Depressed Mood

Question 1

What is anhedonia?

Answer 1

lack of enjoyment/pleasure

Question 2

What is anergia?

Answer 2

lack of energy

Question 3

What is amotivation?

Answer 3

lack of motivation

Question 4

What is diurnal variation of mood?

Answer 4

mood which varies over the course of the day

Question 5

What is early morning wakening?

Answer 5

Waking at least 2 hours before the expected/normal waking time

Question 6

What is Psychomotor Retardation?

Answer 6

subjective or objective slowing of thoughts and/or movement

Question 7

What is euthymia?

Answer 7

normal mood

Question 8

What is the classical appearance of a depressed patient?

Answer 8

• reduced facial expression
• furrowed brow
• reduced eye contact
• limited gesturing or slowed movement
• difficult to establish rapport

Question 9

What is speech like in a depressed patient?

Answer 9

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

Question 10

What is mood?

Answer 10

a prolonged prevailing state or disposition associated with what the patient describes - SUBJECTIVE

Question 11

what is affect?

Answer 11

the patients mood applied to the surroundings, events and people and how it changes.

Is it congruent with the mood described?

Question 12

What is mood like in depression?

Answer 12

low, miserable, unhappy, sad.

“flat” “empty” “black”

Question 13

What is affect like in depressed patients?

Answer 13

depressed i.e. low
reduced range
limited reactivity

Question 14

What are features of thought in depression?

Answer 14

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

Question 15

What is paranoia?

Answer 15

Self-referential thinking?

Question 16

What are the characteristics of depressive hallucinations?

Answer 16

almost always auditory

usually second person and derogatory (you are a bad person)

Typically reflect the depression rather than cause it

Question 17

Depressed cognition?

Answer 17

slowed with poor memory - to do with inattention

Question 18

What is insight like in depressed patients?

Answer 18

usually preserved and people are usually aware of their symptoms however attribution of these can be disordered - personal failings etc

Question 19

How long should a depressive episode last to diagnose?

Answer 19

2 weeks

Question 20

What are the 3 core features of depression?

Answer 20

depressed mood

anhedonia

anergia

Question 21

What additional symptoms of depression are there?

Answer 21

loss of confidence/esteem

self-reproach

suicidal behaviour

inability to concentrate

sleep disturbance

change in appetite

Question 22

what is required for a diagnosis of depression?

Answer 22

2 core features + at least 2 additional features

Question 23

what is required for a diagnosis of moderate depression?

Answer 23

at least two core features + at least 4 additional symptoms to give a total of 6

Question 24

what is required for a diagnosis of severe depression?

Answer 24

All three core features + at least 5 additional symptoms to give a total of 8

Question 25

What is atypical depression?

Answer 25

mood reactivity (brightens in response to positive events)

two or more of:
1. significant weight gain or increase in appetite

2. hypersomnia
3. leaden paralysis (that is, heavy, leaden feelings in arms or legs)
4. long-standing pattern of interpersonal rejection sensitivity

Question 26

What is Psychotic depression?

Answer 26

depression with paranoid delusions

Question 27

What is Cotards Syndrome

Answer 27

Depression subtype common in the elderly commonly including nihilistic delusions - “i cant eat because my bowels have turned to dust”

Question 28

What are the 5 R’s of depression?

Answer 28

Response 
Remission 
Relapse 
Recovery 
Recurrence