2 - PSY - Depression Flashcards Preview

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Flashcards in 2 - PSY - Depression Deck (21):
1

Core Sx of depression

low mood
loss of interest and enjoyment
reduced energy

2

Additional symptoms of depression

reduced concentration
reduced confidence and self esteem
ideas of guilt and unworthiness
pessimism about the future
ideas/acts of self harm/suicide
disturbed sleep
changes in appetite

3

symptoms of somatic syndrome

reduced appetite
wt loss
early morning wakening
diurnal variation in mood
psychomotor agitation/retardation
loss of libido
anhedonia
blunted affect

4

Depression with psychosis - which hallucinations?

olfactory - filth/rotting flesh
2nd person auditory - accusing etc

5

Depression with psychosis - delusions - 4 points

-mood congruency with (low mood)
-worthlessness/guilt/ill health/poverty/disaster
-nihilistic delusions
-persecutory delusions may occur

6

Mild depressive episode criteria

2/3 core Sx
+additional Sx - totalling to 4 Sx
-w/w/o somatic syndrome

7

Moderate depressive episode

2/3 core Sx
+additional Sx totalling to 6 Sx
-w/w/o somatic syndrome

8

Severe depressive episode

3 core Sx
+additional Sx totalling to 8 Sx

9

Severe depressive episode with psychotic symptoms

3 core Sx
+ additional Sx totalling to 8 Sx
+delusions/hallucinations/depressive stupor

10

Epidemiology of depression:
m:f
lifetime prev
point prevalence

M:F = 1:2
lifetime prev = 10-20%
point prev = 5%

11

Biological aetiology

genetics, hormonal changes, substance misuse, serious illness

12

Psych aetiology

learned helplessness
negative thoughts
psychodynamic defence mechanisms

13

social aetiology

life events
social isolation
bereavement
loss
childhood abuse
social adversity

14

Bio Tx of depression

antidepressants 1st line SSRI
ECT for severe
Augmentation with Lithium/T3/atypical AP in treatment resistant depression

15

Psych Tx of depression

psychoeducation
CBT
Interpersonal therapy
self help materials

16

Social Tx of depression

carer support
support with regard to housing, benefits, education, training, employment
CPN and OP appntmts to monitor Sx, mood, mental state for severe depression
work around social inclusion

17

Step 1 of management

assessment, monitoring, psychoeducation, CBT on computer, sleep hygiene, guided self help

18

Step 2 of management (mild/mod)

primary care - low intensity psych interventions, -medication (SSRI)

19

Step 3 of management (mod/severe)

primary care - medication, high intensity psych interventions, consider secondary care referral

20

Step 4 of management (severe complex/severe self neglect)

Secondary care

-meds
-high intensity psych interventions
-ECT
-Crisis team
-MDT approach
-inpatient care

21

preventing relapse - how long pharmacotherapy following recovery from single epsiode + recurrent depression?

6 months for single episode
2y for recurrent depression

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