Affective disorders Flashcards
When is depression diagnosed?
2 core symptoms plus 2 typical symptoms for 2 weeks
What are the core symptoms of depression?
Low mood
Anhedonia
Fatigue
What are the typical symptoms of depression?
Weight loss and appetite change Sleep change Psychomotor retardation Decreased libido Poor concentration
Guilt, hopelessness, low self-esteem
Suicidality
What interventions should be started for mild depression
Sleep hygeine
Mindfulness
Self-help CBT
When should antidepressants be started?
Symptoms lasting longer than 8 weeks
Previous episode of depression
What is the medical treatment pathway for depression?
SSRI
Different SSRI
Mirtazapine, venlafaxine
Keep switching and try adjuncts/older anti-depressants (MAOI, TCA, SARI)
What are some SSRIs?
Fluoxetine - licensed for use in children
Sertraline
Citalopram
Escitalopram
What are the signs of mania?
Irritable, euphoric, labile
Grandiose, poor concentration
Rapid speech, hyperactivity, little sleep, disinhibition, flight of ideas, poor insight
Delusions, hallucinations
Lasting a week and impairing function
What are the signs of hypomania?
Same as mania without psychotic symptoms and impact on function
What are some organic causes of mania?
Medications - SSRIs, steroids, amphetamines, cocaine
Infection, stroke, neoplasm, epilepsy, MS, metabolic changes
What should be used to treat acute mania?
Atypical antipsychotic
Valproate
What can be used for long term management of mania?
Lithium
Lamotrigine, valproate, carbamezapine
Antipsychotics - olanzapine
Therapy
How should bipolar disorder be managed?
Lithium or other mood stabiliser
With an antidepressent
Psychological intervention
What is Bipolar type 1?
1+ manic episodes, may include a depressive episode
What is bipolar type 2?
1+ depressive episode, atleast one hypomanic episode
