Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry > Affective Disorders > Flashcards

Affective Disorders Flashcards

1
Q

what are mood disorders?

A
  • disorders of mental status and function where altered mood is the (or a) core feature
  • a term referring to states of depression and of elevated mood - mania
  • the commonest group of mental disorders
  • recognition and management forms a large component of activities for GPs, psychiatrists and clinical psychologists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  • disordered mood can present as a ______ problem or as a __________ of other disorder or illness, e.g. cancer, dementia, drug misuse or medical treatment (steroids)
  • often associated with ______ symptoms and _____ disorders. focus on the depressive disorders
A

primary

consequence

anxiety

anxiety

(If anxiety and depression then treat depression first as often the treatment of the depressive disorder helps with the anxiety symptoms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what classification systems are avalible?

A
  • ICD-10 - International Classification of Disease 10th Edition – World Health Organisation
  • DSM-5 - Diagnostic and Statistical Manual of Mental Disorders 5th Edition – American Psychiatric Association
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is depression?

A

•Symptom - An emotion within the range of normal experience

  • describe a state of feeling, or mood, that can range from normal experience to severe, life-threatening illness
  • a ‘systemic’ symptom (complaint) with similarities to fatigue and pain
  • typically considered as a form of sadness, not just an absence of happiness
  • Syndrome - A constellation of symptoms and signs
  • Recurrent illness - Recurrent depressive disorder
  • A leading cause of disability worldwide
  • A common condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When does depression become abnormal?

A

•no clear and convenient division. consensus problematic, often a matter of perspective

psychiatry places emphasis on:

  1. persistence of symptoms
  2. pervasiveness of symptoms
  3. degree of impairment
  4. presence of specific symptoms or signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

SYMPTOMS OF DEPRESSIVE ILLNESS occurs in 3 spheres which are what?

A

PSYCHOLOGICAL

PHYSICAL

SOCIAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are depressive symptoms that may be present in the psychological sphere?

A

CHANGE IN MOOD:

DEPRESSION - May find diurnal variation

ANXIETY - inability to relax

PERPLEXITY - particularly in Puerperal illness

ANHEDONIA

CHANGE IN THOUGHT CONTENT:

GUILT, HOPELESSNESS, WORTHLESSNESS

ANY NEUROTIC SYMPOMATOLOGY e.g.. Hypochondriasis, agoraphobia, obsessions & compulsions, panic attacks.

IDEAS OF REFERENCE

DELUSIONS AND HALLUCINATIONS if severe (psychotic symptoms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are depressive symptoms that may be present in the physical sphere?

A

CHANGE IN BODILY FUNCTION:

ENERGY - Fatigue

SLEEP

APPETITE - weight loss

LIBIDO

CONSTIPATION

PAIN

CHANGE IN PSYCHOMOTOR FUNCTIONING:

AGITATION (restlass anxiety)

RETARDATION (thoughts, speech and movement slowed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are depressive symptoms that may be present in the social sphere?

A

LOSS OF INTERESTS

IRRITABILITY

APATHY

WITHDRAWAL, LOSS OF CONFIDENCE, INDECISIVE

LOSS OF CONCENTRATION, REGISTRATION & MEMORY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is stupor?

A

a state of extreme retardation in which consciousness is intact. The patient stops moving, speaking, eating and drinking. On recovery can describe clearly events which occurred whilst stuporose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Depression – ICD-10

what is their definition 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 (some symptoms of depression may overlap with those)
  • If psychotic symptoms or stupor then severe depression with psychotic symptoms - Need to exclude other psychotic illnesses first like schizophrenia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Depression – ICD-10 – Somatic Syndrome:

One diagnosis within the depressive disorders is somatic syndrome - what is classed as 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 2 hrs before the normal time
  • Depression worse in the morning
  • Objective evidence of psychomotor agitation or retardation
  • Marked loss of appetite
  • Weight loss (5%+ of body weight in a month)
  • Marked loss of libido
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mild Depression – ICD-10

what is classed as mild depression?

A

Left is core symptoms - at least 2 of 3

Then a further 2 form the list on the right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Moderate Depression – ICD-10

what is classed as moderate depression?

A

Same 2 lists

But 4 symptoms from the left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Severe Depression – ICD-10

what is classed as severe depression?

A

All 3 of core symptoms

Then at least 5 from right hand list

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how common is Post-natal Depression?

A
  • increased risk of psychiatric admission in the 30 days following childbirth (risk for 24m)
  • 75% of women experience ‘blues’ within 2 weeks (passes quickly)
  • 10% of women develop MDD within 3-6 months
  • ‘puerperal psychosis’ - 1 in 500 deliveries with a risk of recurrence of 1-3 with subsequent deliveries
  • despite intuitive appeal - no association with hormonal changes has ever been demonstrated
17
Q

what are some differential diagnosis you should consider in a depressive disorder?

A
  • Normal reaction to life event
  • Seasonal Affective Disorder
  • Dysthymia
  • Cyclothymia
  • Bipolar
  • Stroke, tumour, dementia
  • Hypothyroidism, Addison’s, Hyperparathyroidism
  • Infections – Influenza, infectious mononucleosis, hepatitis, HIV/AIDS
  • Drugs
18
Q

what are the main evidence based treatments for depression?

A
  • Antidepressants - Selective Serotonin Reuptake Inhibitors (SSRIs), Tricyclic antidepressants (TCAs), Monamine Oxidase Inhibitors, Other antidepressants
  • Psychological Treatments - CBT, IPT, Individual dynamic psychotherapy, family therapy
  • Physical Treatments - ECT, Psychosurgery, DBS, VNS
19
Q

how do you measure and diagnose depressive disorders?

A
  • SCID (Structured Clinical Interview for DSM disorders)
  • SCAN (Schedules for Clinical Assessment in Neuropsychiatry) (aligns with ICD-10)
  • HDRS (Hamilton Depression Rating Scale)
  • BDI-II (Beck Depression Inventory II)
  • HADS (Hospital Anxiety and Depression Scale)
  • PHQ-9 (Patient Health Questionnaire 9)
20
Q

Summary:

  • Affective disorders are ________, _______ and ________
  • Depression is a leading cause of morbidity _______
  • All have effective __________
  • Depressive disorders can be classified and symptoms _________
A

common

recurrent

disabling

globally

treatments

measured

21
Q

what is mania?

A
  • a term to describe a state of feeling, or mood, that can range from near-normal experience to severe, life-threatening illness
  • rarely a symptom (unlike depression), often associated with grandiose ideas, disinhibition, loss of judgment; with similarities to the mental effects of stimulant drugs (AMPH, cocaine)
  • typically considered as a form of pathological, inappropriate elevated mood
22
Q

how do you classify someone as having mania?

A
  • no clear and convenient division. consensus problematic, often a matter of judgment of deviation from ‘normal self’
  • psychiatry places emphasis on: (Same 4 emphasis as depressive disorders)
  1. persistence of symptoms
  2. pervasiveness of symptoms
  3. degree of impairment
  4. presence of specific symptoms or signs
23
Q

how does ICD-10 classify 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, decreased need for sleep
  • May be irritable
  • Concentration reduced, new interests, mild overspending
  • Not to the extent of severe disruption of work or social rejection
24
Q

how does ICD-10 classify mania (with or without psychosis)?

A
  • 1 Week, severe enough to disrupt ordinary work and social activities more or less completely
  • Elevated mood, increased energy, overactivity, pressure of speech (speak rapidly and difficult to follow), decreased need for sleep
  • Disinhibition (behaving in a way they wouldn’t normally)
  • Grandiosity (elevated sense of yourself)
  • Alteration of senses
  • Extravagant spending
  • Can be irritable rather than elated
25
Q

whata re some differential diagnosis of hypomania and mania?

A

Psychiatric:

  • Mixed affective state
  • Schizoaffective disorder
  • Schizophrenia
  • Cyclothymia
  • ADHD
  • Drugs and Alcohol

Medical:

  • Stroke, MS, Tumour, epilepsy, AIDS, Neurosyphilis
  • Endocrine – Cushing’s, hyperthyroidism
  • SLE
26
Q

whata re some Tools to Measure
Symptoms?

A

SCID

SCAN

Young Mania Rating Scale (YMRS) - used to measure changes in severity of symptoms, track over time how someone’s symptoms are

27
Q

what treatment is avalible for mania?

A
  • Antipsychotics - Olanzapine, Risperidone, Quetiapine
  • Mood Stabilisers - Sodium Valproate, Lamotrigene, Carbamazepine
  • Lithium
  • ECT
28
Q

what are the different types of bipolar disorders?

A

Different phases, depending on if they are manic or hypomanic, weather they have psychotic symptoms or not, weather they are in a depressive episode with or without psychotic symptoms, can be in remission or not

29
Q

What is ICD-10 definition for the diagnosis of bipolar disorder?

A
  • Bipolar Affective Disorder consists of repeated (2+) episodes of depression and mania or hypomania.
  • If no mania or hypomania then diagnosis is recurrent depression.
  • If no depression the diagnosis is hypomania or bipolar disorder
  • (In DSM-5 a single episode of mania is sufficient to diagnose bipolar disorder.)

Very unlikely to have a one of manic episode without the other side

30
Q

what is the epidemiology of bipolar disorder?

A
  • lifetime prevalence rate (n per 100) : 0.7 - 1.6
  • point prevalence rate of mania : 0.08 - 0.8
  • industrialised nations = non-industrialised
  • rates for males = rates for females
  • mean age of onset = 21 (unusual >30)
  • some studies - 1/3 onset < 20
  • early onset (15-19) usually with positive FH
  • no differential prevalence according to income, occupation or educational status
  • prevalence consistently increased in 1st0 relatives (suggesting there is probably a genetic link)
  • other forms of depression also more common
31
Q

what is the epidemiology of depression?

A
  • lifetime prevalence rate (n per 100): 2.9 - 12
  • point prevalence rate of depression: 3.7 - 7.7
  • lifetime risk for less severe manifestations - 20
  • rates for females exceed rates for males - 2:1
  • highest risk from age 18-44 (median 25)
  • mean age of onset = 27
  • onset during old age is not unusual
  • no overall association with socioeconomic status
  • MDD less common in those employed
  • MDD less common in those financially independent (N.B. - direction of effect)
  • association with lower educational attainment
  • stable marriage negatively associated with MDD
  • increased risk in 1st0 relatives where proband has MDD (3x) or BPD (2x)
  • twin studies: MZ ‘v’ DZ = 27% ‘v’ 12%
  • onset of depression (first episode) associated with excess of adverse life events
  • ‘exit events’ - separations, losses
32
Q

what is the Clinical Course and Outcome of major depression?

A
  • typical episode lasts 4-6 months
  • 54% recovered at 26 weeks
  • 12% fail to recover
  • 80+% have further episodes (Depression recurrence is actually about 40%)
  • 15% die by suicide
33
Q

What is the Clinical Course and Outcome of Bipolar Disorder / Mania?

A
  • typical manic episode lasts 1-3 months
  • 60% recovered at 10 weeks
  • 5% fail to recover
  • 90% have further episodes
  • 1/3 have poor outcome
  • 1/3-1/4 have good outcome
  • 10% die by suicide
34
Q

Summary:

  • Affective disorders can be _______ and symptoms _________
  • Affective disorders are ________ and ________
  • Mania less common than _______ disorder (which again is less common than depressive disorders)
  • All have effective _________
A

classified

measured

recurrent

disabling

bipolar

treatments

Psychiatry (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions