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Psychiatry > Affective disorders > Flashcards

Affective disorders Flashcards

Depression Mania BPD

1
Q

Define affective disorders

A

Disorders of mental status/ function

where altered mood is the core features

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2
Q

Affective disorders may be secondary to [4]

A

Cancer
Dementia
Drug misuse
Medical tx

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3
Q

Psychological symptoms of depression:
4 relating to changes in mood
and 1 general feature
4 relating to change in thought content

A 
Changes in mood 
Depressed mood
Anxiety
Perplexity
Anhedonia
[Diurnal variation]
Changes in thought content:
Guilt, hopelessness, worthlessness
Neurotic symptomatology
Ideas of reference
Delusions, hallucination
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4
Q

Physical symptoms of depression:
Change in bodily function 4
Change in psychomotor function 2

A 
Change in bodily function 
- energy
- sleep, appetite
- libido
- constipation
- pain
Change in psychomotor function 
- agitation
- retardation
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5
Q

Social symptoms of depression [5]

A 
Loss of interests affecting job
Irritability
Apathy
Social withdrawal
Loss of confidence
Indecisiveness
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6
Q

Depression Dx ICD-10
General criteria [3 components]
7 additional criteria

A 
General criteria
Depressed mood for most of the day lasting for:
- > 2 weeks
- almost everyday
- largely uninfluenced by circumstances
Anhedonia
Decreased energy

Additional criteria

  1. Loss of self esteem
  2. Unreasonable feelings of guilt
  3. Decreased concentration
  4. Agitation or psychomotor retardation
  5. Sleep disturbance
  6. Appetite change
  7. Suicidal ideation
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7
Q

Severe depression - name 2 defining features

A

psychotic symptoms or stupor accompanying other criteria

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8
Q

Stupor definition

A

State of extreme retardation with intact consciousness
Stops moving, eating, drinking, speaking
But can recall on reocvery

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9
Q

Metabolic ddx to depression [3]

A

Hypothyroidism
Addisons disease
HyperPTH-ism

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10
Q

Infections ddx to depression

A

Influenza
Infectious mono
Hepatitis
HIV/AIDS

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11
Q

Tx depression

Name 3 modes with 3 examples of each

A

Rx

  1. TCA
  2. MAOIs
  3. SSRIs

Psychological

  1. CBT
  2. IPT
  3. Individual/family dynamic psychotherapy

Physical:

  1. ECT
  2. DBS
  3. Psychosurgery eg vagal nerve stimulation
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12
Q

Mania

3 types

A 
Hypomania
Mania with(out) psychotic sx
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13
Q

Hypomania

3 features

A

Lesser degree of mania
No psychosis
But not to extent to disrupt work

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14
Q

Characteristics of hypomania 10

A 
Characteristics:
Mild mood elevation for several days on end
increased energy/activity
marked feeling of well-being
increased sociability, talkativeness
Overfamiliarity, increased libio
Less need for sleep
Increased irritability
Reduced concentration 
New interests
Mild overspending
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15
Q

Mania without psychotic sx
Diagnosis: Duration + Severity
Characteristics [9]

A 
1 week
Enough to disrupt work
9 characteristics:
Elevated mood
increased energy
Pressure of speech
Less need for sleep
Disinhibition
Grandiosity
Alteration of senses
Extravagant spending
Irritability
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16
Q 
Mania without psychotic sx
Treatment
Give 3 eg of antipsychotics
Give 3 eg of mood stabilizers
Give 1 eg of physical tx
A 
Antipsychotics
- olanzapine
- risperidone
- quetiapine
Mood stabilizers
- valproic acid
- lamotrigine
- carbamazepine
Lithium*
ECT
17
Q

BPD dx

A

Repeated episodes of depression AND (hypo)mania

18
Q

If patient has repeated episodes of depression but no mania then diagnosis could be [1]

A

Recurrent depression

19
Q

If patient has manic symptoms but no depression then diagnosis could be [2]

A

Hypomania

Bipolar disorder

20
Q

Classification of severity of depression [DSM]

Mild, moderate, severe

A 
Classification of severity of depression
• Mild depression
	• At least 2 from general criteria
	• At least 4 from additional criteria list
• Moderate depression
	• At least 2 from general criteria
	• At least 6 from additional criteria list
• Severe depression
	• All of general criteria
At least 8 from additional criteria list
21
Q

Treatment of bipolar disorder

Acute episode mania, hypomania or mixed [3]

A

○ If agitated: IM neuroleptic or benzodiazepine
○ No agitation: mood stabilizer or atypical anti-psychotic
Adjunct: clonazepam

22
Q

Treatment of bipolar disorder
If patient presents with mania [2]
If patient is rapid cycling [1]

A

Mania: Atypical anti-psychotic

Rapid cycling: Lithium

23
Q

Treatment of bipolar disorder
After stabilization
Treatment if mania is predominant feature [2]
Treatment if depression is predominant feature [2]

A

Mania - predominant feature
○ Lithium or olanzapine
○ Psychosocial interventions and monitoring
Depression as predominant feature
○ Lamotrigine
○ Psychosocial interventions and monitoring

Psychiatry (8 decks)

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