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Psychiatry > Affective Disorders- Depression, Mania, Bipolar > Flashcards

Affective Disorders- Depression, Mania, Bipolar Flashcards

1
Q

Define a mood disorder

A

Disorder of mental status- alters mood

Can be depressed or elevated

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2
Q

Mood disorders can occur as a primary illness or secondary. Name some causes of secondary mood disorders

A

Cancer
Dementia
Drug misuse
Medical treatment ie steroids

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3
Q

Name the two classification systems used for affective disorders

A

WHO- International Classification of Disease 10th Edition (ICD10)

APA - Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM5)

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4
Q

Describe dysthymia

A

Symptoms of low mood below threshold of depression

Still able to carry out daily tasks/responsibilities

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5
Q

Depression can be described by 3 terms- what are they?

A

Symptom
Syndrome
Recurrent illness

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6
Q

Name some symptoms of depression

A

State of feeling/mood- sadness - can be normal to lifethreatening
Systemic - fatigue, pain

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7
Q

What is meant by depression when described as a syndrome?

A

Constellation of signs and symptoms - not the same in any 2 people

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8
Q

What 4 factors indicate a case where depression has become ‘abnormal’?

A

Persistence of symptoms greater than 2 weeks
Pervasiveness of symptoms
Degree of impairment
Presence of specific signs or symptoms

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9
Q

Symptoms of depression fall under which 3 spheres?

A

Physical sphere
Psychological sphere
Social sphere

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10
Q

Name the symptoms of depression that fall under the Psychological sphere

A

Change in mood

Change in thought content

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11
Q

Describe mood changes in depression

A

Depression- diurnal variation
Anxiety
Anhedonia
Perplexity

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12
Q

Describe changes in thought content seen in depression

A 
Guilt, hopelessness, worthlessness
Neurotic symptomology- hypochondriasis, obsession compulsion, panic attacks
Ideas of reference
Delusions
Hallucinations
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13
Q

3 types of neurotic symptomology that may be seen in depression

A

Hypochondriasis
Obsession compulsion
Panic attacks

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14
Q

What is meant by ideas of reference?

A

Example- thinking people are laughing at you, talking about you

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15
Q

Describe symptoms of depression within the physical sphere

A

Change in bodily function

Change in psychomotor function

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16
Q

What changes may be seen in bodily function in people with depression?

A 
Energy
Sleep
Appetite
Libido
Constipation
Pain
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17
Q

What changes may be seen in psychomotor function in depression?

A

Agitation

Retardation

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18
Q

What symptoms are exhibited in depression that can be described by the social sphere?

A

Loss of interest
Irritability
Apathy

Withdrawal
Loss of confidence
Indecisive

Loss of concentration
Memory
Recognition

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19
Q

Which criteria must be met as described by ICD10 to diagnose depression?

A

Symptoms lasting at least 2 weeks
No hypomaniac or manic episodes in lifetime
Cannot attribute to psychoactive substance or organic mental disorder
Exclude psychotic illnesses

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20
Q

How does somatic syndrome differ from depression>

A

Depression worse in the morning

No low mood symptoms

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21
Q

Symptoms of somatic syndrome

A 
Marked loss of interest or pleasure
Lack of emotional reaction
Waking 2 hours before normal time
Objective evidence of psychomotor agitation or retardation
Marked loss of appetite
Weight loss
Marked loss of libido
22
Q

What are the 3 core symptoms for the diagnosis of depression using ICD10

A

Depressed mood that is abnormal, for most of the day, everyday for the past 2 weeks
Loss of interest or pleasure
Decreased energy or increased fatiguability

23
Q

Additional symptoms to diagnose depression using ICD10

A

Loss of confidence or self esteem
Unreasonable feelings of guilt or self reproach / excessive guilt
Recurrent thoughts of death by suicide or any suicidal behaviour
Decreased concentration
Agitation or retardation
Sleep disturbance
Change in appetite

24
Q

According to ICD10 how many symptoms must be evident to diagnose Mild Depression?

A

2 of the core symptoms
Any 2 of additional symptoms
= 4

25
Q

According to ICD10 how many symptoms must be evident to diagnose Moderate Depression?

A

2 of the core symptoms
Any 4 of additional symptoms
= 6

26
Q

According to ICD10 how many symptoms must be evident to diagnose Severe Depression?

A

All 3 of the core symptoms
Any of additional symptoms
= 8

27
Q

What percentage of women experience ‘baby blues’ and within what time frame after giving birth?

A

75% within 2 weeks

28
Q

What percentage of women will develop a Major Depressive Disorder after giving birth?

A

10% within 3-6 months

29
Q

Puerpural psychosis and its recurrence occurs at what rate?

A

1 in 500 deliveries

Recurrence risk of 1 to 3 in subsequent deliveries

30
Q

Differentials for Depression

A 
Normal reaction to life event
Seasonal Affective Disorder
Dysthymia
Cyclothymia
Bipolar
Stroke
Tumour
Dementia
Hypothyroidism, Addison's, Hyperparathyroidism
Infections - Influenze, infectious mononucleosis, hepatits, HIV/AIDs
Drugs
31
Q

Treatment for depression

A

Antidepressants - SSRIs, TCAs, MAOIs
CBT, IPT, Individual Dynamic Psychotherapy, Family therapy
ECT, Psychosurgery, DBS, VNS

32
Q

What psychological therpaies can be used for treatment of depression?

A

CBT
IPT
IDP
Family therapy

33
Q

What physical treatmennt can be used for depression?

A

ECT
Psychosurgery
DBS
VNS

34
Q

Which measurement tools can be used in depression?

A

SCID

SCAN

35
Q

Symptoms of mania

A

Grandiose ideas
Inhibition
Loss of judgement
Inappropriate elevated mood

36
Q

Questions for when mania is abnormal?

A

Persistence of symptoms
Pervasiveness of symptoms
Degree of impairment
Specific signs and symptoms present

37
Q

Classification of Mania by ICD 10- list the different types

A 
Hypomania
Mania without psychotic symptoms
Mania with psychotic symptoms
Other manic epsiodes
Manic episode unspecified
38
Q

What is the difference between mania and hypomania?

A

Hypomania- lesser degree of mania

No psychosis

39
Q

Symptoms of hypomania

A

Mild elevation of mood for several days on end
Increased energy and activity
Increased sociability, talkativeness, overfamiliarity, sexual energy
Decreased need for sleep
Irritable
Concentration reduced
New interest
Mild overspending
Function not drastically impaired - can still work

40
Q

Symptoms of mania

A 
1 week- severe enough to disrupt ordinary work and social activities
Elevated mood
Increased energy
Overactivity
Pressure of speech
Decreased need for sleep
Disinhibition
Grandiosity
Alteration of senses
Extravagant spending
Can be irritable rather than elated
41
Q

Differentials for Mania - Psychiatric

A 
Mixed affective state
Schizoaffective disorder
Schizophrenia
Cyclothymia
ADHD
Drugs and alcohol
42
Q

Differentials for Mania - Medical

A 
Stroke
MS
Tumour
Epilepsy
AIDs
Neurosyphilis
Endocrine- Cushing's hyperthyroidism
43
Q

measuring tools for mania

A

SCID
SCAN
Young Mania Rating Scale

44
Q

Treatment for Mania

A

Antipsychotics
Mood stabilisers
Lithium
ECT

45
Q

Diagnosis of Bipolar using ICD10

A

Repeated episodes of mania/ hypomania and depression
No depression –> hypomania or bipolar
No mania/hypomania –> recurrent depression

46
Q

Onset of bipolar

A

Early

With family history

47
Q

Length of bipolar episodes

A

Typically 1-3 months

48
Q

What percentage of bipolar patients go on to have further episodes?

A

90%

49
Q

How long are episodes of major depression typically?

A

4-6 months

50
Q

What percentage of patients relapse after major depression?

A

Over 80%

Psychiatry (6 decks)

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