Mood disorders Flashcards
(27 cards)
Give an example of a unipolar mood disorder
Depression
What are the 3 core symptoms of Depression?
Persistent low mood
Anhedonia
Lack of energy
Need to be present for 2 weeks
What are the cognitive symptoms of Depression?
Unnecessary feelings of guilt/self blame Decrease in self esteem Hopelessness Hypochondriacal thoughts Poor concentration/attention Suicidal thoughts/thoughts of self harm
What are the biological symptoms of Depression?
Early morning wakening Reduced appetite Weight loss Psychomotor retardation Loss of libido
What are the symptoms of Atypical depression?
Variably depressed mood Overeating Oversleeping Extreme fatigue/Heaviness of limbs Pronounced anxiety Psychomotor agitation eg restlessness, irritability
According to the ICD-10, what is mild Depression?
2 core symptoms + 2 other symptoms.
Patient can function
According to the ICD-10, what is moderate Depression?
2 core symptoms + 3/4 other symptoms.
According to the ICD-10, what is severe Depression?
3 core symptoms + 4
What psychotic symptoms can occur in Depression?
Hallucinations eg auditory
Delusions - guilt, persecutory. Mood congruent/egosyntonic
What is post natal depression?
Within 6 months of birth
Worries about babies’ health or ability to cope with new child
What are some of the risk factors for post natal depression?
Personal history of depression or post natal depression FH of depression Older age Single mother Unwanted pregnancy Poor social support
What are some of the risk factors for Depression?
2-3x increase in physical health conditions
Female
Give an example of a bipolar mood disorder
Manic depression/Bipolar disoder
What is Bipolar disorder?
Patient alternates between low mood and high mood (Mania, Hypomania). Need 2 episodes for ICD-10 classification
Thought to be due to changes in 5HT/Na in brain
What is Mania?
A very noticeable elevation of mood for minimum of 1 week. Need elevated, expansive + irritable mood plus >3 of; - Increased energy/agitation - Grandiosity - Pressured speech/Flight of ideas - Decreased need for sleep - Increased libido - Increased sociability - Decreased eating/drinking Psychotic symptoms
What is Hypomania?
> 3 characteristic symptoms for a minimum of 4 days that are not severe enough to interfere with functioning;
- Mildly elevated, expansive or irritable mood
- Increased energy/activty
- Increased self esteem
- Sociability - over familiarity, talkative
- Decreased concentration
- Increased libido
- Decreased need for sleep
What are the differentials for Bipolar disorder?
Fluctuations in mood
Adjustment disorders eg stress, bereavement, PTSD
Dementia
Underlying physical illness
Personality disorders eg Emotionally unstable PD - BUT up/down on daily basis
Anxiety disorders
What are the predisposing factors for mood disorders?
Genetics
Childhood experiences
What are the precipitating factors for mood disorders?
Life events
Substance use
Iatrogenic
What are the perpetuating factors for mood disorders?
Difficult relationships
Financial stressors
Substance misuse - alcohol can effect effectiveness of drugs
What are the BioPsychoSocial factors for mood disorders?
Bio - Genetics, Brain/Physical illness
Psycho - Thinking/Personality traits, Childhood experiences, View of self/word
Social - Work, Housing, Finances, Relationships, Support
What is the treatment for Bipolar disorder?
- Mood stabilisers eg Lithium, Sodium valproate, Lamotrigine, Carbamazepine
- Antipsychotics eg Olanzipine, Quetiapine (Used most as has mood stabilising effects too)
- AVOID ANTIDEPRESSANTS - can precipitate mania. Use Anxiolytics instead eg Benzodiazepine
- Psychoeducation, CBT, IPT
- Housing, Family/financial help, General coping mechanisms
What is the treatment for Depression?
SSRIs eg Cialopram, SNRIs eg Duloxetine, TCAs eg Amitryptilline, NASSA eg Mirtazepine, MAOi, SARIs eg Trazidone
ECT
What are the ADRs of NASSAs? (Noradrenaline, Selective Serotenergic Antidepressant)
*Mirtazepine* Constipation Dry mouth Increased appetite Somnolence Weight gain May cause dizziness/weakness
