Mood disorders Flashcards
(55 cards)
what are the 3 main symptoms depressive illness, and for how long should the patient be experiencing them
low mood, anhedonia, reduced energy. at least 2 of these for at least 2 weeks
features depression
decreased concentration, low self esteem, ideas of guilt and self worth, hopelessness, thoughts self harm, decr sleep or appetite
what is common in depression with regards to pattern of the depression
diurnal variation- worse on waking. early morning waking
what are the features of psychotic depression
delusions- nihilistic, hallucinations- 2nd person
what differentiates psychosis in schizophrenia and depression
the thought content in depression is mood congruent
differentials for depression
normal sadness to bereavement, schizophrenia if psychotic, alcohol/drug withdrawal
aetiology of depression
genetics, parental loss, early childhood, abuse, alcohol/drug use, severe physical illness, life event, deprivation, lack of relationship
neurochemical changes in depression
decreased monoamines- noradrenaline and serotonin.
what hormone is high in depression
cortisol
what system isn’t functioning well in depression
limbic system and prefrontal cortex
what guides the severity of the depression
no of symptoms, severity of symptoms, degree of associated distress, interference with daily life
management mild depression
self help groups, physical activity sessions, computerised CBT
management moderate depression
add antidepressant and individual CBT
management severe depression
ECT
how long to continue antidepressants for
6 months- reduced relapse
what can you give for resistant depression
combine (augment) antidepressant with lithium, atypical antipsychotic or another anti depressant
which antidepressant is the only one licensed for use in the UK for adolescents
fluoxetine
what emergency can you get from antidepressants
serotonin syndrome
what is serotonin syndrome
increased serotonin- agitation,confusion, tremor, tachycardia, hypertension
how do SSRIs work
selective serotonin reuptake inhibitor. inhibit the reuptake of serotonin
examples of SSRIs
citalopram, fluoxetine, setraline
when should you give SSRIs
once a day- in the morning
side effects SSRIs
N&V, headache, diarrhoea, dry mouth, insomnia. linked to suicidality
what is the syndrome you get when stopping SSRIs
discontinuity syndrome- shivery, dizzy, anxiety, headache, nausea, ‘electric shocks’
