Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psych > Depression > Flashcards

Depression Flashcards

You may prefer our related Brainscape-certified flashcards:
Psychology 101 flashcards GRE® Psychology flashcards
1
Q

What are the core symptoms of depression?

A
  • Low mood
  • Anhedonia
  • Lack of energy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the biological symptoms of depression?

A
  • Weight change
  • Disturbed sleep: early morning waking, insomnia or hypersomnia
  • Psychomotor retardation
  • Restlessness
  • Reduced libido
  • Worthlessness or guilt feelings
  • Reduced concentration
  • Nihilistic thoughts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the psychotic symptoms of depression?

A

Mood-congruent
- Delusions: often revolving around guilt or personal inadequacy
- Hallucinations: auditory, olfactory or visual

Mood-incongruent
- Delusions/ hallucinations that aren’t consistent with depressive symptoms/ thoughts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the classification tool for depression?

A

ICD-10 classification
- Mild depression: 2 core symptoms, >=2 cognitive symptoms
- Moderate depression: 2 core symptoms, >=3/4 cognitive symptoms
- Severe depression: 3 core symptoms, >=5 cognitive symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How are risk factors for depression classified?

A
  • Predisposing
  • Precipitating (trigger)
  • Perpetuating (maintaining)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the predisposing biological risk factors?

A
  • Family hx depression and anxiety
  • Age (teenage - early 40s)
  • Female sex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the predisposing psychological risk factors?

A
  • Personality traits
  • Childhood trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the predisposing/ percipitating social risk factors?

A
  • Lack of social support
  • Poor socioeconomic status
  • Marital status (separated/ divorced)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the percipitating/ perpetuating biological risk factors?

A
  • Substance misuse
  • Physical health problems (chronic pain etc)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the percipitating psychological risk factors?

A
  • Traumatic life events
  • Low self-esteem
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the perpetuating psychological risk factors?

A
  • Failure to cope with loss
  • Ongoing loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the protective factors for depression?

A
  • Current employment
  • Good social support
  • Marital status: being married
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is dysthymia?

A

Chronic low grade depression for >=2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is minor depressive disorder?

A

1-2 symptoms of depression or <2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the PHQ-9?

A

Patient Health Questionnaire - 9

Usually used in primary care to evaluate the severity of depression and response to treatment, rather than for depression screening itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the NICE stepped-care model for managing depression?

A

Step 1: any case of suspected depression
- Assessment
- Consider active monitoring and psychoeducation

Step 2: subthreshold depression resistant to interventions step 1, mild and moderate depression
- Low-intensity psychological and psychosocial therapies
- Pharmacological management
(either alone or in combination)

Step 3: subthreshold, mild or moderate depression resistant to step 2 and severe depression
- Pharmacological
- High-intensity psychological therapies
(either alone or in combination)

Step 4: severe depression at high risk of self harm
- Pharmacological
- High-intensity psychological therpy
- Electroconvulsive therapy
(either alone or in combination)
- Involvement of specialist services

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the principals of CBT?

A
  • Behavoiural activation
  • Cognitive work (challenging core beliefs)
  • Compassion-based therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the commonly used classes of anti-depressants?

A
  • SSRIs
  • TCAs (lower doses for neuropathic pain, higher doses for depression)
  • Monoamine Oxidase Inhibitors (MAOIs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the common side effects of SSRIs?

A
  • Headache
  • GI (nausea, diarrhoea/ constipation)
  • Sleep disturbance/ vivid dream
  • Sexual dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What drug interaction with SSRIs can be dangerous?

A

SSRIs + NSAIDs as this can result in GI bleeding

If giving NSAIDs and SSRI, must give PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why should patients on SSRIs be monitored in the first 1-2 weeks?

A

There is a small chance of increased suicidality <1/10000, but more common in younger people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How often should patients on SSRIs be reviewed?

A

Initially every 2 weeks (if <30 every 1 week) then regularly after that

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are examples of SSRIs?

A
  • Fluoxetine
  • Sertraline
  • Citalopram
24
Q

What are the side effects of TCAs?

A
  • Anticholinergic/muscarinic (dry mouth, blurred vision, constipation, urinary retention)
  • Cardiotoxic (QT prolongation, ST elevation, AV block)
  • Anti-histaminergic (sedation, postural hypotension, weight gain)
25
Q

Why does fluoxetine have to be stopped completely before starting a different anti-depressive?

A

Because the 1/2 life is weeks long after prolonged use and therefore can’t be cross titrated with other medications

26
Q

What is serotonin syndrome?

A

Excessive seratonin in the brain

27
Q

What are the three core symptoms of seratonin syndrome?

A
  1. Altered mental state: agitation, confusion, coma
  2. Neuromuscular changes: hallmark features are myoclonus, hypertonia, hyperreflexia, tremor
  3. Autonomic dysfunction: tachycardia, hypertension, hyperthermia, diaphoresis, mydriasis
28
Q

Why are TCAs not commonly prescribed in depression?

A
  • Associated with many side effects
  • Lethal in overdose and therefore avoided in high risk patients
29
Q

What are examples of TCAs?

A

Amitriptyline, clomipramine, lofepramine

30
Q

What diet is required for patients taking MAOIs?

A

Low tyramine diet (cheese is high in tyramine) as this can lead to acute hypertension

31
Q

What are examples of MAOIs?

A

Phenelzine, moclobemide

32
Q

What is Mirtazapine?

A

A tetracyclic antidepressant

33
Q

What are the side effects of mirtazapine?

A
  • Drowsiness
  • Increased appetite
  • Weight gain

So is useful for patients who are struggling with insomnia and appetite

34
Q

What is venlafaxine/ duloxetine?

A

An SNRI (similar side effects to SSRIs)

35
Q

What is important to monitor when patients are given venlafaxine?

A

Patients require blood pressure monitoring (possibly due to increased sympathetic activation)

36
Q

What are the steps for managing depression that does not respond to treatment?

A
  1. Check medication adherence, side effects and optimize dose
  2. Switch antidepressants: initially to alternative SSRI
  3. Alternative antidepressant class
  4. At this stage depression can be classed as refractory
37
Q

What are the options for managing refractory depression?

A
  • Combinations: add mirtazapine to an SSRI
  • Augmentation with lithium/ antipsychotic
  • ECT
38
Q

What are the symptoms of discontinuation syndrome?

A
  • Flu-like symptoms
  • Electric shock symptoms
  • Headache
  • Dizziness
  • GI effects
  • Anxiety
  • Trouble sleeping
39
Q

How does discontinuation syndrome differ from withdrawal?

A

Anti-depressants aren’t addictive, therefore the symptoms aren’t withdrawal symptoms

40
Q

Which SSRI has the highest risk of discontinuation syndrome?

A

Paroxetine because the 1/2 life is ~24 hours, therefore the symptoms come on rapidly after stopping the drug

41
Q

What are the risk factors for serotonin syndrome?

A
  • Antidepressant use
  • Combination of antidepressants
  • Overdose of antidepressants
  • Lithium use
  • ECT
  • Opiates, antiemetics, illicit drugs
42
Q

What are the complications of serotonin syndrome?

A
  • DIC
  • Rhabdomyolysis
  • Renal failure/ metabolic acidosis
  • Seizures
43
Q

What is the management of serotonin syndrome?

A
  • Severe cases managed in hospital
  • Stop the offending medications
  • Supportive measures (A-E)
  • Consider benzodiazepine (eg. clonazepam)
44
Q

Mild-moderate depression mx

A
  • Seep hygiene
  • Self help guidance
  • FU 2 weeks

After 2 weeks:
- Individual-guided self-help based on CBT
- Computerised CBT
- Structured group physical activity programme

If low intensity psychological intervention is delined:
- Group CBT

45
Q

What is individual-guided self-help based on CBT?

A
  • Provision of writeen materials, supported by trained practitioner who reviews progress and outcomes
  • 6-8 sessions (face-to-face or telephone) over 9-12 weeks
46
Q

What is computerised CBT?

A
  • Explains CBT
  • Encourages tasks between sessions, thought-challenging and active monitoring of behaviour and thought patterns
  • Trained practitioner reviews
  • 9-12 weeks
47
Q

What is structured group physical activity programme?

A
  • Groups by a trained practitioner
  • 3 sessions per week (45-60 mins) over 10-14 weeks
48
Q

What is group CBT?

A
  • 2 trained practitioners
  • 10-12 meetings of 8-10 participants
  • 12-16 weeks
49
Q

What is the follow up for antidepressants?

A
  • 1 week 18-25, or at risk of suicide
  • 2 weeks, >25 no suicide risk

Review every 2-4 weeks for 3 months

50
Q

Which antidepressants can cause overdose and death from overdose?

A
  • Venlafaxine
  • TCA (except lofepramine)
51
Q

Which antidepressants worsen hypertension?

A

Venlafaxine and duloxetine

52
Q

Which antidepressants cause postural hypotension and arrhythmia?

A

TCAs

53
Q

How long is individual CBT?

A

16-20 sessions over 3-4 months
Follow up during the following 3-6 months

54
Q

How long is interpersonal therapy?

A
  • 16-20 sessions over 3-4 months
55
Q

Which drugs is a 2 week washout period required for?

A

Switching from a non-reversible MAOI

56
Q

When would TCAs be started at a lower dose?

A

If switching from fluoxetine or paroxetine to TCA (they inhibit TCA metbaolism therefore increase risk of serotonin syndrome)

Psych (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions