Depressed Mood Flashcards
What is anhedonia?
lack of enjoyment/pleasure
What is anergia?
lack of energy
What is amotivation?
lack of motivation
What is diurnal variation of mood?
mood which varies over the course of the day
What is early morning wakening?
Waking at least 2 hours before the expected/normal waking time
What is Psychomotor Retardation?
subjective or objective slowing of thoughts and/or movement
What is euthymia?
normal mood
What is the classical appearance of a depressed patient?
- reduced facial expression
- furrowed brow
- reduced eye contact
- limited gesturing or slowed movement
- difficult to establish rapport
What is speech like in a depressed patient?
Reduced rate of speech – speech is slow
• Lowered in pitch
• Reduced in volume – speech is quiet
• Reduced intonation – speech is monotonous
• Increased speech latencies – longer time between end of a question and them starting to speak
• Limited content – answers are often short, brief, and unembellished
What is mood?
a prolonged prevailing state or disposition associated with what the patient describes - SUBJECTIVE
what is affect?
the patients mood applied to the surroundings, events and people and how it changes.
Is it congruent with the mood described?
What is mood like in depression?
low, miserable, unhappy, sad.
“flat” “empty” “black”
What is affect like in depressed patients?
depressed i.e. low
reduced range
limited reactivity
What are features of thought in depression?
FORM - typically normal
FLOW - thoughts slow and pondering, subjectively or objectively absent
CONTENT - negative, self-accusatory, failure, guilt, pessimism.
Delusions of guilt, poverty, nihilism, hypochondriasis
What is paranoia?
Self-referential thinking?
What are the characteristics of depressive hallucinations?
almost always auditory
usually second person and derogatory (you are a bad person)
Typically reflect the depression rather than cause it
Depressed cognition?
slowed with poor memory - to do with inattention
What is insight like in depressed patients?
usually preserved and people are usually aware of their symptoms however attribution of these can be disordered - personal failings etc
How long should a depressive episode last to diagnose?
2 weeks
What are the 3 core features of depression?
depressed mood
anhedonia
anergia
What additional symptoms of depression are there?
loss of confidence/esteem
self-reproach
suicidal behaviour
inability to concentrate
sleep disturbance
change in appetite
what is required for a diagnosis of depression?
2 core features + at least 2 additional features
what is required for a diagnosis of moderate depression?
at least two core features + at least 4 additional symptoms to give a total of 6
what is required for a diagnosis of severe depression?
All three core features + at least 5 additional symptoms to give a total of 8
What is atypical depression?
mood reactivity (brightens in response to positive events)
two or more of:
1. significant weight gain or increase in appetite
- hypersomnia
- leaden paralysis (that is, heavy, leaden feelings in arms or legs)
- long-standing pattern of interpersonal rejection sensitivity
What is Psychotic depression?
depression with paranoid delusions
What is Cotards Syndrome
Depression subtype common in the elderly commonly including nihilistic delusions - “i cant eat because my bowels have turned to dust”
What are the 5 R’s of depression?
Response Remission Relapse Recovery Recurrence
