Affective disorders Flashcards
What are mood disorders?
Disorders of mental status and function where altered mood is core feature
When can disordered mood present?
As primary problem
Consequence of other disorder or illness
What are mood disorders often associated with?
Anxiety symptoms or disorders
What is the classification system for mood disorders?
ICD-10
What is depression?
Symptom - an emotion within the range of normal experience
Syndrome
- constellation of symptoms and signs Recurrent illness
How does psychiatry devise when depression becomes abnormal?
- Persistence of symptoms
- Pervasiveness of symptoms
- Degree of impairment
- Presence of specific symptoms or signs
What are the 3 spheres of the symptoms of depressive illness?
Psychological
Physical
Social
What are the symptoms in the psychological sphere of depression?
Change in mood: - depression - anxiety - perplexity - anhedonia Change in thought content: - guilt - hopelessness - worthlessness -neurotic symptoms - ideas of reference - delusions and hallucinations
What are neurotic symptoms in depression?
Hypochondriasis
Agoraphobia
Obsessions and compulsions
Panic attacks
What is perplexity?
Feelings of being overwhelmed
What are the symptoms in the physical sphere of depression?
Change in bodily function: - energy - sleep - appetite - libido - constipation - pain Change in psychomotor functioning: - agitation - retardation
What are the symptoms in the social sphere of depression?
Loss of interests
Irritability
Apathy
Withdrawal, loss of confidence, indecisive
Loss of concentration, registration & memory
What is apathy?
A loss of interest in surroundings
What is anhedonia?
Loss of ability to derive pleasure from experience
What is stupor?
A state of extreme retardation in which consciousness is intact - patient stops moving, speaking, eating and drinking
What factors give a diagnosis of depression?
Last for at least 2 weeks
No hypomanic or manic episodes in lifetime
Not attributable to psychoactive substance use or organic mental disorder
When is it called a severe depression with psychotic symptoms?
Psychotic symptoms or stupor
What is somatic syndrome?
Anhedonia Lack of emotional reactions to events/activities that normally produce emotional response Waking 2hrs before normal time Depression worse in morning Objective evidence of psychomotor agitation or retardation Marked loss of appetite Weight loss (5%+ body weight in month) Loss of libido
What is the criteria for mild depression?
At least 2:
- Depressed mod that is abnormal for most of the day almost everyday for past two weeks, largely uninfluenced by circumstances
- Loss of interest/pleasure
- Decreased energy/increased fatiguability
Add from this list to give at least 4:
- Loss of confidence/self-esteem
- Unreasonable feelings of guilt/self reproach
- Recurrent thoughts of death by suicide or any suicidal behaviour
- Decreased concentration
- Agitated or retardation
- Sleep disturbance of any sort
- Change of appetite
What is the criteria for moderate depression?
At least 2:
- Depressed mod that is abnormal for most of the day almost everyday for past two weeks, largely uninfluenced by circumstances
- Loss of interest/pleasure
- Decreased energy/increased fatiguability
Add from this list to give at least 6:
- Loss of confidence/self-esteem
- Unreasonable feelings of guilt/self reproach
- Recurrent thoughts of death by suicide or any suicidal behaviour
- Decreased concentration
- Agitated or retardation
- Sleep disturbance of any sort
- Change of appetite
What is the criteria for severe depression?
All of:
- Depressed mod that is abnormal for most of the day almost everyday for past two weeks, largely uninfluenced by circumstances
- Loss of interest/pleasure
- Decreased energy/increased fatiguability
Add from this list to give at least 8:
- Loss of confidence/self-esteem
- Unreasonable feelings of guilt/self reproach
- Recurrent thoughts of death by suicide or any suicidal behaviour
- Decreased concentration
- Agitated or retardation
- Sleep disturbance of any sort
- Change of appetite
What does severe depression usually present with?
Psychotic symptoms
What are differential diagnoses for depression?
Normal reaction to life event SAD Dysthymia Cyclothymia Bipolar Stroke, tumour, dementia Hypothyroidism, Addison's, hyperparathyroidism Infection Drugs
What are treatments for depression?
Antidepressants
Psychological treatments
Physical treatments
