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Psychiatry > Depression > Flashcards

Depression Flashcards

1
Q

What is depression?

A

Describes a state of sadness, not just absence of happiness, that can range from normal experience to severe, life-threatening illness

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2
Q

What is dysthymia?

A

Below threshold level of depression, can go about daily life but with depressive qualities

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3
Q

What sex is depression more common?

A

F>M

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4
Q

What age of onset does depression most commonly occur?

A

Mid 20s

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5
Q

What can cause depression?

A

Genetic/FH

Psychosocial stressors/adverse life event

  • Onset/first episode associated with adverse life events, but can also occur without obvious trigger

Physical Illness/organic disease

  • Endocrine disorder
  • Viruses
  • Chronic pain
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6
Q

How does ICD-10 define depression?

A

Lasts for at least 2 weeks

No hypomanic or manic episodes in lifetime, if had would consider bipolar

Not attributable to psychoactive substance or organic mental disorder

If psychotic symptoms or stupor, exclude psychotic illness

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7
Q

What 3 spheres do depressive symptoms occur in?

A

Psychological

Physical

Social

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8
Q

What are the two aspects of the psychological sphere?

A

Change in mood

Change in thought context

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9
Q

What are the change in mood symptoms?

A

Depression: Presence of sadness often worse in the morning

Anxiety

Perplexity

Anhedonia

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10
Q

What is perplexity?

A

Feeling of being overwhelmed

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11
Q

What is anhedonia?

A

Loss of ability to derive pleasure from experience

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12
Q

What are the change in thought context symptoms?

A

Guilt

Hopelessness

Neurotic symptoms: Hypochondriasis, agoraphobia, obsessions, compulsions and panic attacks

Delusions

Hallucinations

Ideas of Reference: Feel that everything is about you

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13
Q

What are the two aspects of the physical sphere?

A

Change in bodily function

Change in psychomotor functioning

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14
Q

What are the change in bodily functioning symptoms?

A

Fatigue

Disturbed sleep

Weight loss

Loss of libido

Constipation

Pain

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15
Q

What are the change in psychomotor functioning symptoms?

A

Agitation

Retardation

Stupor

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16
Q

What is agitation?

A

State of restless overactivity, aimless or ineffective

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17
Q

What is retardation?

A

Slowing of motor responses

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18
Q

What is stupor?

A

State of extreme retardation in which consciousness is intact and patient stops moving, speaking, eating and drinking

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19
Q

What are the social sphere symptoms?

A

Loss of Interests

Irritability

Apathy

Withdrawal, Loss of Confidence, Indecisive

Loss of Concentration, Registration and Memory

20
Q

What is apathy?

A

Loss of interest in own surroundings

21
Q

What are the general depressive symptoms, according to ICD-10?

A

Depressed mood, abnormal for most of the day almost every day for the past 2 weeks

Anhedonia

Fatigue

22
Q

What are the additional depressive symptoms, according to ICD-10?

A

Guilt

Loss of confidence

Loss of concentration

Sleep disturbance

Suicidal thoughts or behaviour

Change in appetite

Agitation or retardation

23
Q

Define mild depression

A

At least 2 of the general criteria, and additional list to give at least 4

24
Q

Define moderate depression

A

At least 2 of general criteria, and additional list to give at least 6

25
Define severe depression
All of general criteria and additional list to give at least 8
26
What investigations can be used to rule out other causes of depression?
Vitamin B12 FBC: Anaemia U&Es Glucose TFT: Hypothyroidism
27
What is the lifestyle management of depression?
Meditation Exercise Self-guided help Self hygiene and sleep disturbance
28
What is the first line anti-depressant class?
Selective Serotonin Reuptake Inhibitors (SSRI's)
29
What psychological interventions are used in depression?
CBT Interpersonal therapy Family therapy
30
What is used in treatment resistant severe depression?
Electroconvulsive therapy
31
What is ECT?
Small and controlled amount of electro-current is passed through the brain, inducing a brief seizure
32
What is somatic syndrome?
Depression but characterised by a cluster of specific, mostly physical, symptoms
33
How does somatic syndrome present?
Anhedonia Lack of emotional reactions to events that normally produce an emotional response Waking 2 hours before normal time Depression worse in morning Psychomotor agitation or retardation Loss of appetite Weight loss Loss of libido
34
Give differential diagnoses for depression
Normal reaction to life event Seasonal affective disorder Dysthymia Cyclothymia Bipolar disorder Stroke Tumour Dementia Hypothyroidism Addison's Drugs Infection: Influenza, Hepatitis, HIV/AIDS
35
Give examples of suicide red flags
FH of suicide attempt Co-morbid substance use Previous suicide attempts Unemployed Aggressive methods Pre-planning No protective factor : 'I could never go through with it and do that to my partner/child Male: More likely to attempt aggressive methods and more likely to attempt whereas female more likely to self harm
36
How long does normal grief reaction last?
up to 6 months
37
Give side effects of electroconvulsion therapy?
Headache Nausea Short term memory impairment Memory loss of events prior to ECT Arrhythmia
38
Give a contraindication for electroconvulsion therapy
Raised ICP
39
What time of year is suicide more common?
Spring/Summer
40
What age is self harm common between?
15-25
41
What age is suicide more common in?
Over 40 years
42
What is the time frame for post natal depression occurance?
2-6 weeks
43
When is depression automatically classed as severe?
Psychotic symptoms
44
What is the fatality rate of overdose?
Very low, 0.4%
45
What medications are more dangerous in terms of over-dose
Typically, drugs that suppress the respiratory system Benzodiazepines TCA

Psychiatry (11 decks)

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