T3L5 affective disorders clinical aspects

Question 1

psychopathy

Answer 1

abnormal experience, cognition and behaviour

descriptive psychopathy:
» observation of behaviour
»phenomenology

Question 2

3 things to look at when diagnosing affective disorder

Answer 2

1. presenting symptoms and chronology
2. the psychiatric state
3. mental state examination

Question 3

mental state examination

Answer 3

• appearance and behaviour
• speech
• mood
• thought
• perception
• cognition (orientation, memory, intelligence)
• insight

Question 4

4 affective episodes

Answer 4

1. major depressive episode
2. manic episode
3. hypomanic episode
4. mixed affective episode

(panic episode)?

Question 5

symptoms of depression– diagnosis

Answer 5

diagnosis: 5 or more during 2 week period:

Depressed mood most of the day, nearly every day
Diminished interest or pleasure
Weight loss / weight gain or appetite decrease / increase
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive or inappropriate guilt
Diminished ability to think or concentrate, or indecisiveness
Recurrent suicidal ideation or a suicide attempt/plan

Question 6

atypical depression

Answer 6

mood reactivity

or

• weight gain or appetite increase
• hypersomnia
• leaden paralysis (heavy feelings in limbs)
• interpersonal rejection sensitivity

Question 7

manic episode

Answer 7

for a period of at least one week; present most of the day, nearly every day; 3 or more of:

Inflated self-esteem or grandiosity
Decreased need for sleep
More talkative than usual or pressure to keep talking
Flight of ideas or racing thoughts
Distractibility
Increase in goal-directed activity or psychomotor agitation
Excessive involvement in high risk activities

often functional impairment or hospitalization to prevent harm to self or others

Question 8

hypomanic epiosed

Answer 8

at least 4 days and present most of the day, every day. 3 or more of:

Inflated self-esteem or grandiosity
Decreased need for sleep
More talkative than usual or pressure to keep talking
Flight of ideas or racing thoughts
Distractibility
Increase in goal-directed activity or psychomotor agitation
Excessive involvement in high risk activities

same as manic but shorter??

not severe enough to cause functional impairment or hospitalization

Question 9

features associated with both mania and depression

Answer 9

• anxiety
• psychotic symptoms
• catatonia

Question 10

mixed affective episodes

Answer 10

full criteria met for either (hypo)manic or depressive episode, and at least 3 symptoms of the other polarity

Question 11

major depressive disorder

Answer 11

episodes with free interval in-between

age 25-35, but can be any age
f>m
8-20% die from suicide

1 in 5 lifetime prevelance

Question 12

bipolar disorders

Answer 12

bipolar I
- at least 1 manic episode

bipolar II

• at least one hypomanic episode
• at least one major depressive episode

onset 15-24
0.6-2.4% prevalence

very familial (10x higher in first degree relatives)

m=f

highly recurrent, may have progressive course

rate of suicide 20x higher than general population
30-50% patients attempt suicide

SYMPTOMATIC ALMOST 50% of the time