Depression Flashcards
What is an organic disorder?
A change in mental function secondary to a physical process rather than a psychiatric disorder
What is psychosis?
Altered relationship with reality
What is a delusion?
Fixed false belief,
held despite evidence to the contrary
outwit sociocultural norms
What is a hallucination?
Sensory perception in the absence of external stimuli
What is an illusion?
Misperception of real external stimuli
How is mood different from affect?
Mood is a subjective feeling of sustained emotion
affect is an objective immediate conveyance of emotion
What is the term for a normal mood?
Euthymia
What is the term for a significantly high mood?
Mania
There is a large genetic component to depression. T/F?
True
What comorbidities are associated with depression?
Thyroid dysfunction
schizophrenia
Depression is the result of neurochemical imbalances where there is a decrease in which neurotransmitters?
5HT
NA
DA
What evidence is there to support the theory that depression is caused by decrease 5HT, NA and DA?
There are decreased levels of metabolites of these neurotransmitters in CSF in people with depression
The mechanism of action go antidepressants
Neurochemical clockers can induce depression
What psychological factors can increase the likelihood of developing depression?
Personality traits - anxiety, obsessive
personality disorders
coping skills
adverse life events
What social factors can increase the likelihood of developing depression?
Poor Social support
socioeconomic disadvantage
northernisation
What is the definition of depression?
A low mood possibly alongside anhedonia and fatigue which occurs every day for two weeks or more
What is anhedonia?
Loss of pleasure and joy
What are the physical/clinical presentations of depression?
Insomnia reduced appetite weight loss decreased libido constipation amenorrhoea
How can depression affect cognition/thinking?
decreased concentration slow or negative thinking guilt loss of self esteem hopelessness suicidality
Psychosis as a result of depression is mood congruent. T/F?
True
What can be involved in psychosis as a result of depression?
Delusions of guilt, poverty, hypochondriasis and persecutory
What is Cotard’s syndrome?
The belief that the self or part of the self is dead
What type of hallucinations may occur in depression?
Auditory second person delusions
What are the secondary complications or sequelae of depression?
recurrent depressive disorders substance misuse anxiety suicide cardiovascular disease
What are the differential diagnoses of depression?
Dysthymia Cyclothymia Atypical depression Adjustment reactions grief
What is atypical depression?
Decreased mood with reversed associated symptoms
What is bereavement?
A loss event (usually death)
What is grief?
The feelings, thoughts and behaviour associated with bereavement
What are the five stages of grief?
Denial, Anger, Bargaining, Depression, Acceptance
When can grief be considered abnormal?
When it is intense, prolonged (>6months), delayed or absent
What is involved in the diagnosis of depression?
Clear clinical history risk assessment mental state exam physical exam baseline bloods
What is involved in a mental state examination?
Assessment of appearance, behaviour, speech, eye contact, mood, thought, perceptions, cognition and insight
What class of drugs are the first line treatment for depression?
Selective serotonin reuptake inhibitors
Give an example of a selective serotonin reuptake inhibitor.
Citalopram fluoxetine duloxetine modafinil sertraline
What are the side effects of selective serotonin reuptake inhibitors?
Nausea vomiting weight gain dizziness discontinuation syndrome anxiety suicidality mania serotonin syndrome cardiac effects
How long does it take for selective serotonin reuptake inhibitors to have an effect on depression?
4-5 weeks
Give an example of a tricyclic antidepressant
Amitiptyline
What are the side effects of tricyclic antidepressants?
Decreased blood pressure
anticholinergic effects
arrhythmia
Give an example of a monoamine oxidase inhibitor
Isocarboxid
Phenelzine
What side effect occurs when cheese is consumed when using a monoamine oxidase inhibitor?
Hypertensive crisis
What is involved in electroconvulsive therapy?
Induction of a controlled seizure under anaesthesia
What is a side effect of electroconvulsive therapy?
memory loss
Other than ECT and pharmacology, how can depression be treated?
Psychoeducation
encouraging talking, keeping active, eating well and sleeping well
CBT
What is the role of social work and occupational therapy in the treatment of depression?
Addressing housing, financial and employment issues
involved in activity scheduling
The average episode of depression can be halved in duration if treated. What is the average length of an episode of untreated depression?
6 months
What factors are associated with better outcomes for patients with depression?
Male first episode mild or short episode no psychosis no/short hospital stay good social functioning no comorbid psychiatric disorders
What factors would result in a person with depression being unable to drive?
severe depression
attention impairment
agitation
suicidality
