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Psychiatry > Affective Disorders > Flashcards

Affective Disorders Flashcards

1
Q

What is a mood disorder?

A

Disorders of mental status and function where altered mood is the core feature
Refers to states of depression and elevated mood
Commonest group of mental disorders

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2
Q

What 2 systems classify these disorders?

A

ICD-11
DSM-5

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3
Q

What is the spectrum of mood disorders?

A

Mania with psychosis - hypomania - elated - normal - dysthymia - depression - severe depression with mania
Bipolar spans the whole spectrum

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4
Q

What is cyclothymia?

A

From elation to dysthymia on the spectrum of mood disorders

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5
Q

What is the symptom depression?

A

An emotion within the range of normal experience
Describes a state of feeling or mood
Form of sadness

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6
Q

What is depression as a syndrome?

A

Constellation of symptoms and signs
Can be single episode or recurrent illness
Leading cause of disability worldwide

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7
Q

When does depression become abnormal?

A

Persistence of symptoms
Pervasiveness of symptoms
Degree of impairment
Presence of specific symptoms or signs

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8
Q

What is the definition of depression from ICD-11?

A

Low mood or reduced interest/ pleasure
Most of the day and nearly every day
Lasts for at least 2 weeks
No hypomanic or manic episodes in lifetime

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9
Q

What does SIG E CAPS stand for in depression?

A

S - sleep problems
I - interest deficit
G - guilt, worthlessness and hopelessness
E - energy deficit
C - concentration deficit
A - appetite disorder
P - psychomotor retardation or agitation
S - suicidality

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10
Q

Describe mild depression

A

Individual is usually distressed by the symptoms to a mild extent
Some difficulty in continuing to function
No delusions or hallucinations
Managed at GP level

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11
Q

Describe moderate depression

A

Several symptoms of a depressive episode are present to a marked degree or large number of symptoms
Considerable difficulty functioning in multiple domains
Managed in psychiatric outpatient clinic

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12
Q

Describe severe depression

A

Many or most symptoms are present or smaller number in an intense degree
Have serious difficulty continuing to function in most domains
With/ without psychosis
Often requires inpatient admission

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13
Q

Describe post-natal depression

A

10-15% of women having babies
Often within a month or two of giving birth
Can start several months postpartum
75% of women experience blues in first 2 weeks

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14
Q

What is the risk of puerperal psychosis?

A

1 in 1000 deliveries with a risk of recurrence with subsequent deliveries

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15
Q

What is the differential diagnosis for depression?

A

Normal reaction to life event, seasonal affective disorder, dysthymia, cyclothymia, bipolar, stroke, tumour, dementia, hypothyroidism, infections and drugs

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16
Q

What is the treatment for depression?

A

Antidepressants
Antipsychotics
Mood stabilisers
Psychological treatments - CBT, IPT and individual dynamic psychotherapy
Physical treatments - ECT, TMS, psychosurgery and ketamine

17
Q

What antidepressants are used in depression?

A

SSRIs
SNRIs
TCAs - tricyclic antidepressants
MAOIs - monamine oxidase inhibitors
Mirtazapine

18
Q

What are some measurement tools for depression?

A

SCID, SCAN, HDRS, BDI-II, HADS and PHQ-9

19
Q

What is mania?

A

Extreme mood state lasting at least one week unless shortened by treatment
Euphoria, irritability, increased activity, pressured speech, flight of ideas, delusions of grandeur and decreased need for sleep

20
Q

What does DIG FAST mean for mania?

A

D - distractibility
I - impulsivity, poor judgement, spending sprees..
G - grandiosity
F - flight of ideas
A - activities
S - sleep decreased
T - talkativeness

21
Q

What is a mixed affective state?

A

Presence of several prominent manic and several prominent depressive symptoms which occur simultaneously or alternate rapidly
Lasts most of day, every day for at least 2 weeks

22
Q

What are classifications of mixed affective disorders?

A

Bipolar type 1
Bipolar type 2
Cyclothymic disorder
Substance induced mood disorder

23
Q

Describe bipolar type 1

A

At least one manic or mixed episode
Characterised by recurrent depressive and manic/ mixed episodes
Have to be history of at least one manic or mixed episode

24
Q

Describe bipolar II

A

One or more hypomanic episodes
At least one depressive episode
No history of manic or mixed episodes

25
Q

What is psychosis?

A

Usually mood congruent
Paranoia and persecutory experiences more suggestive of schizophrenia

26
Q

What are examples of depressive psychosis?

A

Body is rotting - cotards
Delusions of guilt
Voices telling them to hurt themselves
Voices of family members saying horrible things

27
Q

What is some examples of mania psychosis?

A

Religious
Grandiose
De clerambault syndrome - delusions someone is in love with them

28
Q

What is the definition of cyclothymia?

A

Persistent instability of mood over a period of at least 2 years
Numerous periods of hypomania
Depressive symptoms more present

29
Q

What are differential diagnosis for mixed affective disorders?

A

Schizoaffective disorder, schizophrenia, ADHD, drugs and alcohol
Stroke, MS, tumour, epilepsy, AIDS, neurosyphilis, endocrine and SLE

30
Q

What are tools to measure mixed affective disorders?

A

SCID, SCAN and young mania rating scale (YMRS)

31
Q

What is the treatment for bipolar disorder?

A

Benzodiazepines
Antipsychotics - olanzapine
Mood stabilisers - sodium valproate, lithium and carbamazepine
ECT

32
Q

What is the epidemiology of bipolar disorder?

A

Lifetime prevalence rate is 0.7 - 1.6
Rate of males = females
Mean age of onset is 21
Early onset usually positive FH

33
Q

What is the epidemiology of depression?

A

Lifetime prevalence rate is 2.9-12
Rates of females exceeds males 2:1
Mean age of onset is 27

34
Q

What is the clinical course and outcome of major depression?

A

Typical episodes lasts 4-6 months
54% recovered at 26 weeks
15% die by suicide
80% have further episodes

35
Q

What is the clinical course and outcome of bipolar disorder/ mania?

A

Typical manic episode lasts 1-3 months
60% recovered at 10 weeks
90% have further episodes
10% die by suicide

Psychiatry (20 decks)

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