Affective Disorders Flashcards
What is a mood disorder?
Disorder of mental state and function where altered mood is the core feature
Commonest group of mental disorders
How are affective mood disorders diagnosed?
History
Mental State Examination
What are the two extremes of affective mood disorders?
Depression
Highly elevated- mania
Depression can be a symptom or a syndrome.
When does depression become abnormal?
Persistence of symptoms
Pervasiveness of symptoms
Degree of impairment
Presence of other specific signs and symptoms
What is required for a diagnosis of depression?
Low mood or reduced interest/pleasure
Most of the day, nearly every day
Last for at least 2 weeks
->for a diagnosis of purely depression, must not be any hypomanic or manic episodes if lifetime as could be bipolar disorder
List some of the common symptoms of depression.
SIG E CAPS
S- sleep problems
I- interest deficit
G- guilt, worthlessness, hopelessness, regret
E- energy deficit, fatigue
C- concentration deficit
A- appetite either increased or decreased
P- Psychomotor retardation or agitation
S- suicidality
Post-natal depression?
Occurs after giving birth
Common- 10-15% of women will develop
75% of women experience ‘baby blues’ within 2wks as hormone balance readjusts
Can start several months postpartum, can occur during pregnancy and persist
What are some of the main groups of medication for mood affective disorders?
Antidepressants
Antipsychotics
Mood stabilisers
Give some examples of antidepressants.
SSRIs
SNRIs
TCAs
->research into lithium based drugs as study looked into people with depression and committing suicide and found that an area where less people with depression committed suicide had higher levels of lithium in the water…idk just found it interesteing
What are some psychological treatments for mood affective disorders?
CBT
IPT
Individual dynamic psychotherapy
What are some physical treatments for mood affective disorders?
ECT
TMS
Psychosurgery- very rare
Ketamine
What is a manic episode?
An extreme mood state lasting at least one week unless shortened by treatment intervention
What are the symptoms of mania?
Euphoria, irritability, increased activity, increased energy
Rapid or pressured speech
Increased self-esteem, grandiosity
Decreased need for sleep
Impulsive or reckless behaviour
What is meant by grandiosity?
Thinking they are the best at something e.g. smartest person on the world
RECAP- symptoms using DIG FAST.
D- distractibility
I- Impulsivity
G- grandiosity
F- flights of ideas, racing thoughts
A- activities, psychomotor agitation
S- Sleep decreased
T- talkative, pressure speech
What is meant by a mixed affective state?
Few days after a manic state as patient starts to come down from their manic episode
->characterised by the presence of several prominent manic and several prominent depressive symptoms which can occur simultaneously or change very rapidly
Bipolar 1?
At least one manic or mixed episode with/without psychosis
Bipolar II?
One or more hypomanic episodes
At least one depressive episode
No history manic/mixed episodes
Psychosis?
Usually mood congruent
-if manic, might be the voice of God or the King telling them their the best, if depressed, might be loved ones telling them they are worthless
If someone has paranoia, e.g. thinks someone is poisoning their food, which condition are they likely to have?
Schizophrenia
Cotards?
Feeling like body is rotting or dying
->psychotic depression
What is de clerambault syndrome?
Delusions someone is in love with them
->had a patient that was convinced they were in love with Prince Harry and would speak to an image of him on her computer
Cyclothemia?
Persistent instability of mood over a period of at least 2yrs
Numerous periods of hypomania
List some antipsychotics.
Olanzapine
Risperidone
Quetiapine
List some mood stabiliser drugs.
Sodium valproate
Lithium
Carbemazepine
-> sodium valproate is very teratogenic. Only really used if women over 65. Can affect male fertility. Basically, very effective but very risky.
Summarise epidemiology for bipolar disorder.
Male = female
Mean age of onset is 21, unusual >30
Treatments for bipolar disorder?
Benzodiazepines
Antipsycotics
Mood stabilisers
Summarise epidemiology for depression.
Mean age of onset =27
Less common in those who are unemployed
Less common in those who have financial stability
