affective disorders

Question 1

What is a mood disorder

Answer 1

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

Question 2

How are mood disorders diagnosed

Answer 2

History and mental state exam

ICD-11 or DSM-5

Question 3

When does depression become abnormal

Answer 3

• persistence of symptoms >2 weeks normally
• Pervasiveness of symptoms - affecting life
• Degree of impairment
• Presence of specific symptoms or signs

Question 4

Define depression - ICD-11

Answer 4

Low mood or reduced pleasure most of the day, every day, for at least 2 weeks

No hypomanic or manic episodes in the lifetime

Question 5

What are the depression symptoms

Answer 5

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

Question 6

Describe the presentation of when post-natal depression occurs

Answer 6

• Often one or 2 months after birth
• can occur several months postpartum
• 1/3 cases begin during pregnancy

Question 7

What are the treatments for depression

Answer 7

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

Question 8

What is a manic episode

Answer 8

Extreme mood state lasting at least one week unless shortened by medical intervention

Question 9

What are the features of a manic episode

Answer 9

Euphoria
Irratibility
Increased activity
Increased energy
Rapid speech
Flight of ideas
Decreased need for sleep
Impulsive behaviour
Rapid mood changes

Question 10

What is hypomania

Answer 10

Less severe episode of extreme mood state with minimal functional impairment and no hospitalisation

Question 11

What is the mneumonic for symptoms of mania

Answer 11

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

Question 12

What is a mixed affective state

Answer 12

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

Question 13

Describe bipolar type 1

Answer 13

history of Full depressive and manic episodes or mixed

Question 14

Describe bipolar type 2

Answer 14

Full depressive episodes but wont go full manic - hypomania at the most

Question 15

What are the depressive symptoms of psychosis

Answer 15

Cotards - body rotting feeling
Delusion of guilt
Voices telling to hurt themselves
Voice of family members saying bad things

Question 16

What are the manic symptoms of psychosis

Answer 16

Religious - thinking they are god
Grandiose - they think they are king or rich
De clerambault syndrome - thinking someone is in love with them

Question 17

What is cyclothymia

Answer 17

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

Question 18

What is the treatment for Bipolar disorder

Answer 18

Benzodiazepines

Antipsychotics: olanzapine, risperiodone, quetapine

Mood stabilisers - sodium valproate, lithium and carebemazepine

ECT

Question 19

Who is most likely to have bipolar disorder

Answer 19

21 year old on average and usually under 29 at time of diagnosis
Male = Female

Question 20

Who is most likely to have depression

Answer 20

27 year old average age
18-44 years old highest risk
Females > male 2-1