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Psychiatry > Depression > Flashcards

Depression Flashcards

1
Q

50% of all mental/mood disorders start before the age of 14 and 50% of all mental/mood disorders start before the age of 30.

A

Mental disorders before age of 14

Mood disorders before age of 30

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2
Q

Define anhedonia

A

Loss of enjoyment/pleasure

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3
Q

What is early morning wakening?

A

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

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4
Q

What is psychomotor retardation?

A

Subjective or objective slowing of thoughts and or movement

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5
Q

Define stupor

A

The absence of relational functions i.e. action and speech

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6
Q

List presentation of depression in appearance and behaviour?

A 
Reduced facial expression 
Brow furrowed
Reduced eye contact
Limited gesturing 
Difficult to get rapport
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7
Q

List speech presentation in depression

A 
Reduced rate
Lower in pitch 
Reduced in volume
Reduced intonation (monotonous)
Increased speech latencies (time between speaking) 
Short answers
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8
Q

Define mood vs affect?

A

Mood is prolonged prevailing state (subjective) - how patient feels
Affect is mood in moment (objective) - how patient reacts

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9
Q

Depressed, reduced range, limited reactivity and emotional paralysis are all used to describe patients mood/affect?

A

Affect

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10
Q

Describe presentation in terms of thought in patient with depression

A

Form: normal
Flow: thoughts are slowed, almost absent
Content: negative, self-accusatory, failure, guilt, pessimism, delusions can occur, suicidal thinking, paranoia (self-referential thinking)

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11
Q

What is Cotard’s syndrome?

A

A nihilistic delusion in which patient believes they are already dead and body needs to catch up

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12
Q

What may be different in paranoia in psychosis and paranoia in depression?

A

In psychosis paranoia may have a bizarre element to it whereas depression paranoia will often be tied to guilt/self-blame and sensitivity of criticism by others

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13
Q

What is the presentation of depression in terms of perception?

A

No perceptual disturbance
Maybe some self-referential thinking (he’s talking about me)
Hallucinations can occur - usually 2nd person and derogatory

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14
Q

WHat is presentation of depression in terms of cognition?

A

Cognition is slow - called

Pseudo-dementia

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15
Q

What is presentation of depression in terms of insight?

A

Patients typically have insight

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16
Q

What is the approximate lifetime prevalence of major depression?

A

14-18%

17
Q

List 6 mood disorders as defined by ICD-10.

A 
Manic episode
Bipolar affective disorder
Depressive episode
Recurrent depressive disorder
Persistent mood disorders 
Unspecified mood disorder
18
Q

What is dysthymia another name for?

A

Persistent depressive disorder

19
Q

What is dysthymia mean?

A

Mild to moderate persistent depressive disorder

20
Q

What are general criteria for depression?

A

A. Depressive episode should last at least 2 weeks

B. No hypomanic or manic symptoms sufficient to meet hypomanic or manic criteria at any time in the individuals life

21
Q

At least 2 of 3 CORE symptoms must be present for depression to be diagnosed. What are these 3 symptoms? (MEE)

A
  1. Depressed mood - abnormal for individual, present for most/all day, largely uninfluenced by circumstance for at least 2 weeks (MOOD)
  2. Loss of interest/pleasure in normally pleasurable activities (ENJOYMENT)
  3. Decreased energy or increased fatiguability (ENERGY)
22
Q

An additional symptom(s) from another 7 should be present to give a total of at least 4 for depression to be diagnosed. What are these 7 symptoms?

A
  1. Loss of confidence
  2. Guilt
  3. Suicidal ideas/behaviours
  4. Diminished concentration
  5. Agitation/retardation which is subjective or objective (psychomotor change)
  6. Sleep disturbance
  7. Changes in appetite
23
Q

How does ICD-10 rate severity of depression?

A

According to the number of symptoms (and to a lesser extent, the severity)

24
Q

What is the criteria for a diagnosis of moderate depression?

A

Two core symptoms + four others to give 6

25
Q

What is the criteria for a diagnosis of severe depression?

A

All 3 core symptoms & 5 others to give 8 in totally

26
Q

Antidepressants are indicated for mild depression. True/false?

A

False - not indicated, usually gets better by itself

27
Q

For diagnosis of somatic syndrome, 4 of what 8 symptoms should be present?

A
  1. Loss of interest in activities
  2. Lack of emotional reactions
  3. Early morning wakening (2hours or more before usual time)
  4. Diurnal variation of mood (worse in morning)
  5. psychomotor retardation/agitation
  6. loss of appetite
  7. Weight loss
  8. Loss of libido
28
Q

What is a atypical depression?

A

Mood reactivity - mood brightens in response to actual or potential positive events

29
Q

2 or more of 4 symptoms must be present for a diagnosis of atypical depression. What are these 4 symptoms?

A
  1. Significant weight gain/increase in appetite
  2. Hypersomnia
  3. Leaden paralysis
  4. Long-standing pattern of interpersonal rejection sensitivity that results in significant social/occupational impairment
30
Q

What are two presentations of psychotic depression?

A
  • paranoid

- cotard’s syndrome

31
Q

Chronic depression is always treatment-refractory and so all treatment-refractory depression is chronic. True/false?

A

False - chronic depression is not necessarily treatment-refractory however treatment-refractory depression is usually chronic

32
Q

What is the criteria for chronic depression?

A

Full criteria for a major depressive episode met for at least the past 2 years

33
Q

What are the 5 R’s of depression?

A 
Response to treatment
Remission
Relapse 
Recovery 
Recurrence
34
Q

Affective disorders are common, are usually recurrent (10 year recurrence >80%) and often chronic (20% of cases). True/false?

A

True

35
Q

Unipolar depression has been predicted by the WHO to be the second biggest cause of worldwide morbidity by 2020. Suicide rate in males is 3%. True/false?

A

False!! First part true but suicide rate is 7%

Psychiatry (17 decks)

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