Depression Flashcards

1
Q

3 Core symptoms of depression

A

Lack of energy
Anhedonia
Low mood

For at least 2 weeks

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2
Q

Somatic symptoms of depression

A
Insomnia 
Appetite loss 
Early morning wakening 
Diurnal variations of mood 
Psychomotor retardation - won’t eat or go to the toilet 
Agitation 
Loss of libido
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3
Q

Psychological symptoms

A
Poor concentration 
Low self esteem 
Guilt 
Hopelessness 
Hypochondrial thoughts 
Suicidal thoughts
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4
Q

Mild depression

A

2 core symptoms + 2 others and able to function

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5
Q

Moderate depression

A

2 core symptoms + 3/4 others

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6
Q

Severe depression

A

3 core symptoms + at least 4 other symptoms

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7
Q

Psychotic depression

A

Always severe
Hallucinations
Delusions

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8
Q

Types of delusion

A

Hypochondriacal
Guilt
Nihilistic
Persecutory

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9
Q

Nihilistic delusions

A

Life is meaningless

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10
Q

Persecutory delusions

A

Paranoid

People out to get them

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11
Q

Post natal depression

A

Within 1 - 2 months post partum
Worries about baby’s health
Worries about maternal inadequacy

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12
Q

Risk factors for post natal depression

A
History of depression 
Family history of depression 
Older age 
Single mother 
Unwanted pregnancy 
Poor social support 
Previous post natal depression
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13
Q

Biopsychosocial management of depression

A

Biological:

  • whether to admit or not
  • bloods - exclude organic causes
  • SSRIs
  • ECT

Psychological:

  • CBT
  • psychoeducation
  • CMHT
  • CPN

Social:
- social prescribing

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14
Q

rTMS

A

Repetitive trans- magnetic stimulation

Nodes either side of the head which stimulates the areas of the brain

Non invasive

5 days per week for 6 - 8 weeks

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15
Q

tDCS

A

Transvariable direct current stimulation
Device on head
30 mins for 5 days per week for 6 - 8 weeks

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16
Q

Cause of depression

A

Depression is associated with an imbalance of 5-HT (serotonin) and noradrenaline in the brain and spinal cord

17
Q

ECT

A

Send an electric current through the brain to trigger an epileptic seizure

18
Q

Indications for ECT

A
  • severe treatment resistant depression
  • life threatening depression - dehydrated or anorexia
  • prolonged and severe manic episode
  • Catatonia
19
Q

Length of antidepressant use

A

First episode - continue antidepressants for 6 - 12 months

Multiple episodes - continue antidepressants for much longer

20
Q

ECT monitoring

A

ECT can cause retrograde amnesia therefore assess memory before and after ECT

Antidepressants should be reduced when on ECT

21
Q

Management of mild depression

A

Low intensity psychological interventions

  • sleep hygiene
  • anxiety management
  • computerised CBT
22
Q

Management of moderate depression

A

Anti depressant + high intensity psychological intervention