence of specific signs or symptoms
