Affective Disorders - Depression Flashcards
What are mood disorders?
Disorders of mental status and function where altered mood is the (or a) core feature
What 4 aspects of depression does psychiatry focus on to determine whether or not it is abnormal?
- Persistence of symptoms
- Pervasiveness of symptoms
- Degree of impairment
- Presence of specific symptoms or signs
What are the 3 “spheres” of symptoms of depression?
Psychological
Physical
Social
Give a few symptoms which may occur in the psychological sphere?
- Change in mood (depression, anxiety, perplexity, anhedonia)
- Change in thought content (guilt, hopelessness, worthlessness ect)
What is an idea of reference?
False beliefs that random or irrelevant occurrences in the world directly relates to a person (e.g. think you walk past people and they are talking about/laughing at you)
What is a delusion?
An unshakable belief about where there is no evidence there to support it.
What is a hallucination?
Sensory experience where the person experiences something that is not there/not real
Give a few symptoms which may occur under the physical sphere?
- Change in bodily function (fatigue, sleep, appetite, libido, constipation, pain)
- Change in psychomotor functioning (agitation, retardation)
Give a few symptoms which may occur under the social sphere
- Loss of interests
- Irritability
- Apathy
- Withdrawal, loss of confidence, indecisive
- Loss of concentration, registration and memory
What is anhedonia?
Loss of ability to derive pleasure from experience
How long must symptoms have lasted to be given a diagnosis of depression?
At least 2 weeks
What factors upon presentation would negate from a diagnosis of depression?
- Previous hypomanic or manic episodes in lifetime (bipolar)
- Psychoactive substance use or organic mental disorder
When is someone considered to have severe depression with psychotic symtpoms and what must you do?
If psychotic symtpoms/stupor are present.
Need to exclude other psychotic illnesses (e.g. schizophrenia)
What is somatic syndrome?
A type of depression that is characterised by specific symptoms.
Some symptoms of somatic syndrome?
- Loss of interest in previously enjoyed activities
- Lack of emotional reactions
- Waking 2hrs before normal time
- Depression worse in morning
- Objective evidence of psychomotor agitation or retardation
- Loss of appetite
- Weight loss
- Marked loss of libido
How many core symtpoms and additional symtpoms must someone have to be diagnosed with mild depression?
- 2 core symptoms
- Additional symptoms to give a total of 4 symptoms
Core depression symptoms?
- Depressed mood for 2 weeks
- Anedonia
- Decreased energy
Additional depression symptoms?
- Loss of confidence
- Feeling guilty
- Suicidal thoughts/behaviour
- Decreased concentration
- Agitation/retardation
- Sleep disturbance
- Change in appetite
Differential diagnoses for depression?
- Normal reaction to life event
- Seasonal affective disorder
- Dysthymia
- Cyclothymia
- Bipolar
- Stroke, tumor, demetia
- Hypothyroidism, Addison’s, Hyperparathyroidism
- Infections
Antidepressants used to treat depression?
- SSRI’s
- Tricyclic antidepressants (TCAs)
- Monamine oxidase inhibitors
- Other
Psychological treatments for depression?
- CBT, IPT, Individual dynamic psychotherapy, family therapy
Physical treatments for depression?
- ECT
- Psychosurgery
- DBS
- VNS
