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Psychiatry > Depression > Flashcards

Depression Flashcards

1
Q

What type of disorder is depression

A

Affective

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2
Q

Aetiology Depression

A

F>M
FH
Excess adverse life events
Stress due to life events (births, job loss, divorce, illness)
Stress associated with poor social environment and social isolation
Low self esteem

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3
Q

What criteria needs to be met for mild depression

A

2 core and 2 typical

At leat 4 total

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4
Q

What criteria needs to be met for moderate depression

A

2 core and 4 typical

At least 6 total

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5
Q

What criteria needs to be met for severe depression

A

All 3 core + 5 typical At least 8 total

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6
Q

What does depression + psychosis give a Dx of

A

Severe depression

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7
Q

What are the core symptoms of depression

A
  1. Low mood (most of the day, everyday)
  2. Anhedonia
  3. Fatigue (low energy)
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8
Q

What are typical symptoms of depression

A 
Loss of confidence/low 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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9
Q

1st line Rx for depression

A

SSRI

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10
Q

Name 3 common SSRIs

A

Sertraline
Fluoxetine
Citalopram

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11
Q

What is 2nd line for depression

A

Try another SSRI
Or switch to
SNRI

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12
Q

Classes of anti-depressants

A

SSRIs
SNRIs
TCAs
Monoamine Oxidase inhibitors

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13
Q

When to NICE recommend ECT

A

Rapid improvement of severe symptoms after other methods have proven ineffective
And/or when the condition is life threatening

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14
Q

Psychological therapies for depression

A

CBR
IPT
Individual dynamic psychotherapy
Family therapy

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15
Q

CI to ECT

A

Mainly patients with CI to general anaesthetic

Not really any CI to eCT itself

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16
Q

What is the prophylaxis for 1 episode of depression

A

Continue anti-depressants for 6/12

17
Q

What is the prophylaxis for 2nd episode of depression

A

Continue anti-depressant for 2 years

18
Q

What is the prophylaxis for 3rd episode of depression

A

Discuss life long treatment

19
Q

Does depression reccurr frequently

A

Yes

20
Q

what is the main issue with TCAs

A

They are lethal in overdose

21
Q

How many women experience the baby blues

A

About 75%

22
Q

Risk factors for post-natal depression

A 
Hx of post-partum depression 
Unplanned pregnancy 
Lack of support 
Marital problems 
Social circumstances 
Sleep deprivation 
Hormonal changes
23
Q

When are women at greatest risk of post-natal depression

A

30 days following childbirth

24
Q

Which Scale is used to assess for post-natal depression

A

Edinburgh Post-Natal depresison Scale

25
Q

Why should you observe babies with mothers who are taking anti-depressants

A

If the mother is breast feeding it may pass onto baby and cause SE

26
Q

Rx for post-natal depression

A

SSRIs

CBT

27
Q

Rx for severe post-natal depression

A

ECT considered

28
Q

Psychological therapy for post-natal depression

A

CBT

IPT

29
Q

What should any suspicion of post-partum psychosis trigger

A

Emergency referral to specialist team

30
Q

What is the peak onset of post-partum psychosis

A

2 weeks post partum

31
Q

Risk factors for post-partum psychosis

A

Previous post-partum psychosis
Single parenthood
Reduced social support
Previous mental illness

32
Q

What happens at discharge of post-partum psychosis

A

Referral to local mental health

Health visitors will be needed

33
Q

Clinical features of post-partum psychosis

A 
Psychotic symptoms (delusions, hallucinations)
Affective symptoms (depression or mania)
Mood instability 
Insomnia 
Disorientation 
Paranoia
34
Q

How to treat post-partum psychosis:

A

For affective symptoms:
Mood stabilisers
Antidepressants
ECT

For psychotic symptoms:
Second generation anti-psychotic

Psychological therapy

Psychiatry (15 decks)

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