Affective Disorders - Depression Flashcards
What is a mood disorder?
Disorder of mental status/function where altered mood is the core feature
What mental health issues fall under “mood disorders”
Depression
Mania/Bipolar Disorder
Are mood disorders common?
Yes - commonest type of mental health disorder
Mood disorders can be primary or secondary to another issue, true of false?
True - mood disorders can arise as a consequence of other illnesses
What other disorder is mood disorders closely associated with?
Anxiety disorders
What are the 2 main classification systems for mood disorders?
ICD-10 - (International Classification of Disease 10th Edition - WHO)
DSM-5 (Diagnostic and Statistical Manual of Mental Disorders 5th Edition)
What is a syndrome?
A constellation of symptoms and signs
Is depression an emotion or is it a disorder?
Both, can be a normal emotion within the normal range of human emotion (sadness) which can range from mild to very severe in intensity
No clear consensus on when it becomes a disorder - matter of perspective usually
How do psychiatrists try and differentiate between a short bout of depression and a depressive disorder then?
Persistence of symptoms
Pervasiveness (prevalence) of symptoms
Degree of impairment
Presence of specific symptoms/signs
What 3 categories do depressive symptoms fall under?
Psychological
Physical
Social
What 2 subcategories fall under psychological symptoms?
Changes in mood
Changes in thought content
List examples of “changes in mood” symptoms.
Mood might change to include
- Depression
- Anxiety
- Perplexity
- Anhedonia
What is perplexity and anhedonia ?
Perplexity - inability to deal with or understand something
Anhedonia - loss of pleasure in normally pleasurable activities (disinterested in old hobbies)
What sort of variation can depression as symptom have?
Diurnal variation - occur or grow more severe every day at around the same time, usually the daytime
When is perplexity as symptom more likely to occur?
In post-childbirth illness
What sort of changes in thought can occur in the “changes in thought content” symptom subcategory
Patient can suffer from
- Guilt
- Hopelessness
- Worthlessness
- Delusions and hallucinations if severe
- Also suffer from neurotic symptoms such as hypochondria, agoraphobia, obsessions/compulsions and panic attacks
What physical symptoms can depression have?
Low energy --> fatigue Low appetite --> weight loss Affected sleep Libido Constipation Pain
Changes in psycho-motor functioning such as agitation (restless over activity) or retardation (slowing of motor responses such a speech)
What social symptoms happen in depression?
Withdrawal from social situations Apathy towards others Irritability towards others Loss of concentration, memory Loss of interests (anhedonia ?)
What is stupor?
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
Depression according to the ICD-10 will…
- Last for 10 weeks
- Will not result hypomanic/manic episodes
- Can not be attributable to psychoactive substance abuse or organic mental disorder (causes by injury or disease)
If patient has depression with psychotic symptoms, how is it diagnosed?
MUST rule out other psychotic illnesses like schizophrenia first before classifying it as “severe depression with psychotic symptoms”
What are some ICD-10 criteria’s for Somatic Syndrome
Widespread anhedonia
Lack of an emotional reaction to events which should produce one
Depression worse in the morning
Waking up about 2 hours before normal
Loss of appetite and weight loss (5% in one month)
Loss of libido
Evidence of retardation or psycho-motor agitation
What is the ICD-10 criteria list for MILD, MODERATE and SEVERE depression?
MAJOR
- Depressed mood all day, almost everyday for past 2 weeks with no cause
- Anhedonia
- Low energy
MINOR
- Low self-esteem or confidence
- Low concentration
- Unreasonable feelings of guilt
- Suicidal thoughts
- Agitation or retardation
- Disturbed sleep
- Change in appetite
Mild - At least 2 major with additional minors making 4 at least
Moderate - At least 2 majors with additional minors making 6 total at least
Severe - All 3 majors with additional minors making 8 total (hateful 8)
What % of women develop major depressive disorder after giving birth and within what time frame?
10% within 3 to 6 months
