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*Psychiatry > Affective Disorders > Flashcards

Affective Disorders Flashcards

1
Q

What are mood disorders?

A

Disorders of mental status with altered mood as a core focus
Commonest group
Can be primary or secondary

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2
Q

Mood disorders are often associated with what?

A

Anxiety symptoms/disorders

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3
Q

What are the classification systems for mental illnesses?

A

ICD-10

DSM-5

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4
Q

Depression present as what?

A

Symptom
Syndrome
Recurrent illness

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5
Q

When does depression become abnormal?

A

No clear or convenient division
Persistent, purvasive symptoms
Degree of impairment
Presence of specific symptoms

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6
Q

What are the spheres of depressive symptoms?

A

Psychological
Physical
Social

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7
Q

What is the psychological sphere of depression?

A

Change in mood (depression, anxiety, perplexity, anhedonia)

Change in thoughts (Guilt, Hopelessness, worthlessness, neuroses)

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8
Q

What is the physical sphere of depression?

A 
Change in body:
Energy
Sleep
Appetite 
Libido 
Constipation
Pain
Change in psychomotor function:
Agitation
Retardation
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9
Q

What is the social sphere of depression?

A 
Loss of interests
Irritability 
Apathy
Withdrawal, loss of confidence
Loss of concentration
Memory loss
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10
Q

What is anhedonia?

A

Loss of ability to derive pleasure from experience

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11
Q

What is stupor?

A

Extreme retardation in which consciousness is intact

Patient stops moving, speaking, eating and drinking.

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12
Q

How is depression described by the ICD-10?

A

Atleast 2 weeks
No hypomania/manic episodes in that time
Not attributable to psychoactive/organic mental disorder

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13
Q

How does depression differ from severe depression with psychotic symptoms?

A

Psychotic symptoms or stupor on top

Must exclude other psychotic illnesses first

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14
Q

How does Somatic Syndrome present?

A 
Marked loss of interest 
Lack of emotional reactions to events 
Waking 2hrs early 
Depression worse in morning
Psychomotor agitation/retardation
Loss of appetite - weight loss
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15
Q

What is the ICD-10 criteria for mild depression?

A

At least 2 of:
Depressed mood for most of day in past 2 weeks
Loss of interest or pleasure
Decreased energy
(with additional symptoms making up to 4)

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16
Q

What is the ICD-10 criteria for moderate depression?

A

At least 2 of:
Depressed mood for most of day in past 2 weeks
Loss of interest or pleasure
Decreased energy
(with additional symptoms making up to 6)

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17
Q

What are the additional/minor symptoms of depression?

A 
Loss of confidence 
Unreasonable feelings of guilt or self reproach 
Recurrent thoughts of death by suicide 
Decreased concentration
Agitation or retardation
Sleep disturbance
Change in appetite
18
Q

What is the ICD-10 criteria for severe depression?

A

All of:
Depressed mood for most of day in past 2 weeks
Loss of interest or pleasure
Decreased energy
(with additional symptoms making up to 8)

19
Q

How common is post-natal depression?

A

75% get ‘blues’ within 2 weeks
10% develop MDD within 3-6 mo
1 in 500 get perpetual psychosis

20
Q

What is the differential for depression?

A 
SAD
Dysthymia 
Cyclothymia
Bipolar 
Neurological illness
Hypothyroidism
Drugs
21
Q

What are the treatments for depression?

A

Antidepressions
Psychological treatments
Physical treatments

22
Q

What are the antidepressants indicated for depression?

A

SSRIs - Sertraline, Fluoxetine
Tricyclic antidepressants - Amitriptyline
Monoamine Oxidase inhibitors - Phenelzine

23
Q

What are the psychological treatments indicated for depression?

A

CBT
Interpersonal Therapy
Individual dynamic psychotherapy
Family therapy

24
Q

What are the physical treatments indicated for depression?

A

ECT
Psychosurgery
DBS, VNS

25
Q

What are the measurement tools for depression?

A 
SCID/SCAN
HDRS (Hamilton Depression rating scale)
BDI-II (Beck Depression Inventory II)
HADS
PHQ-9
26
Q

What is Mania?

A 
Pathologically inappropriate elevated mood
Persistence of symptoms
Pervasiveness of symptoms
Degree of impairment
Presence of specific symptoms of signs
27
Q

What are the main types of mania according to the ICD-10?

A 
Hypomania
Mania without psychotic symptoms
Mania with psychotic symptoms
Other manic episodes
Manic episode
28
Q

How does the ICD-10 classify hypomania?

A 
Lesser mania with no psychosis
Mild elevation of mood for several days
Increased energy, wellbeing, sociability
Irritability
Reduced concentration, overspending 
(Not to extent of work/social disruption)
29
Q

How does the ICD-10 classify Mania with/without psychotic symptoms?

A

1 week severe enough to disrupt work/social activity
Elevated mood, energy, overactivity, speech
Disinhibition
Grandiosity
Alteration of senses
Extravagant spending

30
Q

What is the differential diagnosis for mania?

A 
Mixed effective state
Schizoeffective/schizophrenia
Cyclothymia
ADHD
Drugs
Neurological disorders
Hyperthyroid
SLE
31
Q

What tools are used to measure mania symptoms?

A

SCID
SCAN
YMRS (Young Mania Rating Scale)

32
Q

What is the treatment for mania?

A

Antipsychotics - Olanzapine, Quetiapine
Mood stabilisers - Valproate, Carbamazepine, Lamotrigine
Lithium
ECT

33
Q

What antipsychotics are used in mania?

A

Olanzapine
Resperidone
Quetiapine

34
Q

What mood stabilisers are used in mania?

A

Sodium Valproate
Lamotrigine
Carbamazepine

35
Q

What is Bipolar Affective disorder?

A

2+ episodes of depression and hypo/mania
If no mania = recurrent depression
If no depression = hypomania/bipolar

36
Q

How common is bipolar disorder?

A

0.7-1.6

37
Q

Bipolar disorder typically onsets at which age?

A

<30
Mean 21
Early onset with FH

38
Q

Depression is common in which populations?

A

More common in women
18-44 (mean 27)
Associated with unemployment, lower educational attainment, unstable marriage

39
Q

What is the typical clinical course for major depression?

A

4-6mo
54% recover at 26 weeks
80% have further episodes
15% die by suicide

40
Q

What is the typical clinical course for bipolar/mania?

A 
1-3mo
60% recover at 10 weeks
90% have further episodes
10% die by suicide
1/3 have poor outcome

*Psychiatry (18 decks)

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