Affective disorders Flashcards
Are mood disorders the same as affective disorders?
Yes
What is a mood disorder?
Disorder of mental status and function where altered mood is the core feature
How can anxiety disorders associated with mood disorders be treated?
By treating the associated mood disorder
Are mood disorders always primary?
No
What is dysthymia?
A mild form of depression where symptoms fall just below the threshold for depression diagnosis
What is depression as a symptom?
An emotion within the range of normal experience - considered a form of sadness, not as an absence of happiness
What is depression as a syndrome?
A constellation of symptoms and signs
Is depression recurrent?
Yes
What are 4 factors to determine when depression becomes abnormal?
Persistence of symptoms - at least 2 weeks
Pervasiveness of symptoms
Degree of impairment
Presence of specific symptoms or signs
How does the mood of depression change through the day?
Tends to be worst on waking and improves as day goes on
What is anhedonia?
No longer experiencing pleasure or interest in things you used to find pleasure or interest in
How does a person’s thought content change with depression?
Guilt Worthlessness Hopelessness Neurotic symptomatology Delusions and hallucinations if severe
How does mood change in depression?
Feeling depressed
Anxiety
Perplexity
Anhedonia
What are changes of bodily function that occurs in depression?
Reduction of energy - fatigue Sleep problems - too much or too little Appetite - weight loss Loss of libido Constipation Pain
What changes in psychomotor functioning can happen in depression?
Agitation
Retardation
What are social problems in depression?
Loss of interests
Irritability
Apathy
Withdrawal, loss of confidence, indecisive
Loss of concentration, registration, memory
What are ICD-10s factors for depression?
Symptoms last at least 2 weeks
No hypomanic or manic episodes in lifetime
Not attributable to psychoactive substance use
How is mild depression diagnosed?
At least 2 of - depressed mood almost every day uninfluenced by circumstances
Loss of interest or pleasure
Decreased energy or increased fatigability
Add from this list to give 4 total - Loss of confidence
Unreasonable feelings of guilt
Recurrent thoughts of death by suicide
Decreased concentration
Agitation
Sleep disturbance
Change in appetite
How is moderate depression diagnosed?
At least 2 of - depressed mood almost every day uninfluenced by circumstances
Loss of interest or pleasure
Decreased energy or increased fatigability
Add from this list to give 6 total - Loss of confidence
Unreasonable feelings of guilt
Recurrent thoughts of death by suicide
Decreased concentration
Agitation
Sleep disturbance
Change in appetite
How is severe depression diagnosed?
All of - depressed mood almost every day uninfluenced by circumstances
Loss of interest or pleasure
Decreased energy or increased fatigability
Add from this list to give 8 total - Loss of confidence
Unreasonable feelings of guilt
Recurrent thoughts of death by suicide
Decreased concentration
Agitation
Sleep disturbance
Change in appetite
What is post-natal depression?
Baby blues within 2 weeks of childbirth
What are differentials for depression?
SAD Dysthymia Cyclothymia Bipolar Stroke, tumour, dementia Hypothyroid Infections Drugs
What antidepressants can be used to treat depression?
Selective serotonin reuptake inhibitors
Tricycylic antidepressants
Monamine oxidase inhibitors
Others
What physical treatments can be used for depression?
Electroconvulsive therapy
Psychosurgery
Deep brain stimulation
Vagal nerve stimulation
What psychological treatment can be used for depression?
Family therapy
Individual dynamic psychotherapy
Cognitive behavioural therapy
Interpersonal therapy
What is mania?
A state of inappropriate elevated mood - can be life threatening ie think you are invincible and get into danger
What is hypomania?
Mild degree of mania without psychosis
Mild elevation of mood for several days on end woth increased energy, activity, sexual energy, talkativeness, etc
Not to extend of disruption of work or social rejection
What is mania?
Mood lasting 1 week, severe enough to disrupt ordinary work and social activities more or less completely
Elevated mood, increased energy, pressure of speech, decreased need for sleep
Disinhibition
Grandiosity
Heightened senses
Extravagant spending
What are psychiatric differentials for mania?
Mixed affective state Schizoaffective disorder Schizophrenia Cyclothymia ADHD Drugs and alcohol
What antipsychotics can be used for mania?
Olanzapine
Risperidone
Quetiapine
What mood stabilisers can be used for mania?
Sodium valproate
Lamotrigene
Carbamazepine
What is bipolar affective disorder?
2+ episodes of depression AND mania/hypomania
When does bipolar normally onset?
15-19
