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Psychiatry > Affective Disorders > Flashcards

Affective Disorders Flashcards

1
Q

What are mood disorders?

A

Disorders of mental status and function where altered mood is the core feature
Refers to states of depression and mania

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2
Q

Classifications of mood disorders

A

ICD - International Classification of Disease

DSM - Diagnostic and Statistical Manual of Mental Disorders

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3
Q

What is depression (symptom)?

A

Can be an emotion within the range of normal experience

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4
Q

What is depression (syndrome)?

A

A constellation of symptoms and signs

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5
Q

What is depression (recurrent illness)?

A

Recurrent depressive disorder

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6
Q

What are the spheres of the symptoms of depressive illness?

A

Psychological
Physical
Social

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7
Q

What are the psychological symptoms of depressive illness?

A 
Change in mood
  - depression
  - anxiety
  - perplexity
  - anhedonia
Change in thought content
  - guilt
  - hopelessness
  - worthlessness
  - delusions and hallucinations
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8
Q

What is anhedonia?

A

Loss of ability to derive pleasure from experience

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9
Q

What are the physical symptoms of depressive illness?

A 
Change in bodily function
  - energy (fatigue)
  - sleep
  - appetite (weight loss)
  - libido
  - constipation
  - pain
Change in Psychomotor functioning
  - agitation
  - retardation
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10
Q

What are the social symptoms of depressive illness?

A

Loss of interests
Irritability
Apathy
Withdrawal, loss of confidence, indecisive
Loss of concentration, registration and memory

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11
Q

Depression

A

Must last for at least two weeks
No hypomanic or manic episodes in lifetime
Not attributable to psychoactive substance use or organic mental disorder
If psychotic symptoms or stupor then severe depression with psychotic symptoms
- Need to exclude other psychotic illnesses first like schizophrenia

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12
Q

General criteria of mild depression

A

At least two of =>

  • Depressed mood that is abnormal for most of the day almost everyday for the past two weeks, largely uninfluenced by circumstances
  • Loss of interest or pleasure
  • Decreased energy or increased fatigability

Additional to give at least four =>

  • Loss of confidence or self esteem
  • Unreasonable feelings of guilt or self reproach or excessive guilt
  • Recurrent thoughts of death by suicide or any suicidal behaviour
  • Decreased concentration
  • Agitation or retardation
  • Sleep disturbance of any sort
  • Change in appetite
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13
Q

General criteria of moderate depression

A

At least two of =>

  • Depressed mood that is abnormal for most of the day almost everyday for the past two weeks, largely uninfluenced by circumstances
  • Loss of interest or pleasure
  • Decreased energy or increased fatigability

Additional to give at least four =>

  • Loss of confidence or self esteem
  • Unreasonable feelings of guilt or self reproach or excessive guilt
  • Recurrent thoughts of death by suicide or any suicidal behaviour
  • Decreased concentration
  • Agitation or retardation
  • Sleep disturbance of any sort
  • Change in appetite
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14
Q

General criteria of severe depression

A

At least two of =>

  • Depressed mood that is abnormal for most of the day almost everyday for the past two weeks, largely uninfluenced by circumstances
  • Loss of interest or pleasure
  • Decreased energy or increased fatigability

Additional to give at least eight =>

  • Loss of confidence or self esteem
  • Unreasonable feelings of guilt or self reproach or excessive guilt
  • Recurrent thoughts of death by suicide or any suicidal behaviour
  • Decreased concentration
  • Agitation or retardation
  • Sleep disturbance of any sort
  • Change in appetite
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15
Q

Differential diagnosis

A 
Normal reaction to life event
SAD
Dysthymia
Cyclothymia
Bipolar
Stroke, tumour, dementia
Hypothyroidism, Addison’s, Hyperparathyroidism
Infections – Influenza, infectious mononucleosis, hepatitis, HIV/AIDS
Drugs
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16
Q

Treatments of depression

A

Antidepressants
Psychological treatments
Physical treatments

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17
Q

Types of antidepressant

A

Selective Serotonin Reuptake Inhibitors (SSRIs)
Tricyclic antidepressants (TCAs)
Monamine Oxidase Inhibitors

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18
Q

Psychological treatments

A

CBT
IPT
Individual dynamic psychotherapy
Family therapy

19
Q

Physical treatments

A

ECT
Psychosurgery
DBS
VNS

20
Q

IPT

A

Interpersonal therapy

21
Q

ECT

A

Electroconvulsive therapy

22
Q

DBS

A

Deep brain stimulation

23
Q

VNS

A

Vagus nerve stimulation

24
Q

SCID

A

Structured Clinical Interview for DSM disorders

25
Q

SCAN

A

Schedules for clinical Assessment in Neuropsychiatry

26
Q

What is mania?

A

A state of feeling, or mood that can range from near-normal experience to severe, life-threatening illness
Often associated with grandiose ideas, disinhibition, loss of judgment; with similarities to the mental effects of stimulant drugs

27
Q

What is hypomania?

A

Lesser degree of mania, no psychosis,
Mild elevation of mood for several days on end
Increased energy and activity, marked feeling of wellbeing
Increased sociability, talkativeness, overfamiliarity, increased sexual energy, decreased need for sleep
May be irritable
Concentration reduced, new interests, mild overspending
Not to the extent of severe disruption of work or social rejection

28
Q

What is mania (with or without psychosis)?

A

1 Week, severe enough to disrupt ordinary work and social activities more or less completely
Elevated mood, increased energy, overactivity, pressure of speech, decreased need for sleep
Disinhibition
Grandiosity
Alteration of senses
Extravagant spending
Can be irritable rather than elated

29
Q

Psychiatric differential diagnosis mania

A 
Mixed affective state
Schizoaffective disorder
Schizophrenia
Cyclothymia
ADHD
Drugs and Alcohol
30
Q

Medical differential diagnosis mania

A 
Stroke
MS
Tumour
Epilepsy
AIDS
Neurosyphilis
Endocrine =>
  - Cushing’s
  - Hyperthyroidism
SLE
31
Q

Symptom measurement methods for mania

A

SCID
SCAN
YMRS

32
Q

YMRS

A

Young mania rating scale

33
Q

Mania treatment

A

Antipsychotics
Mood stabilisers
Lithium
ECT

34
Q

Antipsychotics

A

Olanzapine
Risperidone
Quetiapine

35
Q

Mood stabilisers

A

Sodium valproate
Lamotrigene
Carbamazepine

36
Q

Classification of mania

A 
Hypomania
Mania without psychotic symptoms
Mania with psychotic symptoms
Other Manic episodes
Manic episode, unspecified
37
Q

Classification of bipolar disorder

A 
Currently hypomanic
Current manic without psychosis
Current manic with psychosis
Current mild/mod depression
Current severe depression without psychosis
Current severe depression with psychosis
Current episode mixed
Current episode in remission
Other bipolar affective disorders
Bipolar affective disorder, unspecified
38
Q

What is bipolar disorder?

A

Repeated (2+) episodes of depression and mania or hypomania.

39
Q

What is psychosis?

A

A mental disorder characterized by symptoms such as delusions or hallucinations, that indicate impaired contact with reality

40
Q

Is misidentification of persons more likely in acute organic psychosis or schizophrenia?

A

Organic psychosis

41
Q

Are visual hallucinations more likely in acute organic psychosis or schizophrenia?

A

Organic psychosis

42
Q

Are audio hallucinations more likely in acute organic psychosis or schizophrenia?

A

Schizophrenia

43
Q

Is clear conscioussness more likely in acute organic psychosis or schizophrenia?

A

Schizophrenia

44
Q

Is presence of delusions more likely in acute organic psychosis or schizophrenia?

A

Schizophrenia

Psychiatry (9 decks)

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