Affective Disorders Flashcards
Affective disorders
Mood disorders
Mood vs Affect
Mood is patient expressed mood
Affect is Dr’s impression of mood
Mania vs Hypomania
Mania: psychotic sx
Hypomania - no psychotic sx
Depression epidemiology
Mean onset 27 yrs
F>M
Depression RFs
Substance abuse Lower socio-economic groups Single / Separated / Divorced / etc Parental deprivation Negative beliefs Poverty
Aetiology of Depression
Low 5HT
Low DA metabolism
Low NA
High cortisol
Hypothyroid
Cognitive triad of depression
Feeling Hopeless
Feeling Helpless
Feeling Worthless
Cluster A features of depression
Low mood
Anhedonia
Decreased activity/energy
Cluster B features of depression
Poor concentration
Guilt
Self harm thoughts
Disturbed sleep - often wake early
Auditory hallucinations in depression
Talk in second person - “you”
Auditory hallucinations in schizophrenia
Talk in third person - talk about them
Bereavement
Hallucinations common for 6 - 9 months
Depression average episode length
6 months
Percentage depression episode recurrence
80%
Mx of depression
Mild - psychological treatment first line
Severe - medication first line
Medications for depression
SSRI SNRI MAOI Tricyclics Lithium augmentation ECT
SSRIs
Selective Serotonin Reuptake Inhibitors
Citalopram
Sertraline
SNRIs
Venlafaxine
Tricyclic antidepressants
Amitriptyline
MAOIs
Phenelzine
Tranylcypromine
Selegiline
Primary use of Lithium
Mood stabiliser
Types of Bipolar Affective Disorder
Type 1
Type 2
Rapid cycling
Type 1 bipolar affective disorder
Manic or depressive episodes
Type 2 bipolar affective disorder
Hypomanic or depressive episodes
Rapid cycling bipolar affective disorder
4 episodes in 12 months of depression or mania or hypomania
Mean age of onset of Bipolar
21
Features of mania
Elated / Irritable Grandiosity Racing thoughts Decreased need for sleep Psychotic sx
Olanzapine
Antipsychotic drug
Risperidone
Antipsychotic drug
Haloperidol
Antipsychotic drug
Mx of bipolar affective disorder
Benzodiazepines - short term
Antipsychotic drugs
Mood stabilisers
Lithium
Mood stabiliser
Carbamazepine
Mood stabiliser
Aripiprazole
Antipsychotic and mood stabiliser
Psychotic sx
auditory hallucination
delusions grandeur
Minimum duration of sx for depression diagnosis
At least 2 wks
