Affective Disorders

Question 1

What is a mood disorder?

Answer 1

Disorder of mental state and function where altered mood is the core feature

Commonest group of mental disorders

Question 2

How are affective mood disorders diagnosed?

Answer 2

History
Mental State Examination

Question 3

What are the two extremes of affective mood disorders?

Answer 3

Depression
Highly elevated- mania

Question 4

Depression can be a symptom or a syndrome.

When does depression become abnormal?

Answer 4

Persistence of symptoms
Pervasiveness of symptoms
Degree of impairment
Presence of other specific signs and symptoms

Question 5

What is required for a diagnosis of depression?

Answer 5

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

Question 6

List some of the common symptoms of depression.

Answer 6

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

Question 7

Post-natal depression?

Answer 7

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

Question 8

What are some of the main groups of medication for mood affective disorders?

Answer 8

Antidepressants
Antipsychotics
Mood stabilisers

Question 9

Give some examples of antidepressants.

Answer 9

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

Question 11

What are some psychological treatments for mood affective disorders?

Answer 11

CBT
IPT
Individual dynamic psychotherapy

Question 12

What are some physical treatments for mood affective disorders?

Answer 12

ECT
TMS
Psychosurgery- very rare
Ketamine

Question 13

What is a manic episode?

Answer 13

An extreme mood state lasting at least one week unless shortened by treatment intervention

Question 14

What are the symptoms of mania?

Answer 14

Euphoria, irritability, increased activity, increased energy

Rapid or pressured speech

Increased self-esteem, grandiosity

Decreased need for sleep

Impulsive or reckless behaviour

Question 15

What is meant by grandiosity?

Answer 15

Thinking they are the best at something e.g. smartest person on the world

Question 16

RECAP- symptoms using DIG FAST.

Answer 16

D- distractibility
I- Impulsivity
G- grandiosity

F- flights of ideas, racing thoughts
A- activities, psychomotor agitation
S- Sleep decreased
T- talkative, pressure speech

Question 17

What is meant by a mixed affective state?

Answer 17

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

Question 18

Bipolar 1?

Answer 18

At least one manic or mixed episode with/without psychosis

Question 19

Bipolar II?

Answer 19

One or more hypomanic episodes

At least one depressive episode

No history manic/mixed episodes

Question 20

Psychosis?

Answer 20

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

Question 21

If someone has paranoia, e.g. thinks someone is poisoning their food, which condition are they likely to have?

Answer 21

Schizophrenia

Question 22

Cotards?

Answer 22

Feeling like body is rotting or dying

->psychotic depression

Question 23

What is de clerambault syndrome?

Answer 23

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

Question 24

Cyclothemia?

Answer 24

Persistent instability of mood over a period of at least 2yrs
Numerous periods of hypomania

Question 25

List some antipsychotics.

Answer 25

Olanzapine
Risperidone
Quetiapine

Question 26

List some mood stabiliser drugs.

Answer 26

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.

Question 27

Summarise epidemiology for bipolar disorder.

Answer 27

Male = female
Mean age of onset is 21, unusual >30

Question 28

Treatments for bipolar disorder?

Answer 28

Benzodiazepines
Antipsycotics
Mood stabilisers

Question 29

Summarise epidemiology for depression.

Answer 29

Mean age of onset =27
Less common in those who are unemployed
Less common in those who have financial stability