Depression Flashcards
What is an organic disorder?
A change in mental function secondary to a physical process other than psychiatric illness e.g. confusion due to a UTI.
Define psychosis?
Altered relationship with reality
Deine delusion?
Fixed false belief eld despite evidence to disprove it, outwith socio-cultural norms.
Define hallucination?
A sensory perception in the absence of external stimuli.
Define illusion?
Misperception of real external stimuli.
Define mood?
Subjective feeling of sustained emotion.
Define affect?
Objective immediate conveyance of emotion.
Define depression?
Pathological low mood that impacts on daily functioning.
Define Euthymia?
normal mood
Define mania?
Excessively elevated mood
Define hypomania?
Slightly elevated mood.
How is bipolar disorder determined?
> 2 mood disturbances with at least one being of elevated mood.
Describe biological factors in the aeitiology of depression?
Genetics
Medical conditions - thyroid, stroke
Psychiatric conditions - anxiety, alcohol, drugs
Medications - Steroids (can cause mania, but in cushings causes depression).
Neurochemical changes - Decreased 5HT, NA and DA
Neuroendocrine - low thyroid hormones, or increased cortisol.
Describe the ‘monoamine hypothesis’? How can it be measured?
That a decrease in 5HT, NA and DA are seen in depression.
Only a hypothesis as it cant be measured directly, although metabolites can be measured in CSF (these are reduced).
Also anti-depressions which increase levels of neurotransmitters work in most patients.
Describe psychological factors in the aeitiology of depression?
Vunerable personality traits - anxious or obsessive
Personality disorders
Coping skills
Adverse life events
Describe social factors in the aetiology of depression?
Poor social support
Socioeconomic disadvantage
Northernisation - low UV exposure?
Describe the epidemiology of depression
mean age - 30
2:1 female to male
Lifetime incidence 20% with and average of 5 depressive episodes (6 months)
1/3rd dont seek help
Describe the diagnostic criteria of depression?
2 out of low mood, anhedonia and fatigue every day for > 2 weeks.
Give examples of clinical features of depression? Biological Cognitive Cognitive distortions Psychosis?
Anhedonia, fatigue, low mood.
Decreased appetite, weight, libido, insomnia, constipation.
Decreased concentration, guilt, low self esteem, suicidality.
Minimising (good things), Magnifying (negative events), Selective abstraction (small bit of evidence blown out of proportion), catastophising.
Delusions - including Cotards syndrome (think they or part of them is dead). Hallucinations - often auditory in 2nd (youre stupid) or 3rd person (Catherines stupid).
How is depression graded?
Mild: 2 core + 2 associated (have ok function)
Moderate: 2 core + 4 associated (decreased function)
Severe: 2 core + 6 associated +/- psychosis (really decreased function).
Define dysthymia?
Chronic low mood >2 years, but not enough to be depression.
Define Seasonal Affective Disorder?
Symptoms around winter time. Possibly due to lack of UV. Must happen for 3 consecutive years.
Outline the stages of grief?
Denial Anger Bargaining Depression Acceptance
Describe assesment for depression?
Clinical history Risk assesment - harm to self or others? Mental State Exam Physical exam - ensure no organic causes. Baseline bloods
