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Year 3 psych (JK) > Affective disorders > Flashcards

Affective disorders Flashcards

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1
Q

What are mood disorders?

A

disorders of mental status and function where altered mood is the (or a ) core feature

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2
Q

Examples of affective disorders

A

States of depression and of mania

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3
Q

What are the most common group of medical disorders?

A

affective/mood disorders

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4
Q

Secondary causes of altered mood

A

consequence of other disorder or illness eg cancer, steroids, drug misuse, dementia

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5
Q

2 classification systems for affective disorders

A

ICD-10

DSM-5

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6
Q

3 ways to classify depression

A

symptom
syndrome
recurrent illness

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7
Q

Depression as a symptom

A

can e systemic eg fatigue

form of sadness

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8
Q

depression as a syndrome

A

constellation of symptoms and signs

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9
Q

Depression as a recurrent illness

A

recurrent depressive disorder

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10
Q

The 4 things which indicate if depression or bipolar becomes abnormal

A

persistence of symptoms
pervasiveness
degree of impairment
specific symptoms or signs

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11
Q

3 spheres of symptoms of depressive illness

A

psychological
physical
social

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12
Q

2 main parts of the psychological sphere of depression

A

change in mood

change in thought content

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13
Q

Change in mood - depression

A

depression - diurnal variation
anxiety
perplexity - puerperal illness
anhedonia

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14
Q

Change in thought content - depression

A 
unjustified guilt
hopelessness 
worthlessness 
neurotic eg hypochondriasis, obsessions, phobias
delusions and hallucinations if severe
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15
Q

2 categories of the physical sphere of depression

A

change in bodily function

change in psychomotor function

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16
Q

change in bodily function - depression

A 
energy - fatigue 
sleep 
libido
appetite
constipation 
pain
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17
Q

Change in psychomotor functioning - depression

A

agitation

retardation

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18
Q

Change in social sphere - depression

A 
loss of interests
irritability 
apathy 
withdrawal, loss of confidence and indecisive
loss of concentration and memory
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19
Q

Agitation

A

A state of restless overactivity, aimless or ineffective

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20
Q

anhedonia

A

loss of ability to derive pleasure from experience

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21
Q

Apathy

A

Loss of interest in own surroundings

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22
Q

anxiety

A

An unpleasant emotion in which thoughts of apprehension and fear predominate

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23
Q

Depression

A

An unpleasant emotion in which sadness or unhappiness predominate

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24
Q

Retardation

A

Slowing of motor responses including speech

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25
Q

Stupor

A

A state of extreme retardation in which consciousness is intact but stop speaking, eating moving
Remember the events after recovery

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26
Q

How long must depression symptoms last to diagnose?

A

2 weeks

27
Q

If there have been hypomanic or manic episodes in their life, can depression be diagnosed?

A

no - bipolar etc

28
Q

Psychoactive substances and organic mental disorder- depression

A

Must not be attributable to these for ICD-10

29
Q

If psychotic symptoms or stupor what must you exclude before diagnosing depression?

A

other psychotic illnesses eg schizophrenia

30
Q

Components of depression - somatic syndrome

A 
anhedonia
lack of emotional reactions
waking 2 hours before normal time 
depression worse in morning
psychomotor agitation or retardation 
loss of appetite 
weight loss 
loss of libido
31
Q

3 general criteria for depression

ICD-10

A

depressed mood, most of the day, almost everyday for atleast 2 weeks
anhedonia
decreased energy or increased fatigability

32
Q

Additional criteria for depression: ICD-10

A 
loss of confidence and self esteem 
unreasonable guilt 
suicidal thoughts 
decreased concentration 
agitation or retardation 
sleep disturbance 
change in appetite
33
Q

mild depression - ICD-10 : how many criteria?

A

at least 2 general

additional list to give 4

34
Q

moderate depression: ICD-10: how many criteria?

A

at least 2 general

additional list to give 6

35
Q

severe depression: ICD-10: how many criteria?

A

all of general

additional list to give 8

36
Q

% of women who experience the blues within 2 weeks after birth

A

75

37
Q

% of women who develop MDD within 3-6 months

A

10

38
Q

Differential diagnosis for depression

A 
SAD 
normal reaction to life event 
dysthymia 
cyclothymia 
bipolar 
stroke, tumour, dementia
hypothyroidism 
infections 
drugs
39
Q

Treatments for depression - broadly in 3 categories

A

antidepressants eg SSRI, SnRI, MAOI, TCA etc
psychological eg CBT, IPT
physical eg ECT, DBS, VNS

40
Q

Measurement tools for depression - main 2

A

SCID and SCAN

41
Q

Other measurement tools for depression

A

HDRS
BD1-11
HADS
PHQ-9

42
Q

What is mania often associated with?

A

grandiose ideas
disinhibition
loss of judgement

43
Q

Mania

A

pathological, inappropriate elevated mood

44
Q

Hypomania - ICD-10

A 
Lesser degree of mania, no psychosis 
mild elevation of mood
increased energy and activity
increase sociability
concentration reduced
45
Q

Does hypomania affect work or social circumstances?

A

not severely

46
Q

ICD-10, mania - how long?

A

1 week

47
Q

ICD-10, mania

classification

A 
disrupt work and social 
elevated mood, increase energy, pressure of speech 
disinhibition 
grandiose 
alteration of senses 
extravagant spending 
irritable 
overactivity
48
Q

Psychiatric differential diagnosis of mania

A 
mixed affective state
schizoaffective disorder 
schizophrenia 
cyclothymia 
dysthymia 
ADHD
49
Q

dysthymia

A

persistent mild depression

50
Q

cyclothymia

A

relatively mild depression and hypomania

51
Q

Medical differential diagnosis for mania

A

stroke, MS, tumour, hyperthyroid, epilepsy, AIDS

52
Q

Tools to measure mania

A

SCID and SCAN

YMRS

53
Q

Main treatments of mania

A

antipsychotics eg risperidone, olanzapine
mood stabiliser eg lamotrigine, sodium valproate
lithium
ECT

54
Q

Bipolar affective disorder - what it consists of

A

repeated (2+) episodes of depression and mania or hypomania

55
Q

If no mania or hypomania it is not bipolar but what instead?

A

recurrent depression

56
Q

No depression but mania or hypomania

A

hypomania or bipolar

57
Q

DSM-5: What is sufficient to diagnose bipolar?

A

1 episode of mania

58
Q

What has improved agreement for mood disorders?

A

SCID and SCAN

59
Q

What has hindered agreement for mood disorders?

A

differences in diagnostic classifications

60
Q

Epidemiology of bipolar

A

M=F, age = 21
early onset with positive FH
no difference with income, education etc
prevalence increased in first degree relatives

61
Q

Epidemiology of depression

A

2.9-12 lifetime prevalence
2:1 for females
mean age 27
MDD less in those employed
lower education, unstable marriage etc
excess of adverse live events

62
Q

clinical outcome of major depression

A

4-6 months
80% have further episodes
15% suicide

63
Q

Clinical outcomes of bipolar/mania

A

1-3 months manic episode
90% further episodes
10% suicide

Year 3 psych (JK) (20 decks)

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