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Psychiatry > Affective and Psychotic Disorders, Schizophrenia and Personality Disorders > Flashcards

Affective and Psychotic Disorders, Schizophrenia and Personality Disorders Flashcards

1
Q

which common mental disorders fall under the bracket of affective disorders?

A

depression
mania
bipolar disorder

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2
Q

what kind of mental disorder are depression and mania?

A

mood disorders

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3
Q

in which three spheres do depressive symptoms be categorised?

A

psychological
physical
social

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4
Q

what type of psychological changes can occur in depression? give examples of symptoms

A

change in mood: anxiety, low mood, bewilderment

change in thought content: guilt, hopeless, worthless

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5
Q

what type of physical changes can occur in depression? give examples of symptoms

A

change in bodily function: disturbed sleep, loss of appetite, loss of libido, weight loss, pain
change in psychomotor function: agitation or retardation

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6
Q

name a few depressive symptoms which may occur in the social sphere

A 
anhedonia
isolation/withdrawal
loss of confidence
lack of concentration
apathy
irritability
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7
Q

which classification is commonly used to differentiate between mild, moderate and severe depression?

A

ICD-10 classification

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8
Q

in general terms, how are mild, moderate and severe depression differentiated?

A

by the number of symptoms presented (eg mild 4 symptoms, moderate 6+ symptoms, severe 8+ symptoms)

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9
Q

what are the main three symptoms which should always be found to diagnose any severity of depression?

A
  • low mood for 2+ weeks
  • fatigue/low energy
  • anhedonia
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10
Q

if a patient presents with depression, but also describes a manic episode, how does that affect the diagnosis of depression?

A

the manic episode in someone with depression with point towards bipolar disorder rather than simply depression

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11
Q

what symptoms could signify that a patient is severely depressed rather than moderate or mild?

A

psychotic symptoms

catatonia/stupor

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12
Q

how can somatic syndrome be different from depression?

A

it doesn’t always present with low mood, but may have a cluster of other symptoms associated with depression

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13
Q

what percentage of women get post partum “blues” and post partum depression?

A

post partum blues - 75%

post partum depression - 10%

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14
Q

what is the incidence of postpartum psychosis?

A

1 in 500 women

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15
Q

define dysthymia and cyclothymia respectively

A

dysthymia - mild, chronic form of depression

cyclothymia - mild form of bipolar disorder

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16
Q

what is the average age of diagnosis for depression and bipolar disorder respectively?

A

depression - late 20’s (27)

bipolar disorder - early 20’s (21)

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17
Q

are females or males more likely to present with depression?

A

incidence is the same for males and females

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18
Q

how many episodes of mania are necessary to diagnose bipolar disorder?

A

one episode of mania is sufficient

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19
Q

name a few possible signs of mania

A 
pressured speech
grandiosity
disinhibition
increased libido
overfamiliarity
reduced sleep
irritability
elated mood
increased spending
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20
Q

what are the main screening tools used for affective disorders?

A

SCAN

SCID

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21
Q

how likely are patients with an affective disorder to have further episodes in the future?

A

> 80% likelihood

22
Q

how many patients with an affective disorder die by suicide on average?

A

10-15%

23
Q

how many patients with an affective disorder recover after the first episode?

A

50-60%

24
Q

how is hypomania different from mania?

A

symptoms not as severe

doesn’t present with psychosis

25
Q

how many episodes of mania and depression are needed to diagnose bipolar affective disorder?

A

2+ episodes

26
Q

name a few common mental disorders that can be treated with psychological therapies

A 
depression
anxiety
OCD
panic/phobia disorders
alcohol/drug/tobacco abuse
PTSD
27
Q

name the four psychological therapies that can be used in certain mental disorders

A 
cognitive behavioural therapy (CBT)
interpersonal psychotherapy (IPT)
behavioural activation (BA)
motivational interviewing (MI)
28
Q

give a brief description of the uses and strategy of cognitive behavioural therapy

A

CBT can be used for affective disorders, panic/phobia disorders and PTSD. it aims to help the patient understand the link between their thoughts, feelings and behaviours following certain events

29
Q

give a brief description of the uses and strategy of behavioural activation

A

BA can be used for depression. it focuses on helping patients plan and carry out activities they have avoided

30
Q

give a brief description of the uses and strategy of motivational interviewing

A

MI can be used in addictive disorders. it aims to help the patient go through the process of considering, planning and acting to stop their addiction

31
Q

give a brief description of the uses and strategy of interpersonal psychotherapy

A

IPT can be used in depression and anxiety, and it aims to help patients reflect on the correlation between interpersonal events and their feelings/mood

32
Q

what is the definition of psychosis?

A

inability to distinguish symptoms of hallucinations, delusions and thought disorders from reality

33
Q

which are the main diseases which can present with psychosis?

A

delirium
schizophrenia
severe depression with psychotic symptoms
mania with psychotic symptoms

34
Q

define a delusion

A

a delusion is a false, unsheakable belief not in keeping with social or cultural background

35
Q

define a hallucination

A

a hallucination is an uncontrolled, real perception of a non-existent stimulus in the external space

36
Q

how long do symptoms need to be present for someone to be diagnosed with schizophrenia?

A

one month at least

37
Q

name a few symptoms which can lead to a diagnosis of schizophrenia

A
  • hallucinations
  • delusions
  • thought disorder
  • speech disorder/neologisms
  • catatonic behaviour
  • negative symptoms
38
Q

name a few positive symptoms found in schizophrenia

A

hallucinations
delusions
thought disorder

39
Q

name a few negative symptoms found in schizophrenia

A

apathy
anhedonia
lack of emotions

40
Q

name a few generic factors which may be involved in schizophrenia

A

biological (neurochemistry, genetics)
psychological (family, events)
social (migration, drugs)

41
Q

which neurotransmitters are thought to play a part in schizophrenia?

A

dopamine
serotonin
GABA
glutamate

42
Q

what is the incidence of schizophrenia?

A

1% of population

43
Q

what is the gender incidence of schizophrenia?

A

males = females

44
Q

what is the age range for diagnosis of schizophrenia?

A

15-35

45
Q

how long should patients stay on antipsychotic medication after an episode of psychosis?

A

18 months to 2 years

46
Q

name a few factors which may improve a prognosis of schizophrenia

A 
no family history
sudden onset
stable family/friends relationships
stable emotions
prompt treatment
47
Q

name a few factors which can worsen a prognosis of schizophrenia

A 
family history (twins especially)
slow insidious onset
substance abuse
unstable social circumstances
early onset
48
Q

what is schizoaffective disorder?

A

it’s a combination of psychotic symptoms (eg hallucinations, delusions or thought disorder) with either depressed or manic features

49
Q

can patients with severe anxiety/depression drive?

A

if mild/moderate with no significant impairment - yes

if severe/psychotic - no

50
Q

in the GP setting, how often should patients be followed up after being put on antidepressants?

A

if high risk/under 30 - see after a week and frequently after that until no longer high risk.
otherwise, every 2 weeks for 3 months then taper off

Psychiatry (7 decks)

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