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Psychiatry > Depression > Flashcards

Depression Flashcards

1
Q

Which group of conditions is depression part of?

A

Affective mood disorder conditions

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2
Q

What are other examples of affective mood disorders?

A

• Affective mood disorder
• Anxiety
• Bipolar Disorder

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3
Q

How can mood disorders present?

A

As a primary problem
Or they can be secondary to another condition

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4
Q

What can depression be secondary to?

A

• Cancer
• Dementia
• Drug misuse
• Medical treatment (steroids)
• Bereavement

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5
Q

What are differential diagnosis of depresison?

A

• Hypothyroidism
• Bipolar disorder
• Cancer/ terminal diagnosis

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6
Q

What 2 ways can depression present?

A

As a single episode
As an ongoing condition with periods of relapse and remission

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7
Q

What do depressed patients have in terms of life?

A

A decreased quality of life
Increase mortality

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8
Q

According to ICD-10, what is required for the diagnosis of mild depression?

A

2 core symptoms
4 additional symptoms

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9
Q

According to ICD-10, what is required for the diagnosis of moderate depression?

A

2 core symptoms
6 additional symptoms

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10
Q

According to ICD-10, what is required for the diagnosis of severe depression?

A

All 3 core symptoms
8 additional symptoms

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11
Q

What are the 3 core symptoms of depression?

A

• Depressed mood for most of the day almost everyday for two weeks, uninfluenced by circumstances
• Loss of interest or pleasure
• Decreased energy or increased fatigability

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12
Q

What are the additional symptoms of depression?

A

• Loss of confidence or self esteem
• Unreasonable feelings of guilt or self reproach or excessive guilt
• Recurrent thoughts of death by suicide or any suicidal behaviour
• Decreased concentration
• Agitation or retardation
• Sleep disturbance of any sort
• Change in appetite

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13
Q

What sleep disturbance can you get with depression?

A

Insomnia
Hyposomnia
Waking to early in the morning and not getting back to sleep

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14
Q

What changes in appetite can you get with depression?

A

Loss of appetite- weight loss
Comfort eating- Increased weight

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15
Q

What are the positive symptoms of depression?

A

• Concentration/ attention
• Self-esteem/ confidence
• Guilt/ worthlessness
• Self-harm /suicide
• Disturbed sleep/ loss of appetitive

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16
Q

What are the somatic symptoms of depression?

A

• Anhedonia
• Early morning waking
• Low mood on waking
• Psychomotor retardation
• Marked libido loss
• Weight loss

17
Q

What should you do before giving an SSRI, especially citalopram?

A

Take an ECG

18
Q

What is the management of mild depression?

A

• Group Based CBT
• Low intensity psychotherapy/ intervention

19
Q

What is the management of moderate depression?

A

Therapy
Medication

20
Q

What is the management of severe depression?

A

Medication and therapy

21
Q

What is common with severe depression?

A

Delusions and hallucinations

22
Q

What medication is commonly used with depression?

A

SSRI’s

23
Q

What are examples of SSRI’s for depression

A

Sertraline

24
Q

What SSRI would you give to a child with depression?

A

Fluoxetine

25
Q

What are alternative treatments for depression?

A

Tricyclic antidepressants
Monoamine oxidase inhibitors

26
Q

If the patient had previously had an MI, what SSRI would you give them?

A

Sertraline

27
Q

How long would you prescribe an SSRI if this is the patients first episode of depression to prevent a relapse?

A

6-9 months

28
Q

If this was the patients second episode of depression, how long would you treat them?

A

2 years

29
Q

If someone had catatonic depression, how would you treat them?

A

With ECT

30
Q

What is the main presentation of catatonic depression?

A

Patient is speechless and motionless-doesn’t respond to their environment

31
Q

How long should people who benefitted from an antidepressant be kept on one?

A

6 months after remission to reduce risk of relapse

32
Q

Examples of other SSRI’s?

A

Citalopram
paroxetine

33
Q

Examples of SNRI’s

A

Venlafaxine

34
Q

Examples of tricyclic antidepressants?

A

Amitriptyline
Clomipramine

35
Q

A PHQ-9 score of what would suggest less severe depression?

A

a PHQ-9 score of < 16

36
Q

A PHQ-9 score of what would suggest more severe depression?

A

a PHQ-9 score of > 16

Psychiatry (28 decks)

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