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Psychiatry > Depression > Flashcards

Depression Flashcards

1
Q

what ages are mood disorders most common

A

2nd
3rd
4th
5th decades

50% start before the age of 30

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2
Q

what age do 50% of all mental disorders start

A

14

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3
Q

what is anhedonia

A

loss of enjoyment/ pleasure

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4
Q

what is anergia

A

lack of energy

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5
Q

what is amotivation

A

lack of motivation

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6
Q

what is the typical diurnal variation of depression

A

worse in the morning

in atypical depression gets worse as day goes on

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7
Q

what is psychomotor retardation

A

subjective/ objective slowing of thoughts and/ or movements

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8
Q

what is stupor

A

absence of relational functions i.e. action and speech

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9
Q

what is early morning wakening

A

waking at least 2 hours before the expected/ normal waking time

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10
Q

what is ethymia

A

normal mood

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11
Q

what are the features of appearance and behaviour in depression

A 
reduced facial expression 
furrowed brow 
reduced eye contact 
limited gesturing, movements may be slowed or absent 
rapport is often difficult to establish
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12
Q

what are common qualities of speech in depression

A

reduced rate
lowered pitch and volume
reduce intonation (monotonous)
increased speech latencies (longer time between end of a question and them starting to speak)
limited content (answers are often short, brief, and un-embellished)

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13
Q

define mood

A

a prolonged prevailing state or disposition, typically associated with what the patient describes= subjective (how you you feel?)

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14
Q

define affect

A

how the patient reacts in relation to their surroundings and the context
something you observed or infer = objective

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15
Q

what is mood like in depression

A

low, miserable, unhappy, sad
flat
when extreme- empty, black, numb

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16
Q

what is affect like in depression

A

depressed (low)
reduced range
limited reactivity
may report emotional paralysis (shutting down their emotions)

17
Q

what is the form, flow and content of thought like in depression

A

form usually normal

flow- slowed, pondering, can be almost absent

content- negative, self accusatory, failure, guilt, low self esteem, pessimism
delusions can occur: guilt, poverty, nihilism, hypochondriasis

18
Q

how does depression affect perception

A

in most cases there is no perceptual disturbance
some people report increased self referential thinking (people are talking about me)

hallucinations can occur- almost always auditory, usually 2nd person and derogatory. reflect negative and depressive themes

19
Q

how is cognition affected in depression

A

slow with complaints of poor memory (due to inattention not information recall)
‘pseudo-dementia’
defects in working memory, attention and planning
often worsened by anxiety

20
Q

how is insight affected in depression

A

typically preserved
usually aware of symptoms however attribution can often be affected- blamed on patients sins, physical illness, personal failings and weakness

21
Q

what form of paranoia can you get in depression

A

increased sensitivity to criticisms of others
much more self conscious/ self aware
feel under scrutiny

22
Q

how much of depression is chronic

A

20%- usually recurrent

23
Q

what is the suicide rate in depression

A

6-7%

7% in males

24
Q

what is the lifetime prevalence of depression

A

14-18%

25
Q

what are the current diagnostic schemes for depression

A

ICD-10 and DSM-5

26
Q

what form of depression is not considered in ICD-10

A

mild

27
Q

what must symptoms be for a patient to truly have depression

A

must be abnormal for the patient
it must persist
should interfere with normal function to a significant degree

28
Q

what is the general diagnostic criteria for depression

A

-episode should last a least 2 weeks
-no hypomanic or manic episodes at any time during the patient life (if yes to this -> bi polar)
at least 2 of:
-depressed mood (definitely abnormal for patient, present for most of day, almost every day, largely uninfluenced by circumstances, sustained for >2 weeks)
-loss of interest or please in activity that are normally pleasurable
-decreased energy or increased fatiguability

(remember by MEE: mood, energy, enjoyment -> MEE people become egocentric)

plus an additional symptom

29
Q

what are the additional symptoms of depression

A
  1. loss of confidence/ self esteem
  2. feelings of self reproach/ excessive and unreasonable guilt
  3. recurrent thoughts of death or suicide/ any suicidal behaviour
  4. complaints/ evidence of diminished ability to think or concentrate (indecisiveness/ vacillation)
  5. change in psychomotor activity with agitation or retardation (either subjective or objective)
  6. sleep disturbance (increase/ decrease)
  7. change in appetite with corresponding weight change (increase/ decrease)
30
Q

what defines a moderate depressive episode

A

two core symptoms + four additional symptoms

= total of at least 6

31
Q

what defines a severe depressive episode

A

all 3 core symptoms + 5 others

= total of at least 8

32
Q

what are the core symptoms of depression

A

depressed mood
reduced enjoyment/ interest
decreased energy

33
Q

when do you give anti depressants for mild depression

A

not indicated unless patient has recurrent episodes of mild to severe, then can give to prevent it become severe

34
Q

what is psychotic depression

A

occasionally paranoid: typically mood congruent or hypochondriacal
“People are out to get me and kill me”
“I’m being poisoned to punish me for my sins”
“I’ve got cancer…I know I have…It’s because I
deserve it”

can have cotards syndrome- often nihilistic delusions, more common in the elderly

35
Q

what is the 10 year recurrence rate for depression

A

> 80%

36
Q

how long until depression becomes classed as chornic

A

2 years

37
Q

what are the features of a typical depression

A

Mood reactivity (that is, mood brightens in response to actual or potential positive events)
Two (or more) of the following:
significant weight gain or increase in appetite
hypersomnia
leaden paralysis (that is, heavy, leaden feelings in arms or legs)
long-standing pattern of interpersonal rejection sensitivity (not limited to episodes of mood disturbance) that results in significant social or occupational impairment

38
Q

what features are present in somatic syndrome (a subtype of depression)

A

marked loss of interest or pleasure in activities that are
normally pleasurable
lack of emotional reactions to events or activities that normally produce an emotional response
waking in the morning 2 hours or more before the usual time
depression worse in the morning
objective evidence of marked psychomotor retardation or
agitation (remarked on or reported by other people)
marked loss of appetite
weight loss (5 % or more of body weight in the past month)
marked loss of libido

Psychiatry (27 decks)

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