Depression

Question 1

What is an organic disorder?

Answer 1

A change in mental function secondary to a physical process rather than a psychiatric disorder

Question 2

What is psychosis?

Answer 2

Altered relationship with reality

Question 3

What is a delusion?

Answer 3

Fixed false belief,
held despite evidence to the contrary
outwit sociocultural norms

Question 4

What is a hallucination?

Answer 4

Sensory perception in the absence of external stimuli

Question 5

What is an illusion?

Answer 5

Misperception of real external stimuli

Question 6

How is mood different from affect?

Answer 6

Mood is a subjective feeling of sustained emotion

affect is an objective immediate conveyance of emotion

Question 7

What is the term for a normal mood?

Answer 7

Euthymia

Question 8

What is the term for a significantly high mood?

Answer 8

Mania

Question 9

There is a large genetic component to depression. T/F?

Answer 9

True

Question 10

What comorbidities are associated with depression?

Answer 10

Thyroid dysfunction

schizophrenia

Question 11

Depression is the result of neurochemical imbalances where there is a decrease in which neurotransmitters?

Answer 11

5HT
NA
DA

Question 12

What evidence is there to support the theory that depression is caused by decrease 5HT, NA and DA?

Answer 12

There are decreased levels of metabolites of these neurotransmitters in CSF in people with depression
The mechanism of action go antidepressants
Neurochemical clockers can induce depression

Question 13

What psychological factors can increase the likelihood of developing depression?

Answer 13

Personality traits - anxiety, obsessive
personality disorders
coping skills
adverse life events

Question 14

What social factors can increase the likelihood of developing depression?

Answer 14

Poor Social support
socioeconomic disadvantage
northernisation

Question 15

What is the definition of depression?

Answer 15

A low mood possibly alongside anhedonia and fatigue which occurs every day for two weeks or more

Question 16

What is anhedonia?

Answer 16

Loss of pleasure and joy

Question 17

What are the physical/clinical presentations of depression?

Answer 17

Insomnia
reduced appetite
weight loss
decreased libido
constipation
amenorrhoea

Question 18

How can depression affect cognition/thinking?

Answer 18

decreased concentration
slow or negative thinking
guilt
loss of self esteem
hopelessness
suicidality

Question 19

Psychosis as a result of depression is mood congruent. T/F?

Answer 19

True

Question 20

What can be involved in psychosis as a result of depression?

Answer 20

Delusions of guilt, poverty, hypochondriasis and persecutory

Question 21

What is Cotard’s syndrome?

Answer 21

The belief that the self or part of the self is dead

Question 22

What type of hallucinations may occur in depression?

Answer 22

Auditory second person delusions

Question 23

What are the secondary complications or sequelae of depression?

Answer 23

recurrent depressive disorders
substance misuse
anxiety
suicide
cardiovascular disease

Question 24

What are the differential diagnoses of depression?

Answer 24

Dysthymia
Cyclothymia
Atypical depression
Adjustment reactions
grief

Question 25

What is atypical depression?

Answer 25

Decreased mood with reversed associated symptoms

Question 26

What is bereavement?

Answer 26

A loss event (usually death)

Question 27

What is grief?

Answer 27

The feelings, thoughts and behaviour associated with bereavement

Question 28

What are the five stages of grief?

Answer 28

Denial, Anger, Bargaining, Depression, Acceptance

Question 29

When can grief be considered abnormal?

Answer 29

When it is intense, prolonged (>6months), delayed or absent

Question 30

What is involved in the diagnosis of depression?

Answer 30

``` Clear clinical history risk assessment mental state exam physical exam baseline bloods ```

Question 31

What is involved in a mental state examination?

Answer 31

Assessment of appearance, behaviour, speech, eye contact, mood, thought, perceptions, cognition and insight

Question 32

What class of drugs are the first line treatment for depression?

Answer 32

Selective serotonin reuptake inhibitors

Question 33

Give an example of a selective serotonin reuptake inhibitor.

Answer 33

``` Citalopram fluoxetine duloxetine modafinil sertraline ```

Question 34

What are the side effects of selective serotonin reuptake inhibitors?

Answer 34

``` Nausea vomiting weight gain dizziness discontinuation syndrome anxiety suicidality mania serotonin syndrome cardiac effects ```

Question 35

How long does it take for selective serotonin reuptake inhibitors to have an effect on depression?

Answer 35

4-5 weeks

Question 36

Give an example of a tricyclic antidepressant

Answer 36

Amitiptyline

Question 37

What are the side effects of tricyclic antidepressants?

Answer 37

Decreased blood pressure anticholinergic effects arrhythmia

Question 38

Give an example of a monoamine oxidase inhibitor

Answer 38

Isocarboxid | Phenelzine

Question 39

What side effect occurs when cheese is consumed when using a monoamine oxidase inhibitor?

Answer 39

Hypertensive crisis

Question 40

What is involved in electroconvulsive therapy?

Answer 40

Induction of a controlled seizure under anaesthesia

Question 41

What is a side effect of electroconvulsive therapy?

Answer 41

memory loss

Question 42

Other than ECT and pharmacology, how can depression be treated?

Answer 42

Psychoeducation encouraging talking, keeping active, eating well and sleeping well CBT

Question 43

What is the role of social work and occupational therapy in the treatment of depression?

Answer 43

Addressing housing, financial and employment issues | involved in activity scheduling

Question 44

The average episode of depression can be halved in duration if treated. What is the average length of an episode of untreated depression?

Answer 44

6 months

Question 45

What factors are associated with better outcomes for patients with depression?

Answer 45

``` Male first episode mild or short episode no psychosis no/short hospital stay good social functioning no comorbid psychiatric disorders ```

Question 46

What factors would result in a person with depression being unable to drive?

Answer 46

severe depression attention impairment agitation suicidality