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ZA - Psychiatry > Affective Disorders - Depression > Flashcards

Affective Disorders - Depression Flashcards

1
Q

What is a mood disorder?

A

Disorder of mental status/function where altered mood is the core feature

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2
Q

What mental health issues fall under “mood disorders”

A

Depression

Mania/Bipolar Disorder

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3
Q

Are mood disorders common?

A

Yes - commonest type of mental health disorder

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4
Q

Mood disorders can be primary or secondary to another issue, true of false?

A

True - mood disorders can arise as a consequence of other illnesses

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5
Q

What other disorder is mood disorders closely associated with?

A

Anxiety disorders

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6
Q

What are the 2 main classification systems for mood disorders?

A

ICD-10 - (International Classification of Disease 10th Edition - WHO)

DSM-5 (Diagnostic and Statistical Manual of Mental Disorders 5th Edition)

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7
Q

What is a syndrome?

A

A constellation of symptoms and signs

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8
Q

Is depression an emotion or is it a disorder?

A

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

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9
Q

How do psychiatrists try and differentiate between a short bout of depression and a depressive disorder then?

A

Persistence of symptoms
Pervasiveness (prevalence) of symptoms
Degree of impairment
Presence of specific symptoms/signs

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10
Q

What 3 categories do depressive symptoms fall under?

A

Psychological
Physical
Social

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11
Q

What 2 subcategories fall under psychological symptoms?

A

Changes in mood

Changes in thought content

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12
Q

List examples of “changes in mood” symptoms.

A

Mood might change to include

  • Depression
  • Anxiety
  • Perplexity
  • Anhedonia
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13
Q

What is perplexity and anhedonia ?

A

Perplexity - inability to deal with or understand something

Anhedonia - loss of pleasure in normally pleasurable activities (disinterested in old hobbies)

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14
Q

What sort of variation can depression as symptom have?

A

Diurnal variation - occur or grow more severe every day at around the same time, usually the daytime

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15
Q

When is perplexity as symptom more likely to occur?

A

In post-childbirth illness

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16
Q

What sort of changes in thought can occur in the “changes in thought content” symptom subcategory

A

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
17
Q

What physical symptoms can depression have?

A 
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)

18
Q

What social symptoms happen in depression?

A 
Withdrawal from social situations
Apathy towards others
Irritability towards others
Loss of concentration, memory 
Loss of interests (anhedonia ?)
19
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

20
Q

Depression according to the ICD-10 will…

A
  • 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)
21
Q

If patient has depression with psychotic symptoms, how is it diagnosed?

A

MUST rule out other psychotic illnesses like schizophrenia first before classifying it as “severe depression with psychotic symptoms”

22
Q

What are some ICD-10 criteria’s for Somatic Syndrome

A

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

23
Q

What is the ICD-10 criteria list for MILD, MODERATE and SEVERE depression?

A

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)

24
Q

What % of women develop major depressive disorder after giving birth and within what time frame?

A

10% within 3 to 6 months

25
Q

What % of women experience “blues” post childbirth and within what time frame?

A

75% within 2 weeks

26
Q

There is an increased risk of BLANK admission in the BLANK days following childbirth.

A

Psychiatric admission

30 days

27
Q

Is post-natal depression a hormonal thing?

A

Not shown to be

28
Q

List some differential diagnosis’ for depression?

A 
Normal reaction to a life event
Seasonal affective disorder
Bipolar
Stroke, tumour, dementia
Endocrine diseases - hypothyroid, hyperparathyroid, addisons
Drug abuse
29
Q

What pharmaceutical managements are there of depression?

A

SSRIs
SNRIs
Tricylic antidepressants (TCAs)
Monamine Oxidase Inhibitors (MAOIs)

30
Q

What psychological managements are there of depression?

A

CBT
Mindfulness based therapies
Family therapy

31
Q

What physical managements are there of depression?

A

Electroconvulsive therapy (ECT)
Psycho-surgery
Deep brain stimulation
Vagus nerve stimulation

32
Q

How ling does a typical episode of MDD last (major depressive disorder)

A

Typical ep. lasts 4 to 6 months

33
Q

How my % of people have further episodes of mdd?

A

80%

34
Q

WHAT % OF PEOPLE WERE RECOVERED BY 26 WEEKS?

A

54%

35
Q

What % of people die by suicide in MDD?

A

15%

36
Q

What % of people fail to recover in MDD?

A

12%

37
Q

What is the ratio for prevalence within gender?

A

2:1 towards females

ZA - Psychiatry (4 decks)

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