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