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Flashcards in Mood Disorders Deck (29)
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1
Q

definition of mood disorder

A

disorder of mental status + function where altered mood is the core feature

they are recurrent and disabling

2
Q

depression - aetiology

A

F > M

peak 30yo

insight common

typical episode: 4-6mnths

3
Q

criteria used for diagnosis of depression

A

ICD 10

4
Q

definition of depression from ICD 10

A

At least 2 wks, no hypomanic or manic episodes, not attributable to psychoactive substance or organic mental disorder (exclude schizophrenia, bipolar)

5
Q

core symptoms of depression

A
  1. low mood - every day for 2 wks, worse in the morning
  2. anhedonia: loss of enjoyment
  3. low energy - fatiguability
6
Q

additional symptoms of depression

A
  • loss of concentration
  • low libido
  • hyper somnolence - early morning awakenings
  • loss of appetite - weight loss
  • guilt, worthlessness
  • suicidal thoughts (self harm)
  • agitation, anxiety, retardation
7
Q

abnormal depression - 4 aspects

A
  • persistent
  • pervasive (majority of the time)
  • impact on QOL / function
  • presence of s+s of depression
8
Q

DDx for depression

A

SAD, bipolar, Stroke, Dementia, hypothyroidism, Addison’s, normal reaction to a life event

9
Q

Different management of depression

A

pharmacological: SSRI, TCA, MAOI

psychological tx: CBT, fam therapy, IPT

physical tx: ECT (severe, resistant depression)

10
Q

definition of stigma

A

social construct that devalues people due to a distinguishing characteristic/mark

11
Q

mania - definition

A

pathological inappropriate elevated mood

12
Q

3 core features of mania

A
  • disinhibition (loss of restraint)
  • grandiose ideas
  • loss of judgement
13
Q

common features associated with mania

A
  • thought disorder: withdrawal (CIA stealing ideas)
  • pressured speech (fleeting ideas, hard to follow)
  • lacks insight - family referral
  • decreased sleep (can lead to neglect)
  • extravagant spending
14
Q

hypomania?

A

features of mania - but doesn’t fulfil full ICD-10 criteria - and pt still able to function

15
Q

mania in isolation common?

A

very uncommon likely to have a come down - bipolar disorder more common

16
Q

DDx for mania

A

mixed affective state

schizoaffective disorder

schizophrenia

ADHD

drug + alcohol

stroke, hyperthyroidism, SLE

17
Q

tx for mania

A

antipsychotics: olanzapine

mood stabilisers:

  • lithium
  • sodium valproate
  • lamotrigene
18
Q

tools to assess mania

A

SCID, SCAN + Young Mania Rating Scale (YMRS)

19
Q

if 2+ episodes of depression and no hypo/mania at time of diagnosis then ?

A

recurrent depression

20
Q

if 2+ episodes of mania - but no depression then?

A

hypomania, or bipolar - very unlikely to be manic without depression

21
Q

definition of BAD

A

consists of 2+ episodes of depression + mania/hypomania

22
Q

gender ratio for BAD

A

M=F

23
Q

mean onset age of BAD

A

21

24
Q

early onset BAD 15-19 - common RF?

A

FHx

25
Q

acute phase tx BAD

A

lithium or

valproate

26
Q

maintenance for BAD

A

lithium/valproate/olanzipine 2 yrs

but relapse rate high (90%)

27
Q

how long does a typical manic episode last in bipolar disorder

A

1-3 months (12wks)

28
Q

BAD % die by suicide?

A

10%

29
Q

RFs for suicide

A
divorce
male 
substance misuse 
previous attempt
FHX
age >45yo 
physical or psychiatric illness