Affective Disorders

Question 1

3 core symptoms - depression?

Answer 1

low mood, anhedonia, loss of energy/ motivation

Question 2

define anhedonia?

Answer 2

lost interest in things you would have usually been interested in e.g. hobbies

Question 3

define mood disorder?

Answer 3

mental status and function where altered mood is the core feature

Question 4

name the 2 classification systems used for categorising mental disorders?

Answer 4

IDC-10, DSM-5

Question 5

name 5 other associated symptoms of depression?

Answer 5

sleep disturbance, decreased appetite, social withdrawal, feelings of guilt, decreased self-esteem

Question 6

what 2 ways can we define depression?

Answer 6

as a symptom and as a syndrome

Question 7

define depression as a symptom?

Answer 7

an emotion within range of normal experience

Question 8

define depression as a syndrome?

Answer 8

a constellation of symptoms and signs

Question 9

name 4 criteria used to decide whether depression is abnormal?

Answer 9

1 - persistence of symptoms, 2 - pervasiveness of symptoms, 3 - degree of impairment, 4 - presence of specific symptoms and signs

Question 10

name 3 categories of depressive symptoms?

Answer 10

social, psychological and physical

Question 11

name 2 types of psychological symptoms associated with depression?

Answer 11

change in mood and change in thought content

Question 12

name 2 types of physical symptoms associated with depression?

Answer 12

change in bodily function and change in psychomotor functioning

Question 13

give 3 examples of social symptoms associated with depression?

Answer 13

anhedonia, apathy, withdrawal

Question 14

describe stupor?

Answer 14

extreme retardation but still conscious - patient stops moving, eating etc. but during recovery, they will be able to clearly describe the events while stuporose

Question 15

describe 3 criteria for diagnosing depression using ICD-10?

Answer 15

lasts @ least 2 weeks, no hypomanic/ manic episodes in lifetime, not attributed to psychoactive substance use/ organic mental disorder

Question 16

what is a somatic syndrome?

Answer 16

a specific type of depression

Question 17

name 7 hallmark features of somatic syndrome?

Answer 17

anhedonia, lack of emotional response, waking up early, worse mood in morning, psychomotor agitation/ retardation, loss of appetite, loss of libido

Question 18

how many classifications of depression are described by ICD-10?

Answer 18

3 - mild, moderate, severe

Question 19

how can we diagnose mild depression?

Answer 19

@ least 2 core symptoms + @ least 2 other symptoms

Question 20

how can we diagnose moderate depression?

Answer 20

@ least 2 core symptoms + @ least 4 other symptoms

Question 21

how can we diagnose severe depression?

Answer 21

all 3 core symptoms + @ least 5 other symptoms

Question 22

how many woman (approx) experience MDD within 3-6 months of childbirth?

Answer 22

~10%

Question 23

what other depressive disorder is increased risk for woman who have recently experienced childbirth?

Answer 23

puerperal psychosis

Question 24

name 4 differentials for depression?

Answer 24

SAD, normal reaction to life event, dysthymia, bipolar

Question 25

name 3 types of antidepressants and highlight which would be first line for treating depression?

Answer 25

SSRIs (1st line), TCAs, Monamine oxidase inhibitors

Question 26

name 4 psychological treatments for depression?

Answer 26

CBT, IPT, Individual dynamic psychotherapy, Family therapy

Question 27

name 4 physical treatments for depression?

Answer 27

ECT, psychosurgery, DBS, VNS

Question 28

name 2 measurement tools for depression?

Answer 28

SCAN, SCID

Question 29

describe mania?

Answer 29

often associated with grandiose ideas, disinhibition, loss of judgment; with similarities to the mental effects of stimulant drugs - considered as a form of pathological, inappropriate elevated mood

Question 30

outline 4 criteria psychiatry describe for defining mania?

Answer 30

1 - persistence of symptoms, 2 - pervasiveness of symptoms, 3 - degree of impairment, 4 - presence of specific symptoms and signs

Question 31

what is hypomania?

Answer 31

less severe version of mania - main difference being that hypomanic patients can still commit to routine in their lives - e.g. they are able to hold down a job

Question 32

how can we differentiate between mania and hypomania in terms of timeline?

Answer 32

hypomania - mild elevation for several days, mania - @ least 1 week of symptoms which are severe enough to disrupt everyday activities

Question 33

describe 4 symptoms of hypomania?

Answer 33

increased energy, marked feeling of wellbeing, increased sociability, reduced concentration

Question 34

describe 4 symptoms of mania?

Answer 34

elevated mood, disinhibition, grandiosity, pressure of speech

Question 35

name 4 differentials for mania?

Answer 35

schizophrenia, ADHD, drugs/ alcohol use, stroke

Question 36

describe 4 main treatment options for mania?

Answer 36

antipsychotics, mood stabilisers, Lithium, ECT

Question 37

name 3 antipsychotics used for treating mania?

Answer 37

Olanzapine
Risperidone
Quetiapine

Question 38

name 3 mood stabilisers used for treating mania?

Answer 38

Sodium Valproate
Lamotrigene
Carbamazepine

Question 39

how can we diagnose BAD (ICD-10)?

Answer 39

BAD consists of repeated (2+) episodes of depression and mania/ hypomania

Question 40

describe epidemiology of BAD in terms of mean age of onset, gender bias and social background?

Answer 40

mean age - 21 (unusual >30), M=F, no differential prevalence according to income, occupation or educational status

Question 41

when is early onset of BAD usually diagnosed?

Answer 41

+ve family history

Question 42

epidemiology od depression - gender bias, mean age of onset, FH?

Answer 42

F:M = 2:1, mean age = 27, increased risk if family members are affected (up to x3)