Affective Disorders Flashcards
Define mania
Mental illness marked by periods of great excitement or euphoria, delusions, and overactivity that lasts at least 7 days.
Define hypomania
A mild form of mania, marked by elation and hyperactivity.
Define euthymia
A normal, tranquil state/mood that is neither manic nor depressive, yet distinguishable from the state of healthy (commonly associated with bipolar disorder).
define subthreshold depression
Clinically relevant depressive symptoms that do not meet the criteria for a major depressive disorder.
Define major depression
Persistently depressed mood and long-term loss of pleasure of interest in life
Define mixed state
A state wherein features unique to both depression and mania occur wither simultaneously or in very short succession.
What is unipolar depression?
Unipolar depression is another name for a major depressive episode. This name indicates that the condition is different from bipolar depression.
What can unipolar depression be divided into?
- First occurence
- Recurrent episodes
What is bipolar depression?
reoccurrences of mania and depression
What are the 3 core symptoms of depression (ICD-10)?
- Low mood
- Anhedonia
- Reduced energy levels (anergia)
Give some other symptoms of depression
- Reduced libido
- Change in appetite
- Poor sleep
- Suicidal thoughts
- Poor concentration
- Worthless/guilt
- Psychomotor retardation
Diagnostic criteria for mild depression
2 core symptoms + 2 other
Diagnostic criteria for moderate depression
2 core + 3 other
Diagnostic criteria for severe depression
3 core + 4 other
N.B. Although ICD suggests diagnosing on symptom count, in practise you get to realise what is mild moderate and severe depression without counting symptoms, and realise that level of functioning is also key
Give some risk factors for depression
- Female (2x more common)
- PMH of depression
- Significant physical illness
- Other mental health problems
- Social issues e.g. divorce, unemployment, poverty
- Childhood experience e.g. parental bereavement, sex abuse
How long do symptoms have to be present to make depression diagnosis?
- Need symptoms for at least two weeks
- And NOT secondary to the effects of drug / alcohol misuse, organic illness, or bereavement
What is diurnal mood variation in depression?
Diurnal mood variation, also known as morning depression, refers to depression that is most severe in the morning and typically lessens as the day progresses.
Give some psychiatric differential diagnoses for depression
- Bipolar disorder
- Schizophrenia
- Dementia
- Seasonal affective disorder (SAD)
- Bereavement
- Anxiety
What are some neurological differentials for depression?
Parkinson’s disease
Dementia
MS
Huntington’s disease
What are some endocrine differentials for depression?
Thyroid dysfunction
Hypoadrenalism (e.g. Addison’s disease)
Hyperadrenalism (e.g. Cushing’s disease)
What are some drugs that can cause low mood?
Steroids
isotretinoin (Roaccutane)
alcohol
beta-blockers
benzodiazepines
methyldopa
What are some chronic conditions that can cause low mood?
diabetes
obstructive sleep apnoea
longstanding infections (e.g. mononucleosis)
What cancer can notably cause low mood?
Pancreatic cancer
What assessments would be done in depression?
- Full History
- MSE
- Risk assessment – to self and others
- Cognitive assessment
- PHQ-9 and other questionnaires, hospital anxiety and depression scale
- Physical exam to rule out suspected physical causes
