Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Psych > Affective Disorders, Anxiety disorders & Personality Disorders > Flashcards

Affective Disorders, Anxiety disorders & Personality Disorders Flashcards

(70 cards)

Start Studying
1
Q

What are mood disorders?

A

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

A term referring to states of depression and of elevated mood – mania

The commonest group of mental disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How can mood disorders present and what are they often associated with?

A

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

Often associated with anxiety symptoms and anxiety disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What mood disorders are classified in ICD 11 that you should be aware of?

A

Depressive disorder – mild/mod/severe – with/without psychosis

Bipolar I
Bipolar II
Cyclothymia

Substance induced
Secondary mood disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the difference between depression as a symptom and as a syndrome?

A

Symptom=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
  • typically considered as a form of sadness, not just an absence of happiness

Syndrome=A constellation of symptoms and signs
- Single episode / Recurrent illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When does depression become abnormal (what psychiatrists place emphasis on)?

A
  1. persistence of symptoms
    1. pervasiveness of symptoms
    2. degree of impairment
    3. presence of specific symptoms or signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How long do depressive symptoms (e.g. low mood or reduced interest/pleasure) have to last before it can be classified as depression?

A

Most of the day, nearly everyday and lasts for at least 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is seen in depression and what might psychotic symptoms make you consider?

A

Significant functional impairment
No hypomanic or manic episodes in lifetime
Not attributable to psychoactive substance use or organic mental disorder
If psychotic symptoms then likely severe depression with psychotic symptoms (but can be moderate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the differences between mild, moderate and severe depression?

A

MILD
The individual is usually distressed by the symptoms to a mild extent
Some difficulty in continuing to function in one or more domains
There are no delusions or hallucinations during the episode.

MODERATE
several symptoms of a depressive episode are present to a marked degree or a large number of depressive symptoms of lesser severity are present overall
The individual typically has considerable difficulty functioning in multiple domains
Can be with/without psychotic sx

SEVERE
many or most symptoms of a Depressive Episode are present to a marked degree
or a smaller number of symptoms are present and manifest to an intense degree
The individual has serious difficulty continuing to function in most domains
With/without psychosis

Domains=personal, family, social, educational, occupational, or other important domains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When does post natal depression occur and what does it increase the risk of?

A

Often within a month or two of giving birth
Can start several months postpartum
A third of cases begin in pregnancy and persist

Increased risk of psychiatric admission in the 30 days following childbirth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How common is blues and how common is puerperal psychosis?

A

75% of women experience ‘blues’ within 2 weeks

‘puerperal psychosis’ - 1 in 1000 deliveries with a risk of recurrence with subsequent deliveries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What treatments are available for depression?

A

Antidepressants:
Selective Serotonin Reuptake Inhibitors SSRIs
Serotonin and norepinephrine reuptake inhibitors SNRIs
Tricyclic antidepressants TCAs
Monamine Oxidase Inhibitors MAOIs
Other antidepressants eg Mirtazapine

Antipsychotics

Mood stabilisers

Psychological Treatments
CBT, IPT, Individual dynamic psychotherapy

Physical Treatments – severe or treatment resistant
ECT, Psychosurgery, ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some measurement tools available to assess depression?

A

SCID (Structured Clinical Interview for DSM disorders)
SCAN (Schedules for Clinical Assessment in Neuropsychiatry)

HDRS (Hamilton Depression Rating Scale)
BDI-II (Beck Depression Inventory II)
HADS (Hospital Anxiety and Depression Scale)
PHQ-9 (Patient Health Questionnaire 9)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is mania?

A

A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the symptoms and signs of mania?

A
  • euphoria, irritability, increased activity, increased energy
  • rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behaviour, and rapid changes among different mood states (i.e., mood lability).
  • Delusions of grandeur /religious delusions can be present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is hypomania?

A

Hypomania indicates a less severe episode with minimal functional impairment, no hospitalisation, no psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a mixed affective state and when do symptoms present?

A

A mixed episode is characterised by the presence of several prominent manic and several prominent depressive symptoms, which either occur simultaneously or alternate very rapidly (from day to day or within the same day).

Symptoms are present most of the day, nearly every day, during a period of at least 2 weeks, unless shortened by a treatment intervention.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the difference between Bipolar I & II

A

I
At least one Manic or Mixed Episode
With/without psychosis

typical course of the disorder is characterized by recurrent Depressive and Manic or Mixed Episodes

Although some episodes may be Hypomanic, there must be a history of at least one Manic or Mixed Episode.

II
One or more hypomanic episodes

At least one depressive episode

No hx manic/mixed episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is cyclothymia and what symptoms are present?

A

Persistent instability of mood over a period of at least 2 years

Numerous periods of hypomania

Depressive symptoms that are present during more of the time than not

The depressive symptomatology has never been sufficiently severe or prolonged to meet the diagnostic requirements for a depressive episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What tools can be used to measure symptoms of bipolar?

A

SCID
SCAN

Young Mania Rating Scale (YMRS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What medications can be used to treat Bipolar?

A

Benzodiazepines

Antipsychotics:
Olanzapine
Risperidone
Quetiapine

Mood Stabilisers:
Sodium Valproate
Lithium

ECT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Is the rate of bipolar different for males and females?

A

No its equal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the mean age of onset of bipolar disorder?

A

21 (unusual >30)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Early onset (15-19) is usually present with a positive what?

A

Usually with positive FH

Prevalence consistently increased in 1st degree relatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Are the rates of depression higher in females or males?

A

F:M=2:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What age is at highest risk of depression developing?
Highest risk from age 18-44 (median 25) Onset during old age is not unusual
26
What is depression (first episode) associated with?
Excess of adverse life events 'exit events'=seperations, losses
27
How long does a typical episode of major depression last and what % have further episodes?
Typical episode lasts 4-6 months 80+% have further episodes
28
Bipolar disorder/Mania: How long is a typical manic episode?
1-3 months 90% have further episodes
29
What is crucial to know about affective disorders?
Affective disorders can be classified and symptoms measured Affective disorders are recurrent and disabling All have effective treatments
30
What is unipolar depression?
Only have depression (can be primary or secondary)
31
What is dysthymia?
Chronic form of depression-rumbling on low mood-hard to treat
32
What are the first lines for depression in primary and secondary care?
- SSRI=1st line - SNRI=1st line in 2ndary care
33
What treatment for depression has the best evidence?
- Best evidence is for a psych treatment with an antidepressant - Some peoples is treatment resistant-so can use physical treatments
34
What is the psychological (Transactional) model of stress?
Interactive An individual’s reaction to stress will depend on a balance between their cognitive processing of any perceived threat and perceived ability to cope
35
What are the 2 ways of coping with stress (e.g. interview or exams)?
Problem focussed Where efforts are directed toward modifying stressor. Preparation, studying or interview practice Emotion focussed Modify emotional reaction. Mental defence mechanisms eg Denial. Relaxation training Take a sedative drug.
36
There are human physiological and psychological reactions to stress: What happens in anxiety disorders?
Normal pathways are not functioning correctly
37
What symptom groups are present in flight or fight response and in anxiety?
Psychological arousal Autonomic Arousal Muscle Tension Hyperventilation Sleep Disturbance
38
What does the Yerkes Dodson curve show?
Empirical relationship between stress and performance
39
What are signs of psychological arousal?
Fearful Anticipation Irritability Sensitivity to noise Poor concentration Worrying Thoughts
40
What are some signs of autonomic arousal (system based)?
Gastrointestinal Dry Mouth Swallowing difficulties Dyspepsia, nausea and wind Frequent loose motions Respiratory Tight chest, difficulty inhaling Cardiovascular Palpitations/Missed beats Chest pain Genitourinary Frequency/urgency of micturition Amenorrhoea/ Dysmenorrhoea Erectile failure CNS Dizziness and sweating Symptoms-reactions to stress Muscle Tension Tremor Headache Muscle pain Hyperventilation Causing CO2 deficit hypocapnia Numbness tingling in extremities may lead to carpopedal spasm Breathlessness Sleep Disturbance Initial insomnia Frequent waking Nightmares and night terrors
41
What is the difference between phobic anxiety disorders & GAD?
Both these sets of disorders have same core anxiety symptoms but they EITHER occur in particular circumstances: PHOBIAS Agoraphobia Social phobia Specific (Isolated) Phobias OR Occur persistently GENERALISED ANXIETY DISORDER (GAD)
42
What is GAD?
Persistent (several months) symptoms not confined to a situation or object. All the symptoms of human anxiety mentioned earlier can occur Psychological arousal Autonomic Arousal Muscle Tension Hyperventilation Sleep Disturbance
43
What are some physical conditions that are differential diagnosis for anxiety disorders?
Thyrotoxicosis Phaeochromoctoma Hypoglycaemia Asthma and or Arrhythmias
44
What is the aetiology of GAD?
No clear line between “normal” anxiety and the anxiety disorders they differ in extent of symptoms and duration. “In general terms GAD for instance is caused by a stressor acting on a personality predisposed to the disorder by a combination of genetic factors and environmental influences in childhood.”
45
How is GAD managed?
Counselling- Clear Plan of Management Explanation and education Advice re caffeine, alcohol, exercise etc. Relaxation training- Group or individual DVDs, tapes or clinician led Medication- Sedatives have high risk dependency Antidepressants SSRI or TCA Cognitive Behavioural Therapy
46
What are some key features of phobic anxiety disorders?
Same core features as GAD ONLY in specific circumstances Person behaves to avoid these circumstances “phobic avoidance” Sufferer also experiences anxiety if there is a perceived threat of encountering the feared object or situation “anticipatory anxiety”
47
What are the 3 clinically important syndromes in phobic anxiety disorders?
- Specific phobias - Social phobia - Agoraphobia
48
What is social phobia?
Inappropriate anxiety in situation where person feels observed or could be criticised (ICD-11 thinks about fleeing being difficult) Restaurants Shops or any queues Public speaking Symptoms are any of the anxiety cluster mentioned above but blushing and tremor predominate
49
How is social phobia managed
CBT addressing the groundless fear of criticism. CBT challenges Negative views of self “Safety barriers” Unrealistically high standards Excessive self monitoring Education and advice Medication SSRI antidepressants
50
What are the core features of OCD?
Experience of recurrent obsessional thoughts &/or compulsive acts - Ideas, images or impulses - Occurring repeatedly not willed - Unpleasant & distressing (often antithesis of personality type) - Recognised as the individuals own thoughts - Usual key anxiety symptoms arise because of distress of the thoughts or attempts to resist
51
Compulsive acts or rituals: What are they and how are they viewed?
Stereotypical behaviours repeated again and again Not enjoyable Not helpful i.e. do not result in useful activity Often viewed by sufferer as preventing some harm to self or others; “magical undoing” Viewed as pointless and resisted with key anxiety symptoms accompanying resistance
52
Does OCD equally affect men and women and and what is the aetiological theory for it?
Equally affects men and women Aetiological Theory - Genetic e.g. gene coding for 5HT receptors - 5 HT function abnormalities
53
How is OCD managed?
- Good Hx & MSE exclude treatable depressive illness - Serotonergic drugs SSRI e.g. Fluoxetine Clomipramine - CBT-Exposure & response prevention, exam of evidence to weaken convictions - Psychosurgery
54
What is PTSD defined as?
“Delayed and or protracted reaction to a stressor of exceptional severity” (would distress anyone) Combat Natural or human-caused disaster Rape Assault Torture Witnessing any of the above
55
In PTSD what are 3 key elements to reaction?
Hyperarousal Re-experiencing phenomena Avoidance of reminders
56
What are symptoms of hyperarousal in PTSD?
Persistent anxiety Irritability Insomnia Poor concentration
57
What occurs with re-experiencing phenomena in PTSD?
Intense intrusive images - Flashbacks when awake - Nightmares during sleep
58
What occurs with re-experiencing phenomena in PTSD?
Intense intrusive images - Flashbacks when awake - Nightmares during sleep
59
How is avoidance seen in PTSD?
Emotional numbness Cue avoidance Recall difficulties Diminishes interests
60
What is the aetiology of PTSD?
Nature of stressor Life threatening and degree of exposure generally confers greater risk however Vulnerability factors: Mood disorder Previous trauma especially as child Lack of social support Female Protective factors (examples) Higher education and social group Good paternal relationship Susceptibility partly genetic
61
How is PTSD managed?
Survivors of disasters screened at one month Mild symptoms “watchful waiting” and review further month Trauma-focused CBT if more severe symptoms Eye Movement Desensitisation and Reprocessing Risk of dependence with any sedatives but patient may prefer medication SSRI or TCA
62
What is disorganised attachment often associated with?
The development of BPD
63
What is a personality disorder?
- Problems in functioning of aspects of the self &/or interpersonal dysfunction - Extended period of time - Extends across a range of personal and social situations Can be classed as mild, moderate or severe
64
What is negative affectivity in personality disorder?
Experiencing a broad range of negative emotions with a frequency and intensity out of proportion to the situation.  Emotional lability and poor emotion regulation. Negativistic attitudes.  Low self-esteem and self-confidence.  Mistrustfulness. 
65
What kinds of detachment can be present in personality disorder?
Social detachment.  - avoidance of social interactions, lack of friendships, and avoidance of intimacy. - They have few to no friends or even casual acquaintances. Their interactions with family members tend to be minimal and superficial. They rarely engage in any intimate relationships and are not particularly interested in sexual relations. Emotional detachment.  - reserve, aloofness, and limited emotional expression and experience. - keep to themselves to the extent possible, even in obligatory social situations. They are typically aloof and respond to direct attempts at social engagement only briefly and in ways that discourage further conversation. - do not talk about their feelings and it is difficult to discern what they might be feeling from their behaviours. In extreme cases, there is a lack of emotional experience itself and they are non-reactive to either negative or positive events
66
What dissociality can present in personality disorder?
- Self Centeredness - Lack of empathy
67
What disinhibition is present in personality disorder?
Impulsivity.  Distractibility.  Irresponsibility.  Recklessness.  Lack of planning
68
What is anankastia in personality disorder?
Perfectionism Emotional & behavioural constraint
69
What is exhibited in BPD?
Frantic efforts to avoid real or imagined abandonment. A pattern of unstable and intense interpersonal relationships Identity disturbance, manifested in markedly and persistently unstable self-image or sense of self. Recurrent episodes of self-harm Emotional instability due to marked reactivity of mood. Chronic feelings of emptiness. Inappropriate intense anger or difficulty controlling anger manifested in frequent displays of temper Transient dissociative symptoms or psychotic-like features (e.g., brief hallucinations, paranoia) in situations of high affective arousal.
70
How are personality disorders managed?
Biopsychosocial approach Assessment for full diagnostic picture, including co-occurring mood and addictive disorders Diagnostic formulation, risk management planning, and setting of treatment goals and realistic ways of meeting them Judicious use of medication Specific psychological treatments Social interventions

Psych (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions