3: Depressed mood

Question 1

By which age do 50% of mental disorders start?

Answer 1

14

Question 2

By which age do 50% of mood disorders start?

Answer 2

30

Question 3

What is the definition of early morning wakening?

Answer 3

Waking up at least 2 hours before your normal time

Question 4

What is stupor?

Answer 4

Extreme of psychomotor retardation, patient shuts down and doesn’t do anything e.g eating

Question 5

What is euthymia?

Answer 5

Normal mood

Question 6

How do depressed people appear and behave?

Answer 6

Reduced facial expression

Furrowed brow

Little/no eye contact

Slow/absent movements

Question 7

Why is it difficult to establish rapport with a depressed patient?

Answer 7

Apathy

Question 8

How do people with depression speak?

Answer 8

Slowly

Quietly

Low pitch, monotonous

Monosyllabic / short responses

Question 9

People who are depressed often have a speech ___.

Answer 9

delay

while they think of an answer

Question 10

Describe a depressed person’s mood.

Answer 10

Low, sad, miserable

“Flat” “empty” “black” “numb”

some patients may be irritable

Question 11

Describe a depressed person’s affect.

Answer 11

Depressed

Flattened

Unreactive - little variance in affect when subject of conversation changes

Question 12

What is emotional paralysis?

Answer 12

“Numbness”, inability to feel emotion - often reported by patients who are depressed

Question 13

How does depression affect a patient’s thoughts?

Answer 13

Slowed / absent

Content is negative, guilty, pessimistic; delusive (guilty, nihilism, hypochondriac, blaming others)

Question 14

Do people with depression experience perception disturbances?

Answer 14

Uncommon

Otherwise second person, self-critical auditory hallucinations

Question 15

Depressed patients may experience ___-person auditory hallucinations.

Give an example?

Answer 15

second-person auditory hallucinations

“You are a bad person” - usually reflects mood

Question 16

How does depression affect a patient’s cognition?

Answer 16

Slowed cognition

Difficulties with concentration and memory (orientation usually intact)

“Pseudo-dementia”

Question 17

Do depressed patients have insight?

Answer 17

Yes

Question 18

Who do people with depression usually blame their symptoms on?

Answer 18

Themselves

Question 19

How can a depressed patient’s posture be described?

Answer 19

Defeated

Question 20

What is the chance that you will have a depressive episode during your lifetime?

Answer 20

Around 20%

Question 21

Depression is often (acute / chronic).

Answer 21

chronic

meaning it lasts > 2 years

Question 22

What are the two extremes of mood?

Answer 22

Mania

Depression

Question 23

What is psychosis?

Answer 23

Impaired relationship with reality, featuring:

delusions

hallucinations

thought disorder

passivity of thought

Question 24

What is the European classification of diseases called?

Answer 24

ICD-10

Question 25

What is the **American** classification of diseases called?

Answer 25

**DSM-5**

Question 26

What are the **four mood disorders** according to the **ICD-10**?

Answer 26

**Mania** **Bipolar disorder** **Depressive disorder** **Dysthymia** (persistent low-grade depression)

Question 27

What is **dysthymia**?

Answer 27

**Chronic, persistent, low-grade depression** e.g patient can still carry out daily activities, work

Question 28

According to the ICD-10, what are the three severities of depression?

Answer 28

**Mild** **Moderate** **Severe**

Question 29

Do the ICD-10 and DSM-5 classifications of depression match up?

Answer 29

**No** just to be confusing :)

Question 30

How do you differentiate **depression** from a normal **low mood?**

Answer 30

**Persistent** **Interfering with normal function**

Question 31

What are the **general criteria** for diagnosing **depression**?

Answer 31

**1. Duration \> 2 weeks** **2. No hypomanic / manic episodes in the past**

Question 32

What are **three core features** of depression?

Answer 32

**Low mood** **Lack of enjoyment in activities** **Lack of energy**

Question 33

What are some **additional symptoms** of **depression**?

Answer 33

**Loss of confidence** **Sleep disturbance** **Loss of appetite** **Guilt** **Suicidal thoughts** **Difficulty concentrating** **Agitation / retardation (psychomotor)**

Question 34

According to the **ICD-10**, how many **core symptoms** and **additional symptoms** are required for a diagnosis of a) **moderate depression** b) **severe depression**?

Answer 34

**a) 2 CORE + 4 ADDITIONAL** (6 in total) **b) ALL 3 CORE + 5 ADDITIONAL** (8 in total)

Question 35

How is **mild depression** managed?

Answer 35

**Watch and wait** Antidepressants not advised unless it's recurrent You could try CBT

Question 36

What is the term used to describe **depression** accompanied by **psychotic symptoms** (e.g delusions)?

Answer 36

**Psychotic depression**

Question 37

When does the **low mood** of depression tend to be at its worst?

Answer 37

**In the morning**

Question 38

**6-7% of depressed patients** will die by \_\_\_.

Answer 38

**suicide**