Abnormal Mood: Depression Flashcards
50% of all mental heath disorders start before what age?
15
50% of mood disorders start before what age?
30
mood disorders are most common in what age groups?
2nd, 3rd and 4th decade
anhedonia?
loss of enjoyment/pleasure
anergia?
lack of energy
amotivation?
lack of motivation
diurnal variation?
mood varies over day
early morning wakening?
waking at least 2 hours before expected/normal time
psychomotor retardation
subjective or objective slowing of thoughts and/or movement
stupor
absence of relational functions (i.e actions and speech)
MSE?
appearance and behaviour speech mood and affect thought perception cognition insight
speech features of depression?
reduced rate, pitch, volume and intonation
increased speech latency (longer time between end of question and them starting to speak)
limited content
how are emotions affected in severe emotions?
emotions cant really respond to extreme positive or negative experiences
“emotional paralysis”
how is thought affected by depression?
form usually normal
flow can be impaired
content is often negative in nature, can be delusional, suicidal
how can perception be affected by depression?
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)
paranoia in depression vs psychosis?
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
how does depression affect cognition?
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
how is insight affected by depression?
typically preserved (unlike schizophrenia) usually recognise that they are unwell but can attribute feelings to other things - sins, personal failings or weakness etc
depression is usually recurrent, true or false?
true
ICD10?
international classification of diseases version 10
DSM5?
diagnostic and statistical manual, version 5
classification system in US
difference between ICD10 and DSM5?
ICD10 groups mood disorders together (mania, bipolar, depressive disorder, dysthymia)
DSM5 separates depressive disorders (major/persistent depressive disorders) and bipolar disorders
how is depression categories in DSM5 and ICD10?
DSM = major depressive disorder (mild, mod, severe) and persistent depressive disorder ICD = depressive disorder (mild, mod and severe)
general criteria for defining depression?
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
what are the 3 core features of depression?
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
7 additional symptoms of depression?
- 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
how does ICD10 rate severity of depression?
the number and to some extent severity, of symptoms
moderate depression?
2 core symptoms + 4 additional symptoms
= 6
severe depression?
all 3 core symptoms + 5 additional symptoms
= 8
the majority of depression in GP is what type?
mild
fairly high weekly prevalence and usually gets better by itself
what is psychotic depression?
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
what is cotard’s syndrome?
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”
