3: Depressed mood Flashcards
By which age do 50% of mental disorders start?
14
By which age do 50% of mood disorders start?
30
What is the definition of early morning wakening?
Waking up at least 2 hours before your normal time
What is stupor?
Extreme of psychomotor retardation, patient shuts down and doesn’t do anything e.g eating
What is euthymia?
Normal mood
How do depressed people appear and behave?
Reduced facial expression
Furrowed brow
Little/no eye contact
Slow/absent movements
Why is it difficult to establish rapport with a depressed patient?
Apathy
How do people with depression speak?
Slowly
Quietly
Low pitch, monotonous
Monosyllabic / short responses
People who are depressed often have a speech ___.
delay
while they think of an answer
Describe a depressed person’s mood.
Low, sad, miserable
“Flat” “empty” “black” “numb”
some patients may be irritable
Describe a depressed person’s affect.
Depressed
Flattened
Unreactive - little variance in affect when subject of conversation changes
What is emotional paralysis?
“Numbness”, inability to feel emotion - often reported by patients who are depressed
How does depression affect a patient’s thoughts?
Slowed / absent
Content is negative, guilty, pessimistic; delusive (guilty, nihilism, hypochondriac, blaming others)
Do people with depression experience perception disturbances?
Uncommon
Otherwise second person, self-critical auditory hallucinations
Depressed patients may experience ___-person auditory hallucinations.
Give an example?
second-person auditory hallucinations
“You are a bad person” - usually reflects mood
How does depression affect a patient’s cognition?
Slowed cognition
Difficulties with concentration and memory (orientation usually intact)
“Pseudo-dementia”
Do depressed patients have insight?
Yes
Who do people with depression usually blame their symptoms on?
Themselves
How can a depressed patient’s posture be described?
Defeated
What is the chance that you will have a depressive episode during your lifetime?
Around 20%
Depression is often (acute / chronic).
chronic
meaning it lasts > 2 years
What are the two extremes of mood?
Mania
Depression
What is psychosis?
Impaired relationship with reality, featuring:
delusions
hallucinations
thought disorder
passivity of thought
What is the European classification of diseases called?
ICD-10
What is the American classification of diseases called?
DSM-5
What are the four mood disorders according to the ICD-10?
Mania
Bipolar disorder
Depressive disorder
Dysthymia (persistent low-grade depression)
What is dysthymia?
Chronic, persistent, low-grade depression
e.g patient can still carry out daily activities, work
According to the ICD-10, what are the three severities of depression?
Mild
Moderate
Severe
Do the ICD-10 and DSM-5 classifications of depression match up?
No
just to be confusing :)
How do you differentiate depression from a normal low mood?
Persistent
Interfering with normal function
What are the general criteria for diagnosing depression?
1. Duration > 2 weeks
2. No hypomanic / manic episodes in the past
What are three core features of depression?
Low mood
Lack of enjoyment in activities
Lack of energy
What are some additional symptoms of depression?
Loss of confidence
Sleep disturbance
Loss of appetite
Guilt
Suicidal thoughts
Difficulty concentrating
Agitation / retardation (psychomotor)
According to the ICD-10, how many core symptoms and additional symptoms are required for a diagnosis of
a) moderate depression
b) severe depression?
a) 2 CORE + 4 ADDITIONAL (6 in total)
b) ALL 3 CORE + 5 ADDITIONAL (8 in total)
How is mild depression managed?
Watch and wait
Antidepressants not advised unless it’s recurrent
You could try CBT
What is the term used to describe depression accompanied by psychotic symptoms (e.g delusions)?
Psychotic depression
When does the low mood of depression tend to be at its worst?
In the morning
6-7% of depressed patients will die by ___.
suicide
