Mood Disorders Flashcards
(40 cards)
Definition of a Mood Disorder
Psychological disorder, characterised by the elevation/lowering of someones mood
Examples of Mood Disorders
Major Depressive Disorder Bipolar affective disorder Seasonal affective disorder Environmental Depression Premenstrual dysphoric disorder Cyclothymic disorders
Who are more affected by mood disorders and by how much
Females, 2:1 to males
What is the relative risk of getting a mood disorder if a 1st degree relative has it
2-3x
what age does a mood disorder most commonly come on in
12-24 or >65
Aetiology of Depression
mostly unknown, multi-factorial, although certain life events, stress and gender can play a part
Prognosis of depression
1/3 recurrence rate within 1 year
50% lifetime recurrence
87% of recurrence is within 15 years
Clinical features of Depression
3 Core symptoms:
Anhedonia
Anergy
Low mood
7 Other: Disturbed sleep Poor concentration psychomotor agitation/slowing low self-confidence changes to appetite guilt/self-blame suicidal ideation
Diagnostic criteria and classification for depression
Symptoms must be present most days, most of the time for at least 2 weeks
Mild - 4 symptoms (at least 2 core symptoms)
Moderate - 6 (at least 2 core symptoms)
Severe - 8 (has to be present for >4 weeks, with every symptom present for most of every day, at least 2 core symptoms)
Severe +Psychosis - all features of severe + psychosis
Differentials for Depression
Bipolar Schizophrenia Grief reaction Dementia Anxiety Hypothyroidism Vit B12 deficiency ADR Sleep apnoea Cushings MS Parkinsons Infection
How do you investigate suspected depression
Thorough Mental health history asking about all the symptoms of depression - (questionnaire PHQ-9)
Bloods - FBC, TFT, metabolic screen, 24-hr cortisol, folic acid, Tox screen, B12, fasting glucose
collateral history
What is somatic syndrome
Physical or biological symptoms of depression
Symptoms of somatic syndrome
decreased appetite weight loss early morning waking diurnal variation in mood -wose in morning decreased libido psychomotor retardation emotional reactivity
How does the presence of a mood disorder modulate the risks of self harm
vastly increased
36-90% of suicides are by people with depression
5-15% of patients with a diagnosis of depression die from suicide
what gender more commonly self harms and by how much
F>M 2:1
How does marital status affect self harming
Divorced > single > widowed > married
what age is self harm most common in
2/3 <35 y/o
what is the most popular form of self harm
cutting or overdose
what factors predispose to repeated self harming
Personal History Personality disorder diagnosis history of violence alcohol/drug misuse being unmarried
What factors indicate intent to commit suicide
isolation planning leaving a note settling debts, leaving a will use of violent methods perceived lethality by patient
What gender commits suicide more commonly and by how much
M>F 3:1
What are some vulnerable groups for suicide
LGBTQ+ Prisoners Asylum seekers Veterans Mental health patients
What is the options for BioPsycoSocial management for depression
BIO antidepressants (1st line bio approach) atypical antipsychotics lithium T3 augmentation ECT
PSYCHO
psychoeducation
CBT
interpersonal therapy
SOCIAL support for education, training and employment housing support carers CPN social inclusion
What is the guideline for treating mild/moderate depression
1st line antidepressant + low intensive (e.g. self help) psychotherapy + social support
2nd line - alternative antidepressant
3rd line St Johns wort monotherapy
keep in primary care as long as not getting worse
