mood disorders

Question 1

3 core symptoms of depression.

Answer 1

low mood
anhedonia
hopelessness

Question 2

Other symptoms of depression

Answer 2

• unplanned weight loss or gain
• sleep disturbance - early waking
• fatigue/malaise/tiredness
• irritability
• psychomotor retardation
• worthlessness or inappropriate guilty
• concentration/memory difficulties
• DEATH thoughts

Question 3

Other than 5 symptoms of depression (one of which being either low mood or anhedonia) what else must be happening for the patient to warrant a diagnosis or depression?

Answer 3

• significant functional impairment
• not due to psychoactive substance or organic disease
• not due to other psych diagnosis
• no Hx of hypomania or mania

FOR GREATER THAN 2 WEEKS

Question 4

What scoring systems can you use for depression?

Answer 4

PHQ-9

HAD

Question 5

How do you scale severity for depression?

Answer 5

mild = 5 Sx + mild impairment 
moderate = 5+ Sx + moderate to sever impairment 
Severe = most symptoms + severe functional impairment +/- psychotic Sx

Question 6

What’s the difference, clinically, between mania and hypomania?

Answer 6

• hypomania’s symptoms are less intense
• hypomania last for 4-7 days and no longer - mania is >1 week
• hypomania doesn’t end up in hospitalisation
• ANY psychotic symptoms = manic episode NOT hypomania

Question 7

What are some symptoms of a manic episode?

Answer 7

• grandiosity
• increased energy
• decrease need for sleep
• loss of inhibitions
• pressure or speech
• flight of ideas
• distractibility

Question 8

What’s the difference between type I and type II bipolar?

Answer 8

I = mania + depression 
II = hypomania + depression

Question 9

Management of bipolar?

Answer 9

mild - reduce stimuli, decrease access to cars + bank accounts + assess precipitating factors (drugs) + stop anti-D if on one (can worsen Sx of mania)
moderate - monotherapy mood stabilisers (lithium or valporate) OR atypical antipsychotic
severe mood stabilisers + antipsychotic