Altered Mood Flashcards
What is the leading cause of disability worldwide?
Depression
WHO 2015
Most common depression diagnosis?
Mixed anxiety and depression
Are men or women more likely to get depression?
M:F 1:2
Life expectancy reduction in someone with depression?
5-10 years
How long must you have had symptoms for to be diagnosed with depression?
2 weeks
Core symptoms of depression
1) Low mood
2) Anhedonia
3) Anergia
(need at least 2 core plus additional symptoms)
Depression Additional Symtpoms
Loss of self confidence/self esteem Self-reproach/excessive guilt Recurrent thoughts: death, suicide, suicidal behaviour Change psychomotor activity Sleep disturbance Change in appetite
Mild/moderate/severe depression scoring
Severity:
Mild: 2 core plus others to total minimum 4
Moderate: 2 core plus others to total minimum 6
Severe: 3 core plus others to total minimum 8
(severe +/- psychotic symptoms)
Somatic Syndrome
Loss of interest/pleasure Lack of emotional reactions Weight loss Loss of appetite Loss of libido Psychomotor agitation/retardation Diurnal variation Early morning waking
- Need at least 4
- Weight loss at least 5% of body weight in past month
- psychomotor agitation/retardation marked on or reported by other people
Hallucinations in depression
- Usually mood congruent
- Auditory most common (second person and derogatory)
- Illusions
What is recurrent depression
Repeated episodes of mild, moderate or severe depression
-No episodes fulfilling criteria for mania or hypomania
Dysthymia
Chronic low mood
(vs depression)
Doesn’t fulfil criteria for RDD
May have fulfilled criteria for mild depressive episode (but not recurrent mild episode)
Tired and depressed for months at a time
Usually able to cope with demands of everyday life
Schizoaffective disorder
- psychotic symptoms, similar to schizophrenia
- mood symptoms of bipolar disorder
- have both psychotic and mood symptoms at the same time or within two weeks of each other
Endocrine cause of low mood
Hypoglycemia
Haematological cause of low mood
Anaemia
Inflammatory cause of low mood
SLE
Infective cause of low mood
Syphilis
Medication which could cause low mood
Beta-blockers
Inflammatory cause of low mood
SLE
Adjustment disorder
A group of symptoms, such as stress, feeling sad or hopeless and physical symptoms that occur after going through a stressful event
- symptoms occur because you’re having a hard time coping
- reaction is stronger than expected for the type of event that occured
Bipolar I
One or more manic or mixed (manic and depressive) episodes
lecture says two or more episodes of mania +/- depression
Bipolar II
Depressive episode with at least one episode of hypomania
What is rapid cycling bipolar?
4 or more mood episodes in one year
- may be interspersed with periods of wellness
- cycling may take place in a matter of days, weeks or months
Mean age of bipolar onset?
21 years
Which is more common, bipolar I or II?
Bipolar II (1.5-5% vs 1%)
Chance of developing bipolar if you have first degree relative with it?
~7 fold risk
Chance of child having bipolar if you have it?
50% risk of psychiatric disorder
Endocrine differential of bipolar?
Hyperthyroidism
Inflammatory differential of bipolar?
SLE
Infection differential of bipolar?
Neurosyphilis
Medication which could cause symptoms similar to bipolar?
Steroids
Cyclothymia
Persistant instability of mood
Numerous periods of mild depression and mild elation
Need prolonged observation or good account of past behaviour
Are men or women more likely to get bipolar?
Equally likely, ratio is 1:1
Lifetime suicide risk if you have bipolar?
10-15%
