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Mental Health (Junior Block) > 4) Mood (affective) disorders > Flashcards

4) Mood (affective) disorders Flashcards

1
Q

How long does the elevated/expansive/irritable mood have to go on for to be considered part of bipolar disorder?

A

1 week or more

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2
Q

Describe the clinical presentation of mania with reference to at least THREE common features.

A

Elevated/expansive/irritable mood and 3 or more of the following:

  • Overinclusive/overfamiliar
  • Increased energy/activity
  • Rapid rate of talking, flight of ideas
  • Distractible
  • Reduced need to sleep
  • Increased sex drive
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3
Q

Describe the treatment of bipolar disorder.

A
  • Biological (lithium first line, then add valproate. Can use antipsychotics also such as quetiapine)
  • Psychological (specific bipolar CBT and family therapy)
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4
Q

What are the THREE core symptoms of depression.

A

Beck’s:

  • Low mood (more than 2 weeks)
  • Anhedonia
  • Lack of energy
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5
Q

Suggest TWO biological symptoms/signs of depression.

A
  • Early morning waking, diurnal variation
  • Reduced appetite
  • Loss of libido
  • Psychomotor agitation/retardation
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6
Q

Suggest THREE cognitive symptoms/signs of depression.

A
  • Low self-esteem
  • Guilt, self-blame
  • Hopelessness
  • Hypochondrial
  • Poor concentration/attention
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7
Q

Describe how depression can be classified into categories based on symptoms.

A
  • Mild (2 core symptoms + 2 others)
  • Moderate (2 core + 3/4 others)
  • Severe (3 core + 4 or more others)
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8
Q

How long do the symptoms of depression have to persist for a diagnosis of depression to be made.

A

2 weeks

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9
Q

Which score is used to assess the risk of a depressed person committing suicide?

A

SADPERSONs score

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10
Q

Which score is used to assess the severity of a persons depression?

A

PHQ-9 score

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11
Q

Name THREE risk factors for the development of post-natal depression.

A
  • Personal/family history of depression
  • Single mother
  • Older mother
  • Unwanted pregnancy
  • Poor social support
  • Previous post-natal depression
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12
Q

Describe the management of moderate depression.

A
  • Supportive - Advice on sleep hygiene
  • Psychological - Interpersonal therapy, behavioural therapy (CBT commonly used for less severe depression)
  • Medical - SSRIs first line (try two of them before switching to SNRI/TCA)
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13
Q

How long do SSRIs take to work?

A

6 weeks

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14
Q

Suggest THREE features of bipolar disorder.

A
  • Elevated/expansive/irritable mood - 1 week (CORE)
  • Overinclusive/overfamiliar
  • Increased energy/activity
  • Pressured speech - uninterrupted
  • Flight of ideas
  • Distractible
  • Reduced need for sleep
  • Increased libido
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15
Q

How may bipolar disorder be classified?

A

Bipolar Type I - 1 or more manic/mixed episodes +/- 1 or more depressive episodes

Bipolar Type II - 1 or more depressive episodes with at least 1 hypomanic episode

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16
Q

Describe how atypical depression commonly presents, with, reference to how this is different to typical depression.

A
  • Oversleep rather than undersleep
  • Weight gain (usually get weight loss in depression)
  • Leaden paralysis (heavy arms/legs)…not a common feature in typical
  • Interpersonal rejection sensitivity - in English this means that the person is just waiting for the person they are talking with to reject/react negatively to them
17
Q

Suggest TWO common specific features of psychotic depression.

A
  • Auditory hallucinations
  • Delusions are mood congruent - delusions of guilt, persecution, nihilism (feeling you’re dying or your world is ending), hypochondriasis (feeling you’re ill)
18
Q

Describe how the psychological therapy differs for patients with mild depression compared to those patients with moderate/severe depression.

A
  • Mild depression - CBT or group activities

- Moderate/severe depression - interpersonal therapy, behavioural activation, couples behavioural therapy

19
Q

How long do SSRIs take to work?

A

6 weeks

20
Q

How often should patients with newly diagnosed depression be seen in the first three months?

A

Every 2-4 weeks

21
Q

What is the CORE symptom of mania? How long does it have to last to be considered diagnostic?

A

Elevated/expansive/irritable mood for one week or more.

22
Q

Describe hypomania.

A

Three or more symptoms of mania for 4 days or more that are not severe enough to interfere with social/occupational functioning.

23
Q

What screening tool can be used for bipolar disorder/mania?

A

Mood disorder questionnaire

24
Q

Describe the management of bipolar disorder.

A
  • Psychological - CBT and complex psychoeducation
  • Pharmacological - antipsychotics for episodes of acute mania, second line add in another antipsychotic & third line is lithium
  • Long term control - lithium first line, second line is sodium valproate
25
Q

Define bipolar disorder in terms of its ICD-10 classification.

A

At least 2 episodes of mood disorder, one of which must be a hypomanic, manic or mixed episode. (don’t need a depressive episode)

26
Q

You suspect a patient has bipolar disorder, suggest THREE other differentials you may consider.

A
  • Normal fluctuations in mood
  • Adjustment disorders/bereavement – like depression, but, resolves once stressor is removed
  • PTSD
  • Dementia and other brain disorders
  • Anxiety disorders
27
Q

Suggest THREE possible risk factors for developing mood disorders.

A
  • Predisposing - genetics, family history, childhood trauma
  • Precipitating - substance use/abuse, change in routine, major life events
  • Perpetuating -difficult relationships, financial trouble

Mental Health (Junior Block) (13 decks)

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