Affective disorders Flashcards Preview

202: Theme 3, Modulatory systems in psychiatry > Affective disorders > Flashcards

Flashcards in Affective disorders Deck (19)
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1
Q

Process of diagnosing an affective illness

A
  1. Patient presents with symptoms in their chronology
  2. A psychiatric history is taken
    - Takes into account how symptoms have presented overtime
  3. A mental state examination is taken
2
Q

Features of the mental state examination

A

Appearance and behaviour

Speech

Mood

Thought

Perception

Cognition

Insight

3
Q

Appearance and behaviour

- Mental state examination

A
  • Lack of personal care can indicate self neglect [depression
  • Body language
  • Psychomotor retardation [depression]
  • Agitation
4
Q

Speech assessment for mental status examination

A

The production of spontaneous speech is assessed

  • Rhythm [fast in mania, slow in depression]
  • Pace [can be slow in depression]
  • Loudness [Loud in mania, quiet in depression]
  • Articulation
  • Latency
  • Phonation
  • Intonation
5
Q

Thought assessment for MSE

A

Assesses one’s thought contents and how it adheres to reality

Can have a flight of ideas
- Thoughts so rapid that speech becomes incoherent

Delusions:
Of guilt- Can rarely present in depression

Suicidal thoughts

Overvalued ideas
Obsessions
Phobias
Preoccupations.

6
Q

Perception assessment for MSE

A

Assesses the presence of:

  • Hallucinations
  • Illusions

Auditory hallucinations can appear in depression
- Congruent to one’s mood

7
Q

Cognitive assessment for MSE

A

Assesses:

  • Memory [impaired in depression]
  • Attention [Impaired in depression]
  • Intelligence
  • Orientation
  • Executive functions
8
Q

Insight assessment for MSE

A

Assesses one’s understanding of their illness.

  • Depressed individuals usually have a great understanding of their depression
  • Psychotic believe their hallucination + delusions
9
Q

Mood assessment for MSE

A

Assessed by the individual describing what their mood is
- Anhedonia [cannot experience pleasure/ motivation]
-

10
Q

Affect

A

Apparent emotion that can be observed from a person
- Can be congruent or incongruent to one’s thoughts

Congruent- suggestive of depression
Incongruent- suggestive of schizophrenia

11
Q

Major depressive episode

  • Symptoms [9]
  • DSM V criteria
A

MUST occur to be diagnosed as depressive

  • Depression of mood
  • Anhedonia

Others [at least 3 more to concur with depression, for at least 2 weeks]

  • Insomnia/ hypersomnia
  • Weight gain/loss/ change in appetite
  • Feeling of inappropriate guilt/ worthlessness
  • Inability to concentrate or be decisive
  • Suicidal thoughts/ attempt
  • Fatigue/ loss of energy
  • Psychomotor agitation/ retardation
12
Q

Melancholic depression [7]

A

Depressive disorder characterised by:

  • Loss of pleasure in all or almost all activities
  • Lack of reactivity

Despondent
Excessive guilt

Early morning awakening, better at night

Psychomotor retardation

Anorexia/ weight loss

13
Q

Atypical depression

A

Type of depressive order characterised mainly by mood reactivity.

Also includes:

  • Hypersomnia
  • Weight gain/ increased appetite
  • Leaden paralysis
  • Interpersonal rejection sensitivity
14
Q

Manic episode DSM V diagnosis

A

Persistent presentation of an elevated, expansive or irritable mood.

  • At leat a week, most of the day
  • Severe enough to cause functional impairment or hospitalisation

At least 3 symptoms:

  • Grandiosity
  • Decreased need for sleep
  • Very talkative
  • Flight of idea/ racing of thoughts
  • Distractibility
  • Increased goal-directed activity
  • Excessive involvement in high risk activity.
15
Q

Hypomanic episode diagnostic criteria

A

Less severe form of mania–> At least days
- Does not cause functional impairment of hospitalisation

At least 3 symptoms:

  • Grandiosity
  • Talkative
  • Racing of thoughts/ flight of ideas
  • Psychomotor agitation
  • High risk activities
  • Decreased need for sleep
16
Q

Mixed affective episide

A

When the full criteria is met for either a hypomanic, manic or depressive episode
AND

At least 3 other symptoms of the opposite polarity presents.

17
Q

Major depressive disorder epidemiology

  • Onset
  • Sex
  • Time period
  • Course
  • Lifetime prevalence
  • Suicide rates
A

Onset: Age 25-35

Sex: More present in females

Time period: Variably across 12 months

Lifetime prevalence: 20%

Suicide rates: 8-19%

18
Q

Bipolar disorder diagnosis

- Type 1 and 2

A

Type 1
- At least one manic episode

Type 2:
- At least one HYPOmanic episode with a major depressive episode

19
Q

Bipolar epidemiology

  • Peak onset
  • Prevalence
  • Genetics
  • Sex
  • Suicide rate
  • Time course
A

Peak onset: 15-24

Prevalence= 0.6-2.4%

Genetics= Individual has a 10x higher risk of developing it if 1st degree relative is affected

Sex: Both men and women affected equally

Suicide rate: >20 higher than general population

Time course:

  • Most of life is spent asymptomatic BUT almost half is spent symptomatic
  • Nearly a third of the time is in a depressive state