Affective Disorders Flashcards
What is a mood/affective disorder?
- disorders of mental status and function where altered mood is the (or a) core feature.
- a term referring to states of depression and of elevated mood - mania.
what is the most common group of mental disorders?
mood disorders
how are mood disorders diagnosed?
- history
- mental state examination
what systems are used to classify mood disorders?
ICD-11
- International Classification of Disease 11th Edition – World Health Organisation
DSM-5
- Diagnostic and Statistical Manual of Mental Disorders 5th Edition – American Psychiatric Association
what is depression?
Depression is a mental health disorder characterised by:
ICD-11 Criteria:
- Depressive Episode: Depressed mood, loss of interest (anhedonia), and reduced energy (fatigue) persisting for at least two weeks.
when does depression become abnormal?
Psychiatry places emphasis on:
- persistence of symptoms
- pervasiveness of symptoms
- degree of impairment
- presence of specific symptoms or signs
how is depression classified in the ICD-11?
- Low mood or reduced interest/pleasure, most of the day, nearly every day, lasting for at least 2 weeks.
Then:
- Sleep problems
- Interest Deficit
- Guilt, worthlessness, hopelessness, regret
- Energy deficit, fatigue
- Concentration deficit
- Appetite disorder either increased or decreased
- Psychomotor retardation or agitation
- Suicidality
Severity depends on how many symptoms and affect on life.
depression differential diagnosis
- normal reaction to life event
- seasonal affective disorder
- dysthymia
- cyclothymia
- bipolar
- stroke, tumour, dementia
- hypothyroidism, addison’s, hyperparathyroidism
- infections - influenza, infectious mononucleosis, hepatitis, HIV/AIDS
- drugs
list the different treatment options for depression
Antidepressants:
- SSRIs
- SNRIs
- tricyclic antidepressants TCAs
- monoamine oxidase inhibitors MAOIs
- other antidepressants e.g. Mirtazapine
Antipsychotics
Mood stabilisers
Psychological treatments:
- CBT, IPT, Individual dynamic psychotherapy
Physical Treatments (severe or treatment resistant):
- ECT
- TMS
- psychosurgery
- ketamine
what is mania? what are its symptoms?
- A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention
- euphoria, irritability, increased activity, increased energy
- rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behaviour, and rapid changes among different mood states (i.e., mood lability).
- Delusions of grandeur /religious delusions can be present
- Hypomania indicates a less severe episode with minimal functional impairment, no hospitalisation, no psychosis
what is the DIG FAST mnemonic?
Used for remembering symptoms of mania:
- Distractibility
- Impulsivity, poor judgement, spending sprees, reckless driving
- Grandiosity - increased self-esteem
- Flight of ideas - racing thoughts
- Activities - psychomotor agitation
- Sleep - decreased need
- Talkativeness - pressured speech
what is a mixed affective state?
A mixed episode is characterised by the presence of several prominent manic and several prominent depressive symptoms, which either occur simultaneously or alternate very rapidly (from day to day or within the same day).
Symptoms are present most of the day, nearly every day, during a period of at least 2 weeks, unless shortened by a treatment intervention.
how is bipolar I classified by the ICD-11?
- at least one manic or mixed episode, with/without psychosis
- typical course of the disorder is characterised by recurrent depressive and manic or mixed episodes
- Although some episodes may be Hypomanic, there must be a history of at least one Manic or Mixed Episode.
how is bipolar II classified by the ICD-11?
- one or more hypomanic episodes
- at least one depressive episode
- no history of manic/mixed episodes
how is cyclothymia classified by the ICD-11?
- persistent instability of mood over a period of at least 2 years
- numerous periods of hypomania
- depressive symptoms that are present during more of the time than not
The depressive symptomatology has never been sufficiently severe or prolonged to meet the diagnostic requirements for a depressive episode.
