affective disorders Flashcards
What is a mood disorder
Disorder of mental staus and function where altered mood is the core feature
How are mood disorders diagnosed
History and mental state exam
ICD-11 or DSM-5
When does depression become abnormal
- persistence of symptoms >2 weeks normally
- Pervasiveness of symptoms - affecting life
- Degree of impairment
- Presence of specific symptoms or signs
Define depression - ICD-11
Low mood or reduced pleasure most of the day, every day, for at least 2 weeks
No hypomanic or manic episodes in the lifetime
What are the depression symptoms
S - sleep problems
I - interest deficit
G - guilt , worthlessness, hopelessness
E - energy deficit
C - concentration deficit
A - appetite disorder - increased or decreased
P - psychomotor retardation or agitation
S - suicidality
Describe the presentation of when post-natal depression occurs
- Often one or 2 months after birth
- can occur several months postpartum
- 1/3 cases begin during pregnancy
What are the treatments for depression
Antidepressants;
Selective serotonin reuptake inhibitors (SSRI) first line
SNRIs
Tricyclic antidepressants - TSA
Monamine oxidase inhibitors (MAOIs)
Antipsychotics
Mood stabilisers
Psychological treatments - CBT
Physical treatments - severe cases:
ECT, psychosurgery
What is a manic episode
Extreme mood state lasting at least one week unless shortened by medical intervention
What are the features of a manic episode
Euphoria
Irratibility
Increased activity
Increased energy
Rapid speech
Flight of ideas
Decreased need for sleep
Impulsive behaviour
Rapid mood changes
What is hypomania
Less severe episode of extreme mood state with minimal functional impairment and no hospitalisation
What is the mneumonic for symptoms of mania
D - distractibility
I - impulsivity poor judgement
G - grandiosity - increased self esteem
F - flight of ideas
A - activites - psychomotor agitation
S - sleep - decreased need
T - talkativeness - rapid and pressured speech
What is a mixed affective state
Mix of several manic and depressive symptoms which occur simultaneously or alternate very rapidly
Symptoms most of the day, nearly every day for at least 2 weeks unless medical intervention shortens it
Describe bipolar type 1
history of Full depressive and manic episodes or mixed
Describe bipolar type 2
Full depressive episodes but wont go full manic - hypomania at the most
What are the depressive symptoms of psychosis
Cotards - body rotting feeling
Delusion of guilt
Voices telling to hurt themselves
Voice of family members saying bad things
What are the manic symptoms of psychosis
Religious - thinking they are god
Grandiose - they think they are king or rich
De clerambault syndrome - thinking someone is in love with them
What is cyclothymia
Persistent instability of mood over a period of at least 2 years
Numnerous periods of hypomania and depressive symptoms that are present more than they are not
The depressive episodes dont last for 2 weeks so cant classify as depression
What is the treatment for Bipolar disorder
Benzodiazepines
Antipsychotics: olanzapine, risperiodone, quetapine
Mood stabilisers - sodium valproate, lithium and carebemazepine
ECT
Who is most likely to have bipolar disorder
21 year old on average and usually under 29 at time of diagnosis
Male = Female
Who is most likely to have depression
27 year old average age
18-44 years old highest risk
Females > male 2-1
