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YEAR 3 PSYCH > Depression > Flashcards

Depression Flashcards

1
Q

what are the core features of depression

A

depressed mood
anhedonia
anergia

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2
Q

elaborate on the “depressed mood” core feature of depression

A

must be present for most of the day almost every day for at least 2 weeks
must be to a degree that is definitely abnormal for that individual
is largely uninfluenced by circumstances

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3
Q

depressed mood in depression tends to be worse at what time of day

A

morning

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4
Q

what is anhedonia

A

loss of interest in activities they previously found pleasurable

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5
Q

what is needed for diagnosis of depression

A

2

and an additional symptom(s) should be present

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6
Q

what is anergia

A

decreased energy or increased fatiguability

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7
Q

what are some additional features that may be seen in depression (7)

A 
loss of confidence/self esteem
unreasonable feelings of guilt 
recurrent thoughts of death or suicide
diminished ability to think or concentrate
change in psychomotor activity
sleep disturbance
change in appetite with weight change
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8
Q

what changes in psychomotor activity might be seen in depression

A 
agitation
psychomotor retardation (slowing of thoughts/movement)
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9
Q

what is the most common sleep disturbance seen in depression

A

early morning wakening (wakening at least 2 hours before expected/normal waking time)

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10
Q

what are some other sleep disturbances

A

broken sleep

initial insomnia

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11
Q

is an increase or decrease in appetite more common in depression

A

decrease

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12
Q

according to ICD 10 what is moderate depression

A

2 core + 4 additional = at least 6

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13
Q

according to ICD 10 what is severe depression

A

3 core + 5 additional = at least 8

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14
Q

what is mild depression

A

less than 6 symptoms

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15
Q

what kind of depression is the majority in primary care

A

mild - antidepressants not indicated

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16
Q

what are some rating scales used to measure severity of depression

A

HRSD/HAM-D

MADRS

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17
Q

what is Beck’s Triad

A

hopelessness
worthlessness
excessive guilt

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18
Q

what is stupor

A

absence of relational functions i.e. actions, speech

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19
Q

what are some somatic symptoms of depression

A 
amenorrhoea
fatigue 
abdominal pain
constipation
indigestion
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20
Q

what hallucinations most commonly occur in depression

A

2nd person auditory derogatory hallucinations

- you are a bad person and deserve to die

21
Q

is insight typically preserved or lost in depression

A

preserved

- attribution may be affected - blame depression on illness/personal feelings/weakness

22
Q

is insight typically preserved or lost in depression

A

preserved

- attribution may be affected - blame depression on illness/personal feelings/weakness

23
Q

50% of all mood disorders start before age

A

30

24
Q

50% of all mental disorders start before age

A

14

25
Q

what system is used for classification of mood disorders in the uk

A

International Classification of Diseases, version 10

ICD 10

26
Q

what system is used for classification of mood disorders in america

A

Diagnostic and Statistical Manual, version 5

DSM-5

27
Q

according to ICD 10 what are the classes of mood disorders

A

mania
depressive disorder
bipolar disorder
dysthymia

Manic episode 
Bipolar Affective Disorder
Depressive Episode
Recurrent Depressive Disorder
Persistent Mood Disorders 
Unspecified Mood Disorder
28
Q

according to ICD 10 what are the classes of depression

A

mild
moderate
severe

29
Q

do ICD 10 outline chronic depression

A

no

30
Q

what is the DSM - IV criteria for chronic depression

A

Full criteria for a Major Depressive Episode have been met continuously for at least the past 2 years

31
Q

what are 3 subtypes of depression

A

somatic syndrome
atypical depression
psychotic depression

32
Q

what is somatic syndrome

A

4 out of 8 of:

  • anhedonia
  • lack of emotional reaction to events that usually produce emotional reaction
  • objective evidence of psychomotor agitation or retardation
  • marked loss of appetite
  • weight loss > 5% body weight in past month
  • loss of libido
  • EMW
  • depression worse in morning
33
Q

what is diurnal variation

A

mood varies throughout the day

34
Q

what is the general criteria for depression

A

depressive episode should last at least 2 days and there be no hypo/manic symptoms sufficient to meet criteria for an episode at any point in individuals life

35
Q

what is atypical depression

A

mood reactivity: mood will brighten in response to actual or potential positive event
- will also see 2 of:
weight gain or increased appetite, hypersomnia, leaden paralysis, long standing pattern of interpersonal rejection sensitivity that results in significant social or occupational impairment

36
Q

psychotic depression is typically ___ _____ or ______

it is occasionally ____

A

mood congruent or hypochondriacal

occasionally paranoid

37
Q

what is cotards syndrome and who is it common in

A

elderly patients

nihilistic delusions

38
Q

what the 5 Rs of depression

A 
response
remission
relapse
recovery
recurrence
39
Q

what is recovery of depression

A

maintenance of remission for 1 year +

40
Q

a relapse after recovery is called

A

recurrence

41
Q

what is dysthymia

A

chronic mild depression for a minimum of 2 years in which episodes are not long enough or severe enough to meet criteria for depression

42
Q

what is the biggest risk factor for suicide

A

history of DSH

43
Q

what is a robust predictor or eventual fatal self-harm and should be included in MSE

A

hopelessness

44
Q

who is most likely to suicide after DSH

A

older males

45
Q

what is the 1st line treatment of depression

A

SSRI

46
Q

what do you do if SSRI doesn’t work

A

dose increase, swap, combine or change

47
Q

what could you combine an SSRI with

A

SNRI

or mirtazapine

48
Q

how long should someone continue to take antidepressant after remission

A

6 months - reduces risk of relapse and not assoc. with addiction

YEAR 3 PSYCH (14 decks)

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