Mood Disorders Flashcards
What are important conditions to rule out when considering a diagnosis of depression?
- Bipolar disorder
- Hypothyroidism
- Anxiety disorder
- Shizoaffective disorder
- PTSD
What are the core features of depression required for a diagnosis?
Minimum duration of two weeks of;
At least 2
- Loss of interest in pleasure
- Lack of energy
- Low mood
Biological symptoms
- Irritation
- Lack of sleep or too much sleep (early morning waking)
- Appetite changes
- Poor concentration
- Guilt and self blame
- Psychosis with delusions of worthlessness and rotting
How do you treat mild to moderate depression?
Psychosocial interventions to start:
- Self help manual supported by a health care worker
- Computerised cognitive behavioural therapy
- Physical exercise programme
- Sleep hygiene
What is the criteria for mild depression?
4 symptoms of the ICD 10 criteria
What is the criteria for moderate depression?
5-6
What is the criteria for severe depression?
7+
What is the treatment for moderate to severe depression?
Psychosocial interventions + an antidepressant
When should a person diagnosed with mild depression be followed up?
2 weeks time
How do patients with generalised anxiety disorder usually present?
With physical symptoms such as:
Sweating / nausea / SOB / headache / fatigue
How is generalised anxiety disorder diagnosed?
An abnormal response to a stressor leading to symptoms of anxiety for more than 3 weeks and interfering with daily life
What are the symptoms of anxiety?
Cognitive: agitation, feeling of doom, poor concentration, insomnia
Somatic: physical symptoms
Behavioural : avoidance, reassurance seeking, dependence
How is anxiety treated?
Psychosocial interventions and advice:
- Regular non obsessive exercise
- Meditation
- CBT
When do you use medication in anxiety?
NICE recommends one or the other - equal efficacy but no evidence of synergy
What are the differentials for generalised anxiety disorder?
Phobia
OCD
These are related to a particular circumstance
