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Phase 2 - Mental Health > Affective Disorders > Flashcards

Affective Disorders Flashcards

1
Q

How do you define depression?

A

A emotional state of persistently feeling low

It is thought to be due to a lack of monoamines

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2
Q

What are the ICD classifications of depression?

A

At least 2 of feeling low, anhedonia and low energy for at least 2 weeks

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3
Q

How do you define mild, moderate and severe depression?

A

Mild: 2 core symptoms and 2 other but no functional limitation
Moderate: 2 core and 3-4 others
Severe: 3 core and 4+ others
Severe and Psychotic

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4
Q

How do you treat depression?

A 
Treat with support - watch and wait
CBT 
SSRI 1st line - Sertraline 50mg
Psychotic/Severe - antipsychotic or mood stabiliser can be used
ECT - severe, life-threatening
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5
Q

Types of anti-depressants?

Examples?

A 
SSRI - Sertraline, Citalopram, Paroxetine 
SNRI - Venlafaxine, Duloxetine
NARI - Reboxetine
TCA - Amytriptiline 
NaSSA - Mirtazapine
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6
Q

What are some symptoms of mania?

A

Elevated mood or anger
Increased impulsivity, speech
Loss of inhibition

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7
Q

How do you define hypomania?

A

Symptoms of mania
Last for fewer than 4 days
Don’t affect function

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8
Q

SSRI side effects

A

GI - nausea, constipation
Headaches
Agitation and bad thoughts

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9
Q

TCA side effects?

A

ANS side effects - dizzy, dry mouth, headache

Sexual Dysfunction

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10
Q

SNRI side effects?

NaSSA side effects? Example

A

Appetite and weight gain, Low Na+, High BP

Mirtazapine: Weight gain, sedation, confusion

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11
Q

What is Bipolar Affective Disorder?

A

Manic Depression

Condition where the patient suffers from severe mood changes

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12
Q

What is Bipolar I?
What is Bipolar II?
What is Rapid Cycling BP?
Cyclothermia?

A

At least one instance of mania lasting more than one week
At least one instance of hypomania lasting more than one week
Both of these also have to have depressive episodes

Where there are more than 4 episodes in a year

Where there is rapid fluctuations of mood over 2 years but not severe enough to be BPAD

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13
Q

What are some symptoms of mania?

A

Elevated mood or anger
Increased impulsivity, speech, energy, self-esteem
Loss of inhibition, lack of sleep

Psychotic - Grandiose or persecutory delusions, auditory hallucinations

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14
Q

How do you define hypomania?

A

3+ Symptoms of mania
Last for more than 4 days
Don’t affect function

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15
Q

Medical DDx linked to depression?

Medications?

A

Diabetes (tiredness)
Hypothyroidism
Anaemia

Beta Blockers

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16
Q

What are the risk factors for Bipolar?

A

Young
Equal in Genders
Black Afrocaribbean (more likely to be psychotic and manic)
Low SE Status
FHx
(Rapid cycling is more common in females)

17
Q

What is the prevalence of depression?

Bipolar?

A

16% lifetime risk

3-4%

18
Q

What is Beck’s Triad?

A

Having a negative view of themselves, the future and the world

19
Q

Other symptoms of depression?

A

Biological: Loss of appetite, loss of libido, early morning waking, diurnal variation of mood, weight loss

Cognitive: feeling helpless, worthless, thoughts of suicide, self harm, social isolation, poor attention, hypochondriasis

Psychotic: Nihilistic, persecutory delusions

20
Q

What is Beck’s Triad?

A

Having a negative view of themselves, the future and the world

21
Q

How do you treat Bipolar Disorder?

A

Acute Mania: Antipsychotic (+ Sedative if needed)
Depression: Antidepressant and mood stabiliser
Long term: Mood Stabiliser

22
Q

How do you treat Bipolar Disorder?

A

Acute Mania: Antipsychotic (+ Sedative if needed)
Depression: Antidepressant and mood stabiliser
Long term: Mood Stabiliser

23
Q

What is self harm?

Parasuicide?

Suicide?

A

Intentional act of harm inflicted on oneself which is not intended to be fatal

Surviving an attempt to take ones life

Intentionally taking ones life

24
Q

Risk factors for suicide?

A 
Middle Aged 
Men
Isolated
High or Low SE status
Previous Attempt
Bereavement 
Access to methods
25
Q

Risk factors for self harm?

A 
Young
Females
EUPD or Dissocial PD
Low SE status
Hx of trauma
Unemployed
Single
Substance Misuse
26
Q

Risk factors for self harm?

A 
Young
Females
EUPD or Dissocial PD
Low SE status
Hx of trauma
Unemployed
Single
Substance Misuse
27
Q

Why don’t we use TCAs as much any more?

A

Not safe in overdose

Have more ANS side effects

28
Q

Name some Mood Stabilisers?

A

Lithium Carbonate
Sodium Valproate
Lamotrigine
Carbamezapine

29
Q

What are some side effects of Lithium?

A 
Leukocytosis
Increased Urine and Thirst
Tremor
Hypothyroidism
Increased Weight
Underactive Memory
Mums (Teratogenic)
30
Q

What are the signs of lithium toxicity?

A

Gross Tremor
Vomiting
Cognitive Impairment
Restlessness

Levels 0.4-1.2mmol/L
Over is unsafe

31
Q

Side effects of Sodium Valproate?

A 
Ataxia
Liver Failure
Pancreatitis
Reversible Hair Loss
Oedema
Appetite 
Teratogenic, Tremor
Encephalopathy
32
Q

What do you need to monitor with lithium?

A

Renal U&Es

Thyroid Function

Phase 2 - Mental Health (11 decks)

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