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Psychiatry > Affective Disorders > Flashcards

Affective Disorders Flashcards

1
Q

What are mood disorders?

A

Disorders of mental state and function where altered mood is a core feature

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2
Q

Name two common mood disorders

A

Depression and mania

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3
Q

What can cause mood disorders?

A
  • Primary

- Secondary: cancer, dementia, drug misuse, medical treatment etc.

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4
Q

Which disorder is often associated with mood disorders?

A

Anxiety disorders (and their symptoms

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5
Q

Name the two classification systems for mood disorders

A
  • ICD-10

- DSM-5

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6
Q

What is depression?

A
  • Symptom: a systemic symptom which is typically considered a form of sadness, not just the absence of happiness
  • Syndrome: a constellation of signs and symptoms
  • Recurrent Illness: recurrent depressive disorder
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7
Q

When does depression become abnormal?

A
  • No clear/convenient division
  • Consensus problematic
  • Persistence of symptoms
  • Pervasiveness of symptoms
  • Degree of impairment
  • Presence of specific symptoms or signs
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8
Q

List the potential psychological symptoms of depression

A
  • Depression
  • Anxiety
  • Perplexity
  • Anhedonia
  • Guilt
  • Hopelessness
  • Worthlessness
  • Neurotic Sympomatology: hypochondriasis, agroraphobia, obsessions and compulsions and panic attacks
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9
Q

List the potential physical symptoms of depression

A
  • Fatigue
  • Disturbed sleep pattern (insomnia or sleeping too much)
  • Appetite changes
  • Libido
  • Constipation
  • Pain
  • Agitation
  • Retardation
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10
Q

List the potential social symptoms of depression

A
  • Loss of interests
  • Irritability
  • Apathy
  • Withdrawal, loss of confidence and indecisiveness
  • Loss of concentration, registration and memory
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11
Q

According to the ICD-10, which features would be in keeping with a diagnosis of depression (not symptoms)?

A
  • Lasts for at least 2 weeks
  • No hypomanic or manic episodes in lifetime
  • Not attributable to psychoactive substance use or organic mental disorder
  • If psychotic syndromes or stupor then severe depression with psychotic symptoms (other psychotic illnesses need excluded first)
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12
Q

What are the features of depression as a somatic syndrome?

A
  • Marked loss of interest or pleasure in activities that are normally pleasurable
  • Lack of emotional reactions to events or activities that normally produce an emotional response
  • Waking two hours before the normal time
  • Depression is worse in the morning
  • Objective evidence of psychomotor agitation or retardation
  • Marked loss of appetite
  • Weight loss
  • Marked loss of libido
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13
Q

List the possible differential diagnosis for depression

A
  • Normal reaction to life event
  • SAD
  • Dysthymia
  • Cyclothymia
  • Bipolar
  • Stroke, tumour or dementia
  • Hypothyroidism, Addison’s or hyperparathyroidism
  • Infections: influenza, infectious mononucleosis, hepatitis, HIV/AIDs
  • Drugs
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14
Q

List the potential treatments for depression

A
  • Antidepressants: selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, monamine oxidase inhibitors etc.
  • Psychological treatments: CBT, IPT, individual dynamic psychotherapy and family therapy
  • Physical treatments: ECT, psychosurgery, DBS and VNS
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15
Q

Name the two most commonly used measurement tools for depression

A
  • Structured clinical interview for DSM disorders (SCID)

- Schedules for clinical assessment in neuropsychiatry (SCAN)

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16
Q

What is mania?

A
  • A form of pathological, inappropriate elevated mood
  • Often associated with grandiose ideas, disinhibition, loss of judgement with similarities to the mental effects of stimulant drugs (AMPH and cocaine)
17
Q

What are the features of 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 and decreased need for sleep
  • May be irritable
  • Reduced concentration, new interest and mild overspending
  • Not to the extent of severe disruption of work or social rejection
18
Q

What are the criteria for classifying someone as having mania?

A
  • 1 week
  • Severe enough to disrupt ordinary work and social activities more or less completely
  • Elevated mood, increased energy, overactivity, pressure of speech and decreased need for sleep
  • Disinhibition
  • Grandiosity
  • Alteration of senses
  • Extravagant spending
  • Can be irritable rather than elated
19
Q

List the differential diagnosis for mania

A
  • Psychiatric: mixed affective state, schizoaffective disorder, schizophrenia, cyclothymia, ADHD, drugs and alcohol
  • Medical: stroke, MS, tumour, epilepsy, AIDs, neurosyphilis, Cushing’s, hyperthyroidism and SLE
20
Q

Which tools can be used to measure the symptoms of mania?

A
  • SCID
  • SCAN
  • Young mania rating scale (YMRS)
21
Q

List the treatment options for mania

A
  • Antipsychotics: olanzapine, riperidone and quetiapine
  • Mood stabilisers: sodium valproate, lamotrigene and carbamazepine
  • Lithium
  • ECT
22
Q

What are the criteria for a diagnosis for bipolar affective disorder?

A

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

23
Q

What are the features of depression according to ICD-10?

A 
D-Depressed mood most of the day
E-Lack of Energy
A-Anhedonia
D-Death thoughts
S-Sleeplessness
W-Worthlessness or excessive guilt
A-Changes in appetite
M-Decreased mentation
P-Psychomotor retardation
24
Q

What are the features of mania according to ICD-10?

A 
D-Distractibility
I-Irritability
G-Grandiosity
F-Flight of Ideas
A-Increased activity
S-Reduced sleep and increased speech
T-Thoughtlessness (risk taking, impulsivity etc.)

Psychiatry (16 decks)

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