Affective Disorders Flashcards
1
Q
What are mood disorders?
A
- disorders of mental status and function, altered mood being the core feature
- states of depression and elevated mood-mania
- primary problem or consequence of other illness e.g. dementia
- most common group of mental disorders
2
Q
What is the ICD-10?
A
International Classification of Disease 10th Ed.- WHO
- F30- manic episode
- F31- bipolar affective disorder
- F32- depressive episode
- F33- recurrent depressive disorder
- F34- persistant mood (affective) disorder
- F38- other mood (affective) disorder
- F39- unspecified mood (affective) disorder
3
Q
What are the psychological symptoms of depressive illness?
A
- change in mood
- depression
- anxiety
- perplexity
- anhedonia
- change in thought content
- guilt
- hopelessness
- worthlessness
- neurotic symptomology
- ideas of reference
- delusions + hallucinations
4
Q
What are the physical symptoms of depressive illness?
A
- change in bodily function
- sleep- fatigue
- constipation
- appetite- weight loss
- libido
- energy
- pain
- change in psychomotor functioning
- agitation
- retardation
5
Q
What are the social symptoms of depressive illness?
A
- loss of interests
- irritability
- apathy
- withdrawal, loss of confidence, indecisive
- loss of concentration, registration + memory
6
Q
What is the ICD-10 criteria for depression?
A
- ≥ 2 weeks
- no hypomanic/manic episodes in lifetime
- not result of; psychoactive substance, organic mental disorder
- if psychotic symptoms/stupor = severe depression with psychotic symptoms
- must exclude other psychotic conditions
7
Q
What is the ICD-10 criteria for depression somatic syndrome?
A
- anhedonia
- lack of emotional reactions
- wake 2 hrs before normal time
- depression worse in morning
- objective evidence of; psychomotor agitation/retardation
- loss of appetite, weight loss
- loss of labido
8
Q
What is the ICD-10 criteria for mild depression?
A
- general criteria
- 2 or more of:
- abnormal depressed mood, most of day, almost everyday, for 2 weeks, largely uninfluenced by circumstance
- anhedonia
- dec. energy/inc. fatigue
- (to reach 4 added criteria):
- dec. confidence/self esteem
- guilt/self reproach
- suicdal thoughts/behaviour
- agitation/retardation
- sleep disturbance
- appetite change
9
Q
What is the ICD-10 criteria for moderate depression?
A
- general criteria
- 2 or more of:
- abnormal depressed mood, most of day, almost everyday, for 2 weeks, largely uninfluenced by circumstance
- anhedonia
- dec. energy/inc. fatigue
- (to reach 6 added criteria):
- dec. confidence/self esteem
- guilt/self reproach
- suicdal thoughts/behaviour
- agitation/retardation
- sleep disturbance
- appetite change
10
Q
What is the ICD-10 criteria for severe depression?
A
- general criteria
- 2 or more of:
- abnormal depressed mood, most of day, almost everyday, for 2 weeks, largely uninfluenced by circumstance
- anhedonia
- dec. energy/inc. fatigue
- (to reach 4 added criteria):
- dec. confidence/self esteem
- guilt/self reproach
- suicdal thoughts/behaviour
- agitation/retardation
- sleep disturbance
- appetite change
11
Q
What are the differential daignoses for depression?
A
- normal reaction to life event
- SAD
- dysthymia
- cyclothymia
- bipolar
- stroke, tumour, dementia
- hypothyroidism, Addison’s, hyperparathyroidism
- influenza, glandular fever, hepatitis, HIV/AIDS
- drugs
12
Q
What are the different types of treatment for depression?
A
- antidepressants
- psychological treatment
- CBT
- IPT
- indivdual dynamic psychotherapy
- family therapy
- physical treatments
- ECT
- psychosurgery
- DBS
- VNS
13
Q
What are different tools for measuring depression?
A
- SCID (Structured Clinical Interview for DSM disorders)
- SCAN (schedules for Clinical Assessment in Neuropsychiatry)
14
Q
What is mania?
A
- feeling/mood from near-normal experience to life-threatening illness
- similarities to mental affects of stimulant drugs
- form of pathological innapropriate elevated mood
15
Q
What are the ICD-10 categories of mania?
A
- F30.0- hypomania
- F30.1- mania without psychotic symptoms
- F30.2- mania with psychotic symptoms
- F30.8- other manic episode
- F30.9- manic episode, unspecified
16
Q
What is the ICD-10 criteria for hypomania?
A
- lesser degree of mania, no psychosis
- mild elevation of mood, several days
- inc. energy, activity, feeling of wellbeing
- inc. sociability, talking, overfamiliarity, sexual energy
- dec. need for sleep
- irritable
- dec. conc, new interests, mild overspending
- no severe disruption of work or social rejection
17
Q
What is the ICD-10 criteria for mania?
A
- 1 week severe disruption to work and social
- elevated mood, inc. energy, overactivity, pressure of speech
- dec. need for sleep
- disinhibition
- grandiosity
- altered senses
- extravagant spending
- irritable rather than elated
18
Q
What are the differential diagnoses for mania?
A
- mixed affective state
- schizoaffective disorder
- schizophrenia
- cyclothymia
- ADHD
- drugs, alcohol
- stroke, MS, tumour, epilepsy, AIDS, neurosyphilis
- Cushing’s, hyperthyroidism
- SLE
19
Q
What are different tools for measuring mania?
A
- SCID
- SCAN
- Young Mania Rating Scale (YMRS)
20
Q
What is the treatment for mania?
A
- antipsychotics
- olanzipine
- risperidone
- quetiapine
- mood stabilisers
- sodium valproate
- lamotrigene
- carbamazipine
- lithium
- ECT
21
Q
What are the ICD-10 categories of bipolar disorder?
A
- F31.0- BAD, current hypomanic
- F31.1- BAD, current manic without psychosis
- F31.2- BAD, current manic with psychosis
- F31.3- BAD, current mild/mod depression
- F31.4- BAD, current severe depression without psychosis
- F31.5- BAD, current severe depression with psychosis
- F31.6- BAD, current episode mixed
- F31.7- BAD, current episode in remission
- F31.8- other bipolar affective disorders
- F31.9- BAD, unspecified
22
Q
What is the ICD-10 criteria for bipolar affective disorder?
A
- repeated (2+) episodes of depression and mania/hypomania
