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Year 2 Psychiatry > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

Criteria for depressive episode?

A

DSM-5 criteria

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2
Q

DSM-5 criteria for depressive episode?

A

2 weeks or more of depressed mood + 4/8 DSM-5 symptoms

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3
Q

DSM-5 symptoms? Depression

A

-sleep alterations (insomnia or hypersomnia)
-appetite alterations
-anhedonia
-decreased concentration
-decreased energy
-guilt
-psychomotor changes (agitation or retardation)
-suicidal thoughts

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4
Q

Major depressive disorder diagnosis?

A

If no manic or hypomanic episodes in the past

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5
Q

Depression triads?

A

Core
Biological
Psychological

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6
Q

Depression core symptoms?

A

Low mood
Anergia
Anhedonia

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7
Q

Depression biological symptoms?

A

Sleep
Libido
Appetite

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8
Q

Depression psychological symptoms?

A

The world
Oneself
The future

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9
Q

Manic episode?

A

Euphoric or irritable mood with 3 or more of the 7 manic criteria

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10
Q

7 manic criteria?

A

-decreased need for sleep with increased energy
-distractibility
-grandiosity or inflated self esteem
-flight of ideas or racing thoughts
-increased talkativeness or pressures speech
-increased goal-directed activities or psychomotor agitation
-impulsive behaviour (sexual impulsivity, spending sprees)

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11
Q

Manic episode vs hypomanic episode?

A

Manic episode - over 1 week, can’t function

Hypomanic episode - over 4 days, can function

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12
Q

Type II bipolar?

A

Not a single manic episode has ever occurred but only hypomanic episodes
Along with at least one major depressive episode

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13
Q

Unspecified bipolar disorder?

A

If manic symptoms occur for less than 4 days

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14
Q

Bipolar 1 vs bipolar 2?

A

Bipolar 1 has more severe amplitudes
More mania
Bipolar two hypomanic

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15
Q

More than 4 cycles per year?

A

Rapid cycling

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16
Q

Cyclothymia?

A

Smaller amplitude compared to bipolar 1 or 2

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17
Q

Bipolar vs unipolar?

A

Bipolar:
-lower age of onset
-shorter episodes
-more frequent episodes
-genetic specificity
-differential treatments

compared to unipolar depression

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18
Q

Differential treatment for bipolar vs unipolar?

A

Unipolar - antidepressants
Bipolar - neuroleptics and lithium for mania

19
Q

Insight in depression vs mania?

A

Depression - insight is preserved
Mania - insight is impaired

20
Q

Attention bias in depression?

A

Difficulty disengaging attention from negative material
more typical of anxiety

21
Q

Memory biases in depression?

A

Preferential recall of negative compared to positive material

22
Q

Perceptual biases in depression?

A

Recognised negative faces more than positive faces

23
Q

Amygdala dysfunction in depression?

A

A bias towards detecting cues signalling potential threats, like expressions of fear

24
Q

Monoamine deficiency hypothesis?

A

Insufficient levels of monoamine neurotransmitters can cause depressive symptoms

25
Q

Monoamine neurotransmitters?

A

-serotonin (5-hydroxytryptamine/5-HT)
-norepinephrine
-dopamine

26
Q

How to measure monoamine receptors and transmitters levels?

A

PET imaging and radiotracer

27
Q

Monoamine scan method?

A

Measure levels of tracer left in brain (using PET scan) before and after challenge
challenge (e.g. amphetamine) - will cause spike in serotonin which will replace tracer. Higher serotonin = less tracer left

28
Q

Tryptamine psychedelics

A

-psilocin
-DMT
-LSD

serotonin receptor agonist - psychedelics are chemically similar to serotonin

29
Q

Psychedelic risks and benefits?

A

Benefits - non addictive, low physiological and brain toxicity, good therapeutic index

Risks - dysphoria, anxiety, nausea, headache

30
Q

Depression cognition?

A

Can cause pseudodementia

31
Q

Bipolar antidepressants effect?

A

Could flip into manic episode

32
Q

Differential personality disorders? (DSM-5)

A

Cluster A - paranoid, schizoid, schizotypal
Cluster B - antisocial, borderline, histrionic, narcissistic
Cluster C - avoidant, dependent, obsessive-compulsive personality disorder

33
Q

Bipolar affective disorder symptoms? BPAD

A

Episodic
Runs in family
Grandiosity
Mood states typically less affected by environment

34
Q

Borderline personality disorder symptoms? BPD

A

-mood changes over course of hours/days (rather than days/weeks in BPAD)
-poor self image
-fear of abandonment
-feelings of emptiness
-Hx of self-harm
-Hx of trauma/disrupted attachment

35
Q

BPAD and BPD shared symptoms?

A

-rapid mood changes
-unstable interpersonal relationships
-impulsive sexual behaviour
-suicidality

36
Q

BPAD and schizophrenia shared symptoms?

A

Both can present with psychosis and mood symptoms (depression and mania)
typically schizophrenia is more prominent disorganisation of thought, paranoid delusional beliefs and auditory hallucinations

37
Q

BPAD and ADHD shared symptoms?

A

-hyperactivity
-impulsivity
-impaired concentration
-impairment of executive function
-abnormal working and short term memory

38
Q

Possible organic causes of mood disorder?

A

Endocrine
Systemic
Deficiencies
Neurological
Medications

39
Q

Other organic causes of mood disorders?

A

Vascular depression (associated with white matter hyperintensities)
Poststroke depression (lesions in left frontal lobe or basal ganglia)

40
Q

Medications that can cause mood disorders?

A

Beta-blockers
Steroids
Anti-Parkinson’s
Some ABx (ciprofloxacin)
Statins
Oestrogen
Opiates
Acne medications

41
Q

Cluster A personality disorders?

A

Paranoid, schizoid, schizotypal

42
Q

Cluster B personality disorders?

A

Antisocial, borderline, histrionic, narcissistic

43
Q

Cluster C personality disorders?

A

Avoidant, dependent, obsessive-compulsive personality disorder

Year 2 Psychiatry (7 decks)

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