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Psychiatry > Abnormal mood > Flashcards

Abnormal mood Flashcards

1
Q

Define euthymic?

A
  • normal mood
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2
Q

Define hyperthymic?

A
  • elevated mood
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3
Q

Define cyclothymic?

A
  • variable mood
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4
Q

Define anhedonia?

A
  • loss of enjoyment
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5
Q

Define stupor?

A
  • absence of relational functions

- e.g. action and speech

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6
Q

Presentation of depression?

A
  • facial expression reduced
  • insight preserved
  • 2nd person hallucinations
  • Reduced rate of speech
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7
Q

Explain mood?

A
  • prolonged prevailing state
  • subjective
  • how do you feel
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8
Q

Explain Affect?

A
  • how the patients feelings change in relation to their environment
  • objective
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9
Q

What is Cortard’s syndrome?

A
  • nihilistic deliusions
  • lost organs
  • bloods
  • body part
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10
Q

Observations seen in depression

A
  • slower movements
  • fiddling
  • defeated posture
  • exhausted
  • worrying
  • mood low
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11
Q

What is the main classification system used in the UK?

A

icd 10

in next year ICD 11

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12
Q

How is depression diagnosed?

A
  • at least 2 weeks

- no hypomanic or mani symptoms to meet that diagnosis

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13
Q

2 out of 3 criteria for depression?

A
  • depressed mood for that person
  • loss of interest or pleasure
  • decreased energy
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14
Q

Minimum score for moderate episode of depression

A
  • 2 core
  • 4 others
  • minimum of 6
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15
Q

Minimum score for severe episode of depression?

A
  • 3 core
  • 5 others
  • minimum 8 in total
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16
Q

What is bipolar 1

A
  • at least 1 previous episode of mania + depression
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17
Q

What is bipolar 2

A
  • current or past hypomanic episodes

- never met criteria for manic episodes

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18
Q

What is hypomania

A
  • elevated to a degree abnormal to the individual
  • for 4 consecutive days
  • 3/7 additional symptoms
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19
Q

Additional hypomania symptoms

A
  • increased activity
  • increased talkative
  • difficulty concentrating
  • decreased need for sleep
  • increased sexual energy
  • mild spending spree
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20
Q

What is a manic episode

A
  • elevated or irritable mood
  • sustained for 1 week
  • severe interference with daily functioning
  • 3/9 additional symptoms
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21
Q

Additional symptoms of a manic episode

A
  • increased activity
  • pressure of speech
  • flight of ideas
  • loss of normal social inhibitions
  • decreased need for sleep
  • inflated self-esteem
  • distractibility
  • reckless behaviour
  • marked sexual energy
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22
Q

Average onset of bipolar disorder?

A

late teens

early 20s

23
Q

Bipolar 1 vs bipolar 2

A
  • bipolar 2 more common - major depression to hypomania

- bipolar 1 - major depression to mania

24
Q

Co-morbidities of bipolar disorder?

A
  • Anxiety disorders
  • Alcohol and drug misuse
  • Personality disorder
  • Eating disorder
  • Schizophrenia
  • Schizoaffective disorder
25
Q

Which has the bigger proportion of depression, bipolar 1 or 2?

A
  • bipolar 2 has a larger proportion of the time with depression
25
Q

Which has the bigger proportion of depression, bipolar 1 or 2?

A
  • bipolar 2 has a larger proportion of the time with depression
26
Q

Most common mood disturbance in bipolar?

A
  • depression

- causes the patient most issues

27
Q

What is cyclothymia?

A
  • cycling between hypomania and dysthymia
28
Q

What is dysthymia?

A
  • low mood
  • persistent
  • usually 2 years
  • less severe than major depression
29
Q

What is the mood spectrum?

A
  • major depression
  • dysthymia
  • normal
  • hypomania
  • mania
30
Q

What is an example of a self-rated scale for mood?

A
  • IDS-30
31
Q

What scaling system is used for ECT and is an observer rated scale?

A
  • MADRS
  • Montgomery-Asberg Rating scale
  • good for ECT
  • Observer rated
32
Q

Often what is the first line pharmacological treatment for depression?

A
  • sertaline

- mirtazapine

33
Q

Side effect of mirtazapine?

A
  • increased appetite

- increased weigh

34
Q

Preventing relapse in depression

A
  • 1st episode = continue antidepressants for 6mnths after full recovery
  • 2nd episode = continue antidepressants for 1-2yrs after full recovery
  • may require to be on antidepressants for life
35
Q

Treatment of acute mania/hypomania in bipolar?

A
  • stop antidepressants
  • hospitalisation??
  • antipsychotics = olanzapine, quetiapine
  • others = lithium, valproate, carbamezpine
36
Q

Treatment of acute depression in bipolar?

A
  • anti-psychotics
  • SSRIs (don’t give anti-depressants alone)
  • ECT
  • Lithium
37
Q

Gold standard for bipolar maintenance?

A
  • lithium
38
Q

Side effect of SSRIs and SNRI?

A
  • Falls in elderly

- hyponatraemia

39
Q

What is ECT used for?

A
  • depression
40
Q

Explain ECT

A
  • Bilateral bitemporal ECT
  • 2 weekly
  • 6-12treatments
  • seizures last 15-30seconds
41
Q

Side effects of ECT?

A
  • Headaches

- memory impairment

42
Q

CBASP vs CBT?

A
  • CBASP like CBT but with more emphasis of the childhood
43
Q

What are the 4 Ps of psychiatric factors?

A
  • Predisposing
  • Precipitating
  • Prolonging
  • Protective
44
Q

What are the 2 functional differentiations in the brain?

A
  • appetitive/approach

- aversive/deffensive

45
Q

The appetitive differentiation of the brain mainly involves what neurotransmitter?

A
  • dopamine
46
Q

The aversive differentiation of the brain is mainly what neurotransmitter?

A
  • serotonin
47
Q

What is over secreted in depression? (endocrine)

A
  • CRF
  • Excess cortisol
  • desensitisation of cortisol receptors
48
Q

What is increased in blood works in depression?

A
  • increased cytokines
49
Q

What happens to the hippocampal volume in depression?

A
  • reduction in hippocampal volume
50
Q

What is the hippocampus connected to?

A
  • prefrontal cortex (working memory, cognition, mood)

- amygdala (emotion and fear)

51
Q

What are potential aetiological theories of depression?

A
  • genetic
  • monoamines reduced
  • increased cortisol
  • increased cytokines
  • hippocampal atrophy
  • reduced BDNF
52
Q

What is BDNF?

A
  • Brain derived neurotrophic factor
  • involved in neogenesis
  • BDNF reduced in depression

Psychiatry (6 decks)

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