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Year 3 - Psychiatry > Affective Disorders > Flashcards

Flashcards in Affective Disorders Deck (47)
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1

What are mood disorders?

Disorders of mental status and function where altered mood is the (or a) core feature

They are the most common group of mental disorders

2

What is mania?

A term referring to states of depression and of elevated mood

3

A term referring to states of depression and of elevated mood?

Mania

4

What disorders/symptoms are often associated with mood disorders?

Anxiety

5

What are the causes of mood disorders?

Disordered mood can present as a primary problem or as a consequence of other disorder or illness, e.g. cancer, dementia, drug misuse or medical treatment (steroids)

6

How are mood disorder classified?

Using the

ICD-10 (International Classification of Disease 10th Edition – World Health Organisation)

or

DSM-5 (Diagnostic and Statistical Manual of Mental Disorders 5th Edition – American Psychiatric Association)

7

What is depression?

An emotion within the range of normal experience:

> Describe a state of feeling, or mood, that can range from normal experience to severe, life-threatening illness

> A ‘systemic’ symptom (complaint) with similarities to fatigue and pain

> Typically considered as a form of sadness, not just an absence of happiness

8

In terms of depression what emphasis does psychiatry place emphasis on?

Psychiatry places emphasis on:
1. persistence of symptoms
2. pervasiveness of symptoms
3. degree of impairment
4. presence of specific symptoms or signs

9

Which three spheres can symptoms of depression fall under?

1) Psychological
2) Physical
3) Social

10

Which three spheres can symptoms of depression fall under - Psychological?

CHANGE IN MOOD:
1) DEPRESSION - May find diurnal variation

2) ANXIETY - inability to relax

3) PERPLEXITY - particularly in Puerperal illness

4) ANHEDONIA

CHANGE IN THOUGHT CONTENT:
1) GUILT

2) HOPELESSNESS

3) WORTHLESSNESS

4) ANY NEUROTIC SYMPOMATOLOGY e.g.. Hypochondriasis, agoraphobia, obsessions & compulsions, panic attacks.

5) IDEAS OF REFERENCE

6) DELUSIONS AND HALLUCINATIONS if severe

11

Which three spheres can symptoms of depression fall under - Physical?

CHANGE IN BODILY FUNCTION
1) ENERGY - Fatigue

2) SLEEP

3) APPETITE - weight loss

4) LIBIDO

5) CONSTIPATION

6) PAIN

CHANGE IN PSYCHOMOTOR FUNCTIONING:
1) AGITATION

2) RETARDATION

12

Which three spheres can symptoms of depression fall under - Social?

1) LOSS OF INTERESTS

2) IRRITABILITY

3) APATHY

4) WITHDRAWAL, LOSS OF CONFIDENCE, INDECISIVE

5) LOSS OF CONCENTRATION, REGISTRATION & MEMORY

13

Definition of symptoms - Agitation?

A state of restless overactivity, aimless or ineffective

14

Definition of symptoms - Anhedonia?

Loss of ability to derive pleasure from experience

15

Definition of symptoms - Apathy?

Loss of interest in own surroundings

16

Definition of symptoms - Anxiety?

An unpleasant emotion in which thoughts of apprehension or fear predominate

17

Definition of symptoms - Depression?

An unpleasant emotion in which sadness or unhappiness predominates

18

Definition of symptoms - Retardation?

A slowing of motor responses including speech

19

Definition of symptoms - Stupor?

A 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 whilst stuporose

20

General criteria for depression - ICD10?

1) Last for at least 2 weeks

2) No hypomanic or manic episodes in lifetime

3) Not attributable to psychoactive substance use or organic mental disorder

4) If psychotic symptoms or stupor then severe depression with psychotic symptoms
> Need to exclude other psychotic illnesses first like schizophrenia

21

General criteria for depression, somatic syndrome - ICD10?

1) Marked loss of interest or pleasure in activities that are
normally pleasurable

2) Lack of emotional reactions to events or activities that normally produce an emotional response

3) Waking 2 hrs before the normal time

4) Depression worse in the morning

5) Objective evidence of psychomotor agitation or retardation

6) Marked loss of appetite

7) Weight loss (5%+ of body weight in a month)

8) Marked loss of libido

22

Criteria for mild depression - ICD10?

General criteria
At least two of:
1) Depressed mood that is abnormal for most of the day almost everyday for the past two weeks, largely uninfluenced by circumstances

2) Loss of interest or pleasure

3) Decreased energy or increased fatigability


Additional from this list to give at least 4
1) Loss of confidence or self esteem

2) Unreasonable feelings of guilt or self reproach or excessive guilt

3) Recurrent thoughts of death by suicide or any suicidal behaviour

4) Decreased concentration

5) Agitation or retardation

6) Sleep disturbance of any sort

7) Change in appetite

23

Criteria for moderate depression - ICD10?

General criteria
At least two of:
1) Depressed mood that is abnormal for most of the day almost everyday for the past two weeks, largely uninfluenced by circumstances

2) Loss of interest or pleasure

3) Decreased energy or increased fatigability


Additional from this list to give at least 6:
1) Loss of confidence or self esteem

2) Unreasonable feelings of guilt or self reproach or excessive guilt

3) Recurrent thoughts of death by suicide or any suicidal behaviour

4) Decreased concentration

5) Agitation or retardation

6) Sleep disturbance of any sort

7) Change in appetite

24

Criteria for severe depression - ICD10?

General criteria
All of:
1) Depressed mood that is abnormal for most of the day almost everyday for the past two weeks, largely uninfluenced by circumstances

2) Loss of interest or pleasure

3) Decreased energy or increased fatigability


Additional from this list to give at least 8:
1) Loss of confidence or self esteem

2) Unreasonable feelings of guilt or self reproach or excessive guilt

3) Recurrent thoughts of death by suicide or any suicidal behaviour

4) Decreased concentration

5) Agitation or retardation

6) Sleep disturbance of any sort

7) Change in appetite

25

Post-natal Depression - Percentage of women who experience "blues" within 2 weeks?

75%

26

Post-natal Depression - Percentage of women who experience MDD within 3-6 months?

10%

27

Post-natal Depression - Percentage of women who experience puerperal psychosis?

1 in 500 deliveries with a risk of recurrence of 1-3 with subsequent deliveries

28

Differential diagnosis to depression?

> Normal reaction to life event
> SAD
> Dysthymia
> Cyclothymia
> Bipolar
> Stroke, tumour, dementia
> Hypothyroidism, Addison’s, Hyperparathyroidism
> Infections – Influenza, infectious mononucleosis, hepatitis, HIV/AIDS
> Drugs

29

Treatments for depression?

1) Antidepressants
2) Psychological treatments
3) Physical treatments

30

Treatments for depression - anti-depressants?

1) Selective Serotonin Reuptake Inhibitors (SSRIs)

3) Tricyclic antidepressants (TCAs)

4) Monamine Oxidase Inhibitors

5) Other antidepressants