Affective Disorders Flashcards
(64 cards)
What are mood disorders?
Disorders of mental status and function where altered mood is the/a core feature
A term referring to states of depression and of elevated mood
Used interchangeable with affective disorders
Mood disorders are the commonest group of mental disorders, true or false?
True
How can disordered mood present?
As a primary problem or as a consequence of another disorder or illness e.g. cancer, dementia, drug misuse
What are mood disorders often associated with?
Anxiety symptoms and anxiety disorders
What can depression be thought of as?
A symptom, syndrome and recurrent illness
Features of depression as a symptom
An emotion within the range of normal experience
Describes a state of feeling or mood that can range from near-normal experience to severe life-threatening illness
Systemic symptom with similarities to fatigue and pain
Typically considered as a form of sadness, not just an absence of happiness
Features of depression as a syndrome
Constellation of symptoms and signs
Features of depression as a recurrent illness
Recurrent depressive disorder
When does depression become abnormal?
No clear/convenient division Consensus is problematic, often a matter of perspective Psychiatry places emphasis on; - persistence of symptoms - pervasiveness of symptoms - degree of impairment - presence of specific symptoms or signs
What spheres do symptoms of depressive illnesses occur in?
Psychological
Physical
Social
Psychological sphere of depression
Change in mood
- depression
- anxiety, inability to relax
- perplexity, particularly in Puerperal illness
- anhedonia
Change in thought content
- guilt
- hopelessness
- worthlessness
- any neurotic symptomatology e.g. hypochondriasis, agoraphobia, obsessions and compulsions, panic attacks
- ideas of reference
- delusions and hallucinations (if severe)
Physical sphere of depression
Change in bodily function
- energy, fatigue most common
- sleep, commonly insomnia with early wakening, disturbed sleep and difficulty falling asleep
- appetite, more commonly reduced with weight loss
- libido
- constipation
- pain
Changes in psychomotor functioning
- agitation
- retardation
Social sphere of depression
Loss of interests Irritability Apathy Withdrawal, loss of confidence, indecisive Loss of concentration
What is agitation?
State of restless over-activity, aimless or ineffective
What is anhedonia?
Loss of ability to derive pleasure form experience
What is apathy?
Loss of interest in own surroundings
What is anxiety?
Unpleasant emotion in which thoughts of apprehension and fear predominate
What is depression?
Unpleasant emotion in which sadness or unhappiness predominate
What is retardation?
Slowing of motor responses, including speech
What is stupor
State of extreme retardation in which consciousness is intact
The patient stops moving, speaking, eating and drinking
On recovery, can describe clearly events which occurred while stuporose
ICD 10 classification of depression
Symptoms must last for at least 2 weeks
No hypomanic or manic episodes in lifetime
Not attributable to psychoactive substance use or organic mental disorder
If psychotic symptoms or stupor then diagnosis is severe depression with psychotic symptoms - need to exclude other psychotic illnesses first before reaching this diagnosis
Features of somatic syndrome
Marked loss of interest or pleasure in activities that are normally pleasurable
Lack of emotional reactions to events or activities that normally produce an emotional response
Waking 2 hours before normal time
Depression worse in the morning
Objective evidence of psychomotor agitation or retardation
Marked loss of appetite
Weight loss (5% body weight in a month)
Marked loss of libido
ICD 10 core symptoms of depression
Depressed mood that is abnormal for most of the day almost every day for the past two weeks, largely uninfluenced by circumstances
Loss of interest or pleasure
Decreased energy or increased fatiguability
ICD 10 additional symptoms of depression
Loss of confidence or self-esteem
Unreasonable feelings of guilt or self-reproach or excessive guilt
Recurrent thoughts of death by suicide or any suicidal behaviour
Decreased concentration
Sleep disturbance of any sort
Change in appetite
