Affective Disorders

Question 1

pathology of manic and depressive episodes

Answer 1

mania - increase in NA and 5-HT

depression - decrease in NA and 5-HT

Question 2

What are predisposing, precipitating, and perpetuating factors?

Answer 2

predisposing - increase vulnerability to develop psychological problems - eg genetics, childhood experiences (why me)
precipitating - trigger the onset or exacerbation of the psychological problems - eg life events, substances, bereavement (why now)
perpetuating - maintains the psychological problems and prevents its resolution - relationships, finance, work etc. (what can i change)

Question 3

treatment of depression - biopsychosocial

Answer 3

bio: antidepressants, mood stabilisers, ECT
Psych - psychoeducation (about illness, relapse), CBT, interpersonal therapy
Social - targeted interventions (family, housing, finance, employment)

Question 4

Core symptoms of depression

Answer 4

pervasive low mood (at least 2 weeks)
anhedonia
tiredness

Question 5

other symptoms of depression

Answer 5

Retardation, Eating, Sleep, Suicidal thoughts, Im a failure (low self worth), Only me to blame (guilt), No conc

Question 6

Define mild, moderate, severe, and severe with psychosis depression

Answer 6

mild = 4 symptoms
moderate = 5-6 symptoms
severe = 7+ symptoms
severe with psychosis = severe + agitation, anxiety, mood congruent delusion

Question 7

treatment of mild, moderate and severe depression

Answer 7

mild - reassess in 2 weeks, exercise, individual CBT
moderate - CBT or antidepressant
severe - CBT and antidepressant, ECT

Question 8

how treat bipolar biopsychosocial

Answer 8

Bio - LT of atypicals, antidepressants, lithium, sodium valproate. Acute episodes of haloperidol or olanzapine or BZDs.
Psycho - CBT for depression, psychoeducation
Social - tell job, partner, bank etc.

Question 9

diagnostic criteria of mania

Answer 9

elevated mood + 3 others for 1 week
DIG FAST - Distractibility, Irresponsbility, Grandiosity, Flight of ideas, Activity increase, Sleep deficit, Talkativeness

Question 10

diagnostic criteria of hypomania

Answer 10

3+ symptoms not severe enough to interfere with social function at least 4 days
increased energy, mood, self esteem, sex drive, sociability, reduced sleep

Question 11

diagnostic criteria of bipolar

Answer 11

2 episodes with at least 1 of mania