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Psychiatry > Depression > Flashcards

Depression Flashcards

1
Q

What is depression?

A

Describes a state of sadness, not just absence of happiness, that can range from normal experience to severe, life-threatening illness

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2
Q

What is dysthymia?

A

Below threshold level of depression, can go about daily life but with depressive qualities

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3
Q

What sex is depression more common?

A

F>M

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4
Q

What age of onset does depression most commonly occur?

A

Mid 20s

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5
Q

What can cause depression?

A

Genetic/FH

Psychosocial stressors/adverse life event

  • Onset/first episode associated with adverse life events, but can also occur without obvious trigger

Physical Illness/organic disease

  • Endocrine disorder
  • Viruses
  • Chronic pain
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6
Q

How does ICD-10 define depression?

A

Lasts for at least 2 weeks

No hypomanic or manic episodes in lifetime, if had would consider bipolar

Not attributable to psychoactive substance or organic mental disorder

If psychotic symptoms or stupor, exclude psychotic illness

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7
Q

What 3 spheres do depressive symptoms occur in?

A

Psychological

Physical

Social

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8
Q

What are the two aspects of the psychological sphere?

A

Change in mood

Change in thought context

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9
Q

What are the change in mood symptoms?

A

Depression: Presence of sadness often worse in the morning

Anxiety

Perplexity

Anhedonia

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10
Q

What is perplexity?

A

Feeling of being overwhelmed

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11
Q

What is anhedonia?

A

Loss of ability to derive pleasure from experience

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12
Q

What are the change in thought context symptoms?

A

Guilt

Hopelessness

Neurotic symptoms: Hypochondriasis, agoraphobia, obsessions, compulsions and panic attacks

Delusions

Hallucinations

Ideas of Reference: Feel that everything is about you

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13
Q

What are the two aspects of the physical sphere?

A

Change in bodily function

Change in psychomotor functioning

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14
Q

What are the change in bodily functioning symptoms?

A

Fatigue

Disturbed sleep

Weight loss

Loss of libido

Constipation

Pain

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15
Q

What are the change in psychomotor functioning symptoms?

A

Agitation

Retardation

Stupor

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16
Q

What is agitation?

A

State of restless overactivity, aimless or ineffective

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17
Q

What is retardation?

A

Slowing of motor responses

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18
Q

What is stupor?

A

State of extreme retardation in which consciousness is intact and patient stops moving, speaking, eating and drinking

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19
Q

What are the social sphere symptoms?

A

Loss of Interests

Irritability

Apathy

Withdrawal, Loss of Confidence, Indecisive

Loss of Concentration, Registration and Memory

20
Q

What is apathy?

A

Loss of interest in own surroundings

21
Q

What are the general depressive symptoms, according to ICD-10?

A

Depressed mood, abnormal for most of the day almost every day for the past 2 weeks

Anhedonia

Fatigue

22
Q

What are the additional depressive symptoms, according to ICD-10?

A

Guilt

Loss of confidence

Loss of concentration

Sleep disturbance

Suicidal thoughts or behaviour

Change in appetite

Agitation or retardation

23
Q

Define mild depression

A

At least 2 of the general criteria, and additional list to give at least 4

24
Q

Define moderate depression

A

At least 2 of general criteria, and additional list to give at least 6

25
Q

Define severe depression

A

All of general criteria and additional list to give at least 8

26
Q

What investigations can be used to rule out other causes of depression?

A

Vitamin B12

FBC: Anaemia

U&Es

Glucose

TFT: Hypothyroidism

27
Q

What is the lifestyle management of depression?

A

Meditation

Exercise

Self-guided help

Self hygiene and sleep disturbance

28
Q

What is the first line anti-depressant class?

A

Selective Serotonin Reuptake Inhibitors (SSRI’s)

29
Q

What psychological interventions are used in depression?

A

CBT

Interpersonal therapy

Family therapy

30
Q

What is used in treatment resistant severe depression?

A

Electroconvulsive therapy

31
Q

What is ECT?

A

Small and controlled amount of electro-current is passed through the brain, inducing a brief seizure

32
Q

What is somatic syndrome?

A

Depression but characterised by a cluster of specific, mostly physical, symptoms

33
Q

How does somatic syndrome present?

A

Anhedonia

Lack of emotional reactions to events that normally produce an emotional response

Waking 2 hours before normal time

Depression worse in morning

Psychomotor agitation or retardation

Loss of appetite

Weight loss

Loss of libido

34
Q

Give differential diagnoses for depression

A

Normal reaction to life event

Seasonal affective disorder

Dysthymia

Cyclothymia

Bipolar disorder

Stroke

Tumour

Dementia

Hypothyroidism

Addison’s

Drugs

Infection: Influenza, Hepatitis, HIV/AIDS

35
Q

Give examples of suicide red flags

A

FH of suicide attempt

Co-morbid substance use

Previous suicide attempts

Unemployed

Aggressive methods

Pre-planning

No protective factor : ‘I could never go through with it and do that to my partner/child

Male: More likely to attempt aggressive methods and more likely to attempt whereas female more likely to self harm

36
Q

How long does normal grief reaction last?

A

up to 6 months

37
Q

Give side effects of electroconvulsion therapy?

A

Headache

Nausea

Short term memory impairment

Memory loss of events prior to ECT

Arrhythmia

38
Q

Give a contraindication for electroconvulsion therapy

A

Raised ICP

39
Q

What time of year is suicide more common?

A

Spring/Summer

40
Q

What age is self harm common between?

A

15-25

41
Q

What age is suicide more common in?

A

Over 40 years

42
Q

What is the time frame for post natal depression occurance?

A

2-6 weeks

43
Q

When is depression automatically classed as severe?

A

Psychotic symptoms

44
Q

What is the fatality rate of overdose?

A

Very low, 0.4%

45
Q

What medications are more dangerous in terms of over-dose

A

Typically, drugs that suppress the respiratory system

Benzodiazepines

TCA

Psychiatry (11 decks)

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