Depression

Question 1

Define euthymic

Answer 1

Normal mood

Question 2

Define hyperthymic

Answer 2

Elevated mood

Question 3

What is the name given to variable mood?

Answer 3

Cyclothymic

Question 4

What is the name given to an extrovert?

Answer 4

Sanguine

Question 5

Define malancholic

Answer 5

Perfectionist, worrier

Question 6

What is the name given to someone who is self-content, kind?

Answer 6

Phlegmatic

Question 7

What is the name given to leaders in charge?

Answer 7

Choleric

Question 8

State the name given to loss of enjoyment/pleasure

Answer 8

Anhedonia

Question 9

What does anergia mean?

Answer 9

Lack of energy

Question 10

What is the name given to lack of motivation?

Answer 10

Amotivation

Question 11

What term is used to describe mood that varies over the day?

Answer 11

Diurnal variation

Question 12

What is classed as early morning wakening?

Answer 12

2 hours before normal waking time

Question 13

Define psychomotor retardation

Answer 13

Subjective/objective slowing of thoughts and movements

Question 14

Define stupor

Answer 14

Absence of relational functions

Question 15

In depression what will the patients appearance and behaviour look like?

Answer 15

Reduced facial expression, frowning, reduced eye contact, limited gesturing, difficult to establish rapport

Question 16

What can be observed in the speech of a depressed patient?

Answer 16

Slow, lower pitch, reduced volume, monotonous, increased latencies - longer time between question and answer, limited content (short and brief)

Question 17

How will mood and affect appear in depressed patients?

Answer 17

Mood - low, down, miserable, sad, unhappy, flat, empty

Affect - depressed, reduced range and limited reactivity may report emotional paralysis

Question 18

What are the findings in depressed patients - form, flow and content of thought?

Answer 18

Form - normal
Flow - slowed, pondering or even absent
Content - negative, self-accusatory, guilt, pessimism
Suicidal thoughts and delusions can occur

Question 19

What themes of delusions may occur in depression?

Answer 19

Guilt, poverty, nihilism, hypochondriasis

Question 20

Describe the perception in depressed patients

Answer 20

Mainly normal, increased feeling of people looking/talking about them

Question 21

What hallucinations are more likely in depression?

Answer 21

Auditory second person reflect negative themes - derogatory

Question 22

Describe the cognition in a depressed patient

Answer 22

Subjectively slow with poor memory, pseudo-dementia can occur compounded by anxiety

Question 23

Describe the insight in a depressed patient

Answer 23

Typically preserved, aware of symptoms and abnormalities. Attribution often affected and blame their symptoms on past actions

Question 24

What is the general criteria for depression?

Answer 24

Episode should last at least two weeks with no hypomania or manic symptoms at any time in the patients life

Question 25

What are the three core features of depression? How many do you need for diagnosis?

Answer 25

• depressed mood most days for most of the day
• loss of interest or pleasure
• decreased energy/increased fatigue
  2 required for diagnosis

Question 26

What are the additional symptoms of depression and how many are needed for diagnosis?

Answer 26

• loss of confidence
• feelings of guilt
• suicidal thoughts
• concentration difficulties
• psychomotor activity (agitation or retardation)
• sleep disturbance
• change in appetite/weight

Question 27

Define moderate depression

Answer 27

Two core features plus four additional = total of 5- 6

Question 28

Define severe depression

Answer 28

All three core features plus five additional = total of 8 /(>7)

Question 29

What is psychotic depression?

Answer 29

Paranoid, mood congruent or hypochondriacal, worry more, deserve disease due to past actions

Question 30

What is cotards syndrome?

Answer 30

Nihilistic delusions, more common in elderly and often very extreme

Question 31

Define dysthymia

Answer 31

Chronic depression present for 2 years

Question 32

What is first line treatment for depression?

Answer 32

CBT - mild

SSRI - moderate/severe

Question 33

Other than SSRI what other drugs can be used?

Answer 33

Atypical (second line)
SNRI
Tricyclics

Question 34

What does chronic stress lead to?

Answer 34

Cortisol dysregulation and impairment of the HPA axis

Question 35

What area of the brain is particularly susceptible to damage from cortisol?

Answer 35

Hypocampus

Question 36

What process allows medications in depression to be effective?

Answer 36

Increased MAO-A activity which reduced monoamines circulating