Depression Flashcards

1
Q

What are mood disorders?

A

Mood disorders are disorders of mental status and function where altered mood is a core feature.

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2
Q

How can mood disorders present?

A

Can present as a primary problem or as a consequence of other disorders or illnesses e.g. cancer, dementia, drug misuse or medical treatment

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3
Q

What is depression?

A

Depression as a symptom can be a state of feeling or mood that can range from a normal experience to a severe life threatening illness.

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4
Q

When is depression abnormal?

A
  • Persistence of symptoms
  • Pervasiveness of symptoms
  • Degree of impairment
  • Presence of specific symptoms or signs
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5
Q

What are the groups of symptoms for depression?

A

Psychological
Physical
Social

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6
Q

What are the psychological symptoms for depression?

A

Change in mood: Depression (diurnal function), Anxiety, Perplexity Anhedonia

Change in thought content: Guilt, Hopelessness, Worthlessness, Neurotic symptomatology (panics, hypochondrias), Ideas of reference (feeling that someone is laughing at you), Delusions and hallucinations

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7
Q

What is anhedonia?

A

No longer finding enjoyment in things that you once used to enjoy

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8
Q

What are the physical symptoms for depression?

A

Change in bodily function: Energy, Sleep, Appetite, Libido, Constipation, Pain

Change in psychomotor function: Agitation, Retardation (general slowing of thoughts, movements and speech)

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9
Q

What are the social symptoms for depression?

A
  • Loss of interest (anhedonia)
  • Irritability
  • Apathy
  • Withdrawal, loss of confidence, indecisive
  • Loss of concentration, registration and memory
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10
Q

What is somatic syndrome?

A
  • Marked anhedonia
  • Apathy to distressing events
  • Waking (2 hours before)
  • Diurnal symptoms
  • Objective evidence of psychomotor agitation or retardation*
  • Marked loss of appetite*
  • Weight loss*
  • Marked loss of libido*
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11
Q

What is the ICD-10 definition of depression? i.e. the criteria for diagnosing depression

A
  • At least 2 weeks
  • No hypo/manic episodes
  • Not attributable to psychoactive substance use or organic mental disorder
  • If psychotic symptoms or stupor then severe depression with psychotic symptoms (differential schizophrenia)
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12
Q

What is the general criteria for depression? (3)

A
  • Depressed mood for most of the day almost every day for the past two weeks, largely uninfluenced by circumstances
  • Anhedonia
  • Decreased energy, Increased fatiguability
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13
Q

What is the additional criteria for depression? (7)

A
  • Loss of confidence
  • Guilt or self-reproach or excessive guilt
  • Concentration
  • Agitation or retardation
  • Sleep disturbance
  • Change in appetite
  • Recurrent thoughts of suicide or any suicidal behaviour
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14
Q

What is mild depression?

A

Two general criteria and a further two additional criteria. Total 4.

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15
Q

What is moderate depression?

A

Two general criteria and a further four additional criteria. Total 6.

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16
Q

What is severe depression?

A

All general criteria and a further five additional criteria. Total 8.

17
Q

What do we know about post-natal depression?

A
  • Risk of psychiatric admission 30 days following childbirth
  • Most have ‘blues’ within 2 weeks (passes quite quickly)
  • 10% of women developed major depressive disorder within 3-6 months
  • Puerperal psychosis
18
Q

What is cyclothymia?

A

Bipolar disorder but less severe

19
Q

What is dysthymia?

A

Depression but less severe

20
Q

What are the main classes of treatment for depression?

A

Antidepressants
Psychological treatment
Physical treatment

21
Q

What is the first line drug for depression?

A

SSRI - Sertraline

22
Q

What antidepressants are there for depression?

A
  • SSRIs
  • TCAs
  • MAOIs
23
Q

What psychological treatments are there for depression?

A
  • CBT
  • Interpersonal therapy (IPT)
  • Individual dynamic psychotherapy
  • Family therapy
24
Q

What physical treatments are there for depression?

A
  • ECT (severe depression)
  • Psychosurgery
  • Deep Brain Stimulation
  • Vagal nerve stimulation
25
Q

What measurement tools are used for depression?

A

SCID, SCAN, HDRS, PHQ-9