Abnormal mood Flashcards
___ percent of mood disorders start ____ 30
50%, before
Euthymic
Normal mood
Hyperthymic
Elevated mood
Cyclothymic
Variable mood
Sanguine
Extrovert
Phlegmatic
Self-content, kind
Melancholic
Perfectionist, worrier
Choleric
Leader, in charge
Anhedonia
Loss of enjoyment/pleasure
Anergia
Lack of energy
Amotivation
Lack of motivation
Diurnal variation
Mood variation throughout the day
Psychomotor retardation
Subjective or objective slowing of thoughts and or movement
Stupor
Absence of relational functions
Early morning wakening is a feature of ________. What is it?
Depression
Waking at least 2 hours before the expected/normal time
Appearance in depression
Reduced facial expression Brow is furrowed Reduced eye contact Limited gesturing Rapport is often difficult to establish
Speech in depression
Limited content (brief answers) Reduced rate of speech Lowered in pitch Reduced in volume Reduced intonation (pitch) Increased latencies (longer time between end of question and them starting to speak)
What is mood?
Prolonged prevailing state; typically associated with what the patient describes (subjective)
How do you feel?
What is affect?
It’s mood applied to things (events, people)
It’s how the patient’s feelings change in relation to their surroundings and the context, it’s something that you typically observe
How the patient reacts
Cotard’s syndrome
Nihilistic delusions: life is meaningless
“Walking corpse syndrome”
Hallucinations in depression are almost always _________
Auditory
Observations in depression
Slower movements Fiddling fingers Defeated posture Reduced facial expression Speech reduced Mood low Poor sleep Exhausted Worrying
Major depression is NOT
Just being sad or a bit unhappy
Not some variation of normal
What is the affective spectrum?
One end “mania” one end “depression”
DSM 5 is for what disorders?
Depressive, and bipolar
ICD-10 categories
Just mood , which encompasses depressive, bipolar, and mania
Depression categories in DSM vs ICD
DSM has a “mild” category, whereas ICD only has moderate and severe
Criteria for diagnosing depression
Depressive episode lasting 2 weeks
There have been no hypomanic or manic symptoms sufficient to meet the criteria for hypomanic or manic episode at nay time in the individual’s life
2/3: depressed mood, loss of interest or pleasure, decreased energy
What is a depressed mood?
To a degree that is definitely abnormal for the individual, present for most of the day and almost every day, largely uninfluenced by circumstances, and sustained for at least 2 weeks
Moderate vs severe depression
All 3 symptoms would be severe depression
Moderate = 6 points
Severe = 8 points
Do anti-depressants work in mild depression?
Not more than a placebo
What is psychotic depression?
Occasionally paranoid - typically mood-congruent
Cotard’s syndrome
Who gets Cotard’s syndrome?
More common in the elderly
Bipolar I vs II
I: has to have met criteria for mania, although previous episode may have been hypomanic and/or depressive
“classic form” of psychosis
II: current or past hypomanic episode AND current or past depressive episode
Never met criteria for manic episode
More ocmmon
Bipolar II
Pseudo
Hypomanic episodes only after antidepressants for depression
What is bipolar disorder?
Characterized by 2+ episodes in which the patient’s mood and activity levels are significantly disturbed (on some occasions hypomania or mania, and on others, depression)
Depression vs bipolar
A single episode of hypomania or mania is bipolar disorder
The first episode of (hypo)mania on a background of recurrent depression means that it’s bipolar disorder and not depression anymore
Hypomania vs mania
Hypomania means lower/below mania
How do you classify a hypomanic episode
- mood is elevated or irritable to a degree that is abnormal for >4 days
- 3 of the following signs must be present (interfering with personal daily living): increased activity, talkativeness, no concentration, decreased need for sleep, increased sexual energy, mild spending sprees
Hypomania vs mania time
4 days and 1 week
BP I is about _____ of BPAD
1/3
When do you get BP?
Late teens or early 20s
BP over 60?
Very rare! Often treatment-resistant and progressive decline in functioning
Organic cause more likely
