Affective Disorders Features Flashcards
Euthymia
normal mood
Disorders of Mood (3):
- depression
- hypomania
- mania
Subsyndromal Mood Disorders:
- dysthymia:
- cyclomythia:
Affective Disorders:
Prevalence of Affective Disorders:
depressive: mid 20s, modest peak in mid-life 40-60
bipolar disorder: before age 25, average 18
Clinical course of Depressive Illness:
- untreated depressive episodes can
last >6 months - minority last years
- treated depressive episode: 2-3
months - may have ongoing subsyndromal
mood symptoms - 80% will have further episode
Diagnostic Features of a Depressive Episode:
Depression: Features: Low Mood:
- sadness, flat, irritable
- diurnal variation (worse in the
morning)
Depression: Features: Anhedonia:
- loss of enjoyment in things that were
previously pleasurable - hard to look forward to things
Depression: Biological Features:
- appetite change affecting weight
- sleep changes: early morning waking
feeling unrefreshed, hard to get to
sleep, frequent waking, oversleeping - loss of libido
- psychomotor retardation (slow
movements) - low energy
- agitation (less common)
Depression: Psychological Features:
Cognitive: poor conc, attention, hard to read a book, follow TV, study
Low Self-Esteem: worthlessness, guilt, loss of self-confidence
Negative Thinking: hopelessness, helplessness, negative view of the future, suicidal thoughts
Anxiety: broad range of symptoms, health anxiety
Depression: Dissociation:
depersonalisationn: separated from other people by a palne of glass
Depression: Obsessions:
intrusive and repetitive thoughts recognised as patients own
Depression: Phobias:
worsening/new
Physical Health Symptoms:
- headaches
- abdo pain
- GI symptoms: IBS
- pain
Depression: Psychotic Features: Delusions:
- may occur in severe depression
- nihilistic
- poverty
- disease
- guilt
- persecutory
Depression: Psychotic Features: Hallucinations:
- may occur in severe depression
- often in the second person
- putting one down (you’ve done
terrible things)
Melancholic Depresson:
- low mood
- decreased pleasure in usual
activities - decreased emotional reactivity
- loss of appetite
- weight loss
- psychomotor changes
- decreased libido
- diurnal variation of mood
Atypical Depression:
- low mood
- increased appetite
- weight gain
- increased sleep
- anxiety
- fatigue
Depression and Cognition:
- impaired executive function:
reduced concentration and
attention, impact on memory due
to reduced registering of
information - cognitive impairment due to
depression improves with the
treatment of depression
Effect depression on dementia:
- 2 fold increased risk from first
episode, which increases with
number of episodes - depression can also be a prodrome
for dementia - depression is common in people
with dementia
Neurovascular link between depression and dementia:
- frontostriatal vascular damage
- hippocampal atrophy from
chronicly high cortisol - impaired amyloid clearance due to
high cortisol - chronic inflammatory processes
Aetiology of Depression:
Depression and Genetics:
- multiple genes that each have a
small effect - 3x increased risk in first degree
relatives