Mood and Affective Disorders Flashcards
What are the risk factors for depression?
Bio: - Low monoamines - Being female - Chronic health problem Psycho - Personality type - Poor coping strategies - Mental health co-morbidities Social: - Poor support network - Stressful events
What is beck’s triad for depression?
Negative views about the world
Negative views about oneself
Negative views about the future
What are the core symptoms of depression?
Low mood
Lack of energy
Anhedonia - no pleasure in normally pleasurable activities
What are the other symptoms of depression?
Cognitive: - Suicidal ideation - Guilt/worthlessness - Lack of concentration Biological: - Diurnal mood variation - Loss of appetite - Early morning wakening - Loss of libido - Psychomotor retardation Psychotic - 2nd person auditory hallucinations - Persecutory, nihilistic, guilt, hypochondriacal delusions
How long must symptoms be present for before considering a diagnosis of depression?
> 2 weeks
What are the DSM-IV (NICE guidelines) stages of depression?
Subthreshold: <5 symptoms
Mild: 5 symptoms with minimal functional impairment
Moderate: Somewhere between mild and severe
Severe: Most symptoms with significant impairment
What differentials would you consider for depression?
Functional - bipolar, schizophrenia, seasonal affective disorder
Organic - drug use, dementia, hypothyroidism
How is subthreshold and mild depression managed?
Watchful waiting with monitoring and sleep hygiene advice
Low intensity therapy: Self help, computerised CBT, group physical activity class
Group based CBT
Antidepressants if:
- > 2 years
- Past episode of severe
- Physical health complications
- Failure of other interventions
How is moderate-severe depression managed?
Suicide risk assessment
SSRI
High intensity therapy: CBT, IPT, behavioural activation
When is ECT used in depression?
Life threatening
Psychotic
Severe psychomotor retardation
Failure of other therapies
What is dysthymia?
Depressive state for >2 years which doesn’t meet depression criteria
What is cyclothymia?
Mood fluctuations for >2 years where elation and depression do not meet criteria
What is atypical depression?
Mild-moderate depression with reversal of biological symptoms: e.g. overeating, hypersomnia
What is masked depression?
Mood isn’t the prominent feature however sleep disorders and diurnal mood variation are present?
What is seasonal affective disorder? How is it managed?
Depressive episodes occurring in the winter months
Treated same as mild depression but don’t give sleeping tablets as makes it worse
