Abnormal Mood: Depression

Question 1

50% of all mental heath disorders start before what age?

Answer 1

15

Question 2

50% of mood disorders start before what age?

Answer 2

30

Question 3

mood disorders are most common in what age groups?

Answer 3

2nd, 3rd and 4th decade

Question 4

anhedonia?

Answer 4

loss of enjoyment/pleasure

Question 5

anergia?

Answer 5

lack of energy

Question 6

amotivation?

Answer 6

lack of motivation

Question 7

diurnal variation?

Answer 7

mood varies over day

Question 8

early morning wakening?

Answer 8

waking at least 2 hours before expected/normal time

Question 9

psychomotor retardation

Answer 9

subjective or objective slowing of thoughts and/or movement

Question 10

stupor

Answer 10

absence of relational functions (i.e actions and speech)

Question 11

MSE?

Answer 11

appearance and behaviour
speech
mood and affect
thought
perception
cognition
insight

Question 12

speech features of depression?

Answer 12

reduced rate, pitch, volume and intonation
increased speech latency (longer time between end of question and them starting to speak)
limited content

Question 13

how are emotions affected in severe emotions?

Answer 13

emotions cant really respond to extreme positive or negative experiences
“emotional paralysis”

Question 14

how is thought affected by depression?

Answer 14

form usually normal
flow can be impaired
content is often negative in nature, can be delusional, suicidal

Question 15

how can perception be affected by depression?

Answer 15

usually not affected but can have increased self-referential thinging (“people are talking about me”)
can have increase in paranoia
can have hallucinations in some people (usually auditory, second person and derogatory in nature)

Question 16

paranoia in depression vs psychosis?

Answer 16

psychosis = bizarre quality (watched by aliens etc), often other symptoms (persecutory ideas/delusions etc), insight often lost
depression = increased sensitivity to criticism (guilt/self blame), more self conscious/aware in bust places, feel under scrutiny

Question 17

how does depression affect cognition?

Answer 17

subjectively, cognition is slow
complaints of poor memory (probably more to do with poor attention)
“pseudo-dementia”
can have deficits in working memory, attention and planning
can be compounded by anxiety

Question 18

how is insight affected by depression?

Answer 18

typically preserved (unlike schizophrenia)
usually recognise that they are unwell but can attribute feelings to other things - sins, personal failings or weakness etc

Question 19

depression is usually recurrent, true or false?

Answer 19

true

Question 20

ICD10?

Answer 20

international classification of diseases version 10

Question 21

DSM5?

Answer 21

diagnostic and statistical manual, version 5

classification system in US

Question 22

difference between ICD10 and DSM5?

Answer 22

ICD10 groups mood disorders together (mania, bipolar, depressive disorder, dysthymia)
DSM5 separates depressive disorders (major/persistent depressive disorders) and bipolar disorders

Question 23

how is depression categories in DSM5 and ICD10?

Answer 23

DSM = major depressive disorder (mild, mod, severe) and persistent depressive disorder
ICD = depressive disorder (mild, mod and severe)

Question 24

general criteria for defining depression?

Answer 24

the depressive episode should last at least 2 weeks
there have been no hypomanic or manic symptoms to meet the criteria for hypomanic or manic episode at any time in the individuals life

Question 25

what are the 3 core features of depression?

Answer 25

must have at least 2 of

• depressed mood (abnormal for the individual, there most of the day, every day for at least 2 weeks and uninfluenced by circumstances)
• loss of interest or pleasure in activities
• decreased energy/increased fatigability

Question 26

7 additional symptoms of depression?

Answer 26

• loss of confidence or self esteem
• unreasonable feelings of self-reproach or excessive guilt
• recurrent thoughts of death or suicide
• complaints or evidence of diminished ability to think/concentrate
• change in psychomotor activity, with agitation or retardation
• sleep disturbance of any type
• change in appetite with weight change

Question 27

how does ICD10 rate severity of depression?

Answer 27

the number and to some extent severity, of symptoms

Question 28

moderate depression?

Answer 28

2 core symptoms + 4 additional symptoms

= 6

Question 29

severe depression?

Answer 29

all 3 core symptoms + 5 additional symptoms

= 8

Question 30

the majority of depression in GP is what type?

Answer 30

mild

fairly high weekly prevalence and usually gets better by itself

Question 31

what is psychotic depression?

Answer 31

occasionally paranoid, typically “mood-congruent” or “hypochondrial”
- “ people are going to get me or kill me bc I deserve it”
- “ive got cancer bc of my sins”
can have cotard’s syndrome

Question 32

what is cotard’s syndrome?

Answer 32

part of psychotic depression
more common in elderly
often have nihilistic delusions “I cant eat bc my bowels have turned to dust, don’t bother treating me I have no brain”
can be extreme as “im dead, the world doesn’t exist any more”