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Affective Disorders Flashcards

1
Q

what are mood disorders?

A

disorders of mental status and function where altered mood is a core feature

refer to states of depression and of mania

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2
Q

How can mood disorders present?

A

primary

or

secondary: consequence of another disorder/illness

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3
Q

What are mood disorders often associated with?

A

Anxiety symptoms and anxiety disorders

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4
Q

give 2 examples of classification systems

A

ICD10

DSM5

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5
Q

what is depression when thought of as a symptom?

A

state of feeling or mood that can range from normal experience to a severe, life-threatening illness

typically associated as a form of sadness

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6
Q

What is depression when thought of as a syndrome?

A

A constellation of symptoms and signs

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7
Q

What is depression when thought of as a recurrent illness?

A

Recurrent depressive disorder

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8
Q

when does depression become abnormal?

A

not clear cut but psychiatry places emphasis on

  • symptoms: persistent, pervasive
  • degree of impairment
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9
Q

What are the 3 spheres that depressive illness symptoms occur in?

A
  • Psychological
  • Physical
  • Social
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10
Q

What changes can occur in the psychological sphere with depression?

A
  • Changes in mood

- Changes in thought content

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11
Q

What changes in mood can occur with depression?

A
  • Depression (can have diurnal variation)
  • Anxiety
  • Perplexity
  • Anhedonia
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12
Q

What changes in thought content can occur with depression?

A
  • Undue guilt
  • Hopelessness
  • Worthlessness
  • Any neurotic symptomatology
  • Ideas of reference
  • Delusions and hallucinations
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13
Q

What changes can occur in the physical sphere with depression?

A
  • Change in bodily function

- Change in psychomotor functioning

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14
Q

what changes with bodily function can occur with depression?

A

changes in

  • energy
  • sleep
  • apetite
  • libido
  • constipation
  • pain
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15
Q

What changes with psychomotor functioning occur with depression?

A
  • Agitation

- Retardation

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16
Q

what changes can occur to the social sphere in depression?

A
  • loss of interests
  • loss of concentration
  • loss of confidence
  • irritability
  • apathy, withdrawal
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17
Q

Agitation

A

A state of restless over activity, aimless or ineffective

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18
Q

Anhedonia

A

Loss of ability to derive pleasure from experience

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19
Q

Anxiety

A

An unpleasant emotion in which thoughts of apprehension or fear predominate

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20
Q

Apathy

A

Loss of interest in own surroundings

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21
Q

depression

A

unpleasant emotion in which sadness or unhappiness predominates

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22
Q

Retardation

A

A slowing of motor responses including speech

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23
Q

Stupor

A

A state of extreme retardation in which consciousness is intact.

The patient stops moving, speaking, eating and drinking.

On recover, they can describe clearly events which occurred whilst stuporose

24
Q

What is the ICD10 criteria for depression?

A
  • at least 2 week history
  • no hypomanic/manic episodes ever
  • not attributable to substances/organic mental disorder
  • excluded other diagnosis if presents with psychosis
25
What occurs in somatic syndrome?
loss in: - energy - sleep: waking up 2 hrs earlier, depression worse in morning - apetite - weight loss - libido - psychomotor - agitation or retardation
26
What is the general criteria for depression.
- low mood - low energy - loss of interest/pleasure
27
what is the additional criteria for depression?
change in - confidence - concentration - sleep - apetite - guilt, suicidal thoughts, agitation or retardation
28
According to ICD10, what is the criteria for mild depression.
- At least 2 general criteria | - Additional criteria to give score of at least 4
29
According to ICD10, what is the criteria for moderate depression?
- At least 2 general criteria | - Additional criteria to give score of at least 6
30
according to ICD10, what is the criteria for severe depression?
- all of the general criteria - additional criteria to give score of at least 8 - if psychotic symptoms or stupor then severe depression
31
How many people experience post-natal depression?
75% of women within 2 weeks
32
examples of differential diagnosis for depression
normal reaction to life event seasonal affective disorder (SAD) dysthymia, cyclothymia, bipolar stroke, tumour, dementia hypothyroidism, Addison’s, hyperparathyroidism infections: influenza, infectious mononucleosis, hepatitis, HIV/AIDS drugs
33
what treatment options are there for depression?
- antidepressants - psychological treatments - physical treatments
34
types of antidepressants
- selective serotonin reuptake inhibitors (SSRIs) - tricyclic antidepressants (TCAs) - monamine oxidase Inhibitors
35
what forms of psychological treatment are there for depression?
- CBT - IPT - individual dynamic psychotherapy - family therapy
36
physical treatments for depression
- ECT - psychosurgery - DBS - VNS
37
what are the 2 main measurement tools used in depression?
SCID (Structured Clinical Interview for DSM disorders) SCAN (Schedules for Clinical Assessment in Neuropsychiatry)
38
what is mania?
a state of feeling, or mood, that ranges from near-normal experience to severe, life-threatening illness inappropriate elevated mood
39
What is mania often associated with?
- disinhibition - loss of judgement - grandiose ideas
40
examples of classifications of mania
hypomania mania without psychotic symptoms mania with psychotic symptoms other manic episodes manic episode, unspecified
41
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42
what is the ICD10 criteria for hypomania
lesser degree of mania, no psychosis mild elevation of mood for several days on end increased energy: activity, marked feeling of wellbeing increased sociability: talkativeness, overfamiliarity, sexual energy, decreased need for sleep may be irritable decreased concentration: new interests, mild overspending not severe enough to disrupt ordinary work and social activities more or less completely
43
what is the ICD10 criteria for mania (with or without psychosis)?
1 Week & severe enough to disrupt ordinary work and social activities more or less completely - elevated mood - increased energy: overactivity, pressure of speech, decreased need for sleep - disinhibition - grandiosity - alteration of senses - extravagant spending - may be irritable rather than elated
44
examples of differential diagnosis for mania
mixed affective state schizoaffective disorder, schizophrenia cyclothymia, ADHD stroke, MS, epilepsy, AIDS, neurosyphilis cushing's, hyperthyroidism, SLE drugs and alcohol
45
What measurement tools are there for mania?
- SCID - SCAN - Young mania rating scale (YMRS)
46
What treatment options are there for mania?
antipsychotics: olanzapine, risperidone, quetiapine mood stabilisers: sodium valproate, lamotrigine, carbamazepine lithium ECT
47
Give examples of ICD10 classifications of bipolar disorder.
- BAD, currently hypomanic - BAD, current manic without psychosis - BAD, current manic with psychosis - BAD, Current mild/mod depression - BAD, current severe depression without psychosis - BAD, current severe depression with psychosis - BAD, current episode mixed - BAD, current episode in remission - Other bipolar affective disorders - Bipolar affective disorder, unspecified
48
What is bipolar affective disorder?
It is a condition which consists of repeated (2+) episodes of depression and mania or hypomania
49
If a patient presents with no episodes of mania or hypomania, what is the diagnosis?
Recurrent depression
50
If a patient presents with no depression, what is the diagnosis?
Hypomania or bipolar disorder
51
What is the epidemiology of bipolar disorder?
- Lifetime prevalence rate: 0.7-1.6 - M=F - Mean age of onset= 21 (unusual after 30) - 1/3 have onset <20 years
52
When does early onset of bipolar disorder usually occur?
When there is a family history
53
What is the epidemiology of depression?
-Lifetime prevalence risk: 2.9-12 (less severe manifestations= 20) -F:M 2:1 -highest risk 18-44 (median 25) -Mean age of onset =27 -
54
What is the typical outcome of major depression?
- Typical episode 4-6 months - 80% have further episodes - 54% have recovered by 26 weeks - 15% die by suicide - 12% do not recover
55
What is the typical outcome of bipolar disorder/mania?
- Typical manic episode 1-3months - 90% have further episodes - 60% recovered by 10 weeks - 10% die by suicide - 5% fail to recover

psychiatry (23 decks)

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