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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 core feature

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2
Q

When can disordered mood present?

A

As primary problem

Consequence of other disorder or illness

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3
Q

What are mood disorders often associated with?

A

Anxiety symptoms or disorders

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4
Q

What is the classification system for mood disorders?

A

ICD-10

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5
Q

What is depression?

A

Symptom - an emotion within the range of normal experience
Syndrome
- constellation of symptoms and signs Recurrent illness

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6
Q

How does psychiatry devise when depression becomes abnormal?

A
  1. Persistence of symptoms
  2. Pervasiveness of symptoms
  3. Degree of impairment
  4. Presence of specific symptoms or signs
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7
Q

What are the 3 spheres of the symptoms of depressive illness?

A

Psychological
Physical
Social

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8
Q

What are the symptoms in the psychological sphere of depression?

A 
Change in mood:
- depression
- anxiety
- perplexity
- anhedonia
Change in thought content:
- guilt
- hopelessness
- worthlessness
-neurotic symptoms
- ideas of reference
- delusions and hallucinations
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9
Q

What are neurotic symptoms in depression?

A

Hypochondriasis
Agoraphobia
Obsessions and compulsions
Panic attacks

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10
Q

What is perplexity?

A

Feelings of being overwhelmed

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11
Q

What are the symptoms in the physical sphere of depression?

A 
Change in bodily function:
- energy
- sleep
- appetite
- libido
- constipation
- pain
Change in psychomotor functioning:
- agitation
- retardation
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12
Q

What are the symptoms in the social sphere of depression?

A

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

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13
Q

What is apathy?

A

A loss of interest in surroundings

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14
Q

What is anhedonia?

A

Loss of ability to derive pleasure from experience

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15
Q

What is stupor?

A

A state of extreme retardation in which consciousness is intact - patient stops moving, speaking, eating and drinking

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16
Q

What factors give a diagnosis of depression?

A

Last for at least 2 weeks
No hypomanic or manic episodes in lifetime
Not attributable to psychoactive substance use or organic mental disorder

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17
Q

When is it called a severe depression with psychotic symptoms?

A

Psychotic symptoms or stupor

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18
Q

What is somatic syndrome?

A 
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
19
Q

What is the criteria for mild depression?

A

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

20
Q

What is the criteria for moderate depression?

A

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

21
Q

What is the criteria for severe depression?

A

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

22
Q

What does severe depression usually present with?

A

Psychotic symptoms

23
Q

What are differential diagnoses for depression?

A 
Normal reaction to life event
SAD
Dysthymia
Cyclothymia
Bipolar
Stroke, tumour, dementia
Hypothyroidism, Addison's, hyperparathyroidism
Infection
Drugs
24
Q

What are treatments for depression?

A

Antidepressants
Psychological treatments
Physical treatments

25
Q

What are measurement tools for depression?

A

SCID (structured clinical interview for DSM disorders)
SCAN (schedules for clinical assessment in neuropsychiatry)

HDRS
BDI-II
HADS
PHQ-9

26
Q

What is mania?

A

A state of feeling, or mood, that can range from near-normal experience to severe, life-threatening illness
Rarely symptom, often grandiose ideas, disinhibition, loss of judgement, similarities to being on stimulant drugs

27
Q

What are the ICD-10 classifications of mania?

A 
Hypomania
Mania without psychotic symptoms
Mania with psychotic symptoms
Other manic episodes
Manic episode
28
Q

What are the signs of hypomania?

A

Less degree mania, no psychosis
Mild elevation of mood for several days on end
Increased energy/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 extent of disruption of work or social rejection

29
Q

What are the signs of mania (with or without psychosis)?

A

1 week, severe enough to disrupt work/social activities
Elevated mood, increased energy, overactivity, pressure of speech, decreased need for sleep
Disinhibition
Grandiosity
Alteration of senses
Extravagant spending
Irritable rather than elevated

30
Q

What are the differential diagnoses for mania?

A

Psychiatric: mixed affective state, schizoaffective disorder, schizophrenia, cyclothymia, ADHD< drugs/alcohol
Medical: stroke, MS, tumour, epilepsy, endocrine, SLE

31
Q

What are tools to measure mania symptoms?

A

SCID (structured clinical interview for DSM disorders)

SCAN (schedules for clinical assessment in neuropsychiatry)

32
Q

What is the treatment for mania?

A

Antipsychotics
Mood stabilisers
Lithium
ECT

33
Q

What are examples of antipsychotics?

A

Olanzapine
Risperidone
Quetiapine

34
Q

What are examples of mood stabilisers?

A

Sodium valproate
Lamotrigene
Carbamazepine

35
Q

What is bipolar affective disorder?

A

Repeated (2+) episodes of depression and mania/hypomania

36
Q

What is the diagnosis if no mania or hypomania?

A

Recurrent depression

37
Q

What is the diagnosis if no depression?

A

Hypomania or bipolar disorder

38
Q

How many episodes of mania is enough to diagnose bipolar disorder?

A

Single episode of mania

39
Q

What is the mean age of onset for bipolar disorder?

A

21 (unusual >30)

40
Q

What is the epidemiology of bipolar disorder?

A

Early onset

Usually positive FH

41
Q

What is the mean age of onset for depression?

A

27

42
Q

What is the onset of depression associated with?

A

Excess of adverse life events e.g. ‘exit events’

43
Q

How long does a typical episode of major depression last?

A

4-6mo

44
Q

How long does a typical manic episode last?

A

1-3mo

Psychiatry (15 decks)

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