Affective Disorders Flashcards
What is a euthymic mood?
That described as normal.
What is anhedonia?
The loss of enjoyment/pleasure.
What is stupor?
The loss of action/speech seen in severe depression.
Is depression usually worse in the mornings or the evenings?
Typically worse in the mornings.
Do depressed patients sleep longer?
No, they usually wake up atleast 2 hours early.
What are the features seen looking at a depressed patient?
Very low mood and affect Reduced facial expression A furrowed brow Slowed movement Reduced eye contact
What are features seen in the speech of depressed patients?
Slowing of speech Low volume and pitch to voice Sound monotonous Increased pausing in speech Brief answers
What is mood?
A prolonged/prevailing state or disposition.
It is subjective.
What is affect?
The application of mood to a patients surroundings.
Can delusions occur in depression?
Yes - usually auditory.
“You are not good enough” - in 2nd person.
Is cognition affected in depression?
Yes, memory is too.
Like a ‘pseudodementia’.
Is insight lost in depression?
No, individuals can see their symptoms.
What is mania?
Severe elevated mood.
What is bipolar disorder?
A condition causing episodes of both depression and mania.
How is depression diagnosed?
Evidence of a depressive episode lasting atleast 2 weeks.
No evidence of hypomanic/manic symptoms at any point in the past.
If a patient has depression with no manic episodes, their condition is thought of as what?
Unipolar
What are the 3 components of depression?
Low mood that is uninfluenced by circumstance.
Loss of enjoyment in previously enjoyed activities.
Decreased energy.
Think ‘MEE’ - as these individuals are egocentric.
What is the treatment for mild depression?
Supportive only - a self-limiting state.
Makes up most cases.
What is Cotard’s syndrome?
An extreme depression associated with nihilistic delusions.
Patients will have lost insight - may think they are already dead.
What age group is most commonly affected by Cotard’s syndrome?
The elderly
What is the first line treatment for depression?
CBT
What is hypomania?
A level of disturbance just below that seen in mania.
Must be present for atleast 4 days.
What is a manic episode?
An episode of predominately elevated, expansive or irritable mood.
It must be sustained for atleast a week and hinders daily life.
In bipolar patients, what should be given alongside an antidepressant?
A mood stabiliser (can be an antipsychotic, anti-convulsant, or lithium).
Is bipolar curable?
No, it is a lifelong condition.
When is bipolar most commonly diagnosed?
Teens/Early 20s
Which mental disorder is associated with the greatest risk of suicide?
Bipolar disorder
What is the timeframe for drugs to take action in treatment of a mood disorder?
Weeks/Months
What drugs are the first-line in management of bipolar disorder?
Anti-psychotics
What are 4 examples of anti-depressants?
Escitalopram (most well tolerated)
Sertraline
Mirtazapine
Venlafaxine
What are 2 examples of anti-psychotics?
Olanzapine
Quetiapine
Is hospital admission needed in mania?
Yes, in some cases.
What must be avoided in a manic/hypomanic episode?
Prescription of an antidepressant.
What is the gold-standard long-term treatment method for bipolar disorder?
Lithium
If a bipolar patient has a tendency towards depressive episodes, which drug should be given in the long-term?
Lamotrigine
If a bipolar patient has a tendency towards manic episodes, which drug should be given in the long-term?
Sodium valproate
What is ECT?
An effective treatment involving an induced seizure.
Lasts 15-30s, patient recovers in minutes.
Mild side-effects.
After an episode of affective disorder, how long should a drug treatment be continued?
If a drug is working for a patient, continue for atleast 6 months before reducing the dose.
