Depression Flashcards
Define euthymic
Normal mood
Define hyperthymic
Elevated mood
What is the name given to variable mood?
Cyclothymic
What is the name given to an extrovert?
Sanguine
Define malancholic
Perfectionist, worrier
What is the name given to someone who is self-content, kind?
Phlegmatic
What is the name given to leaders in charge?
Choleric
State the name given to loss of enjoyment/pleasure
Anhedonia
What does anergia mean?
Lack of energy
What is the name given to lack of motivation?
Amotivation
What term is used to describe mood that varies over the day?
Diurnal variation
What is classed as early morning wakening?
2 hours before normal waking time
Define psychomotor retardation
Subjective/objective slowing of thoughts and movements
Define stupor
Absence of relational functions
In depression what will the patients appearance and behaviour look like?
Reduced facial expression, frowning, reduced eye contact, limited gesturing, difficult to establish rapport
What can be observed in the speech of a depressed patient?
Slow, lower pitch, reduced volume, monotonous, increased latencies - longer time between question and answer, limited content (short and brief)
How will mood and affect appear in depressed patients?
Mood - low, down, miserable, sad, unhappy, flat, empty
Affect - depressed, reduced range and limited reactivity may report emotional paralysis
What are the findings in depressed patients - form, flow and content of thought?
Form - normal
Flow - slowed, pondering or even absent
Content - negative, self-accusatory, guilt, pessimism
Suicidal thoughts and delusions can occur
What themes of delusions may occur in depression?
Guilt, poverty, nihilism, hypochondriasis
Describe the perception in depressed patients
Mainly normal, increased feeling of people looking/talking about them
What hallucinations are more likely in depression?
Auditory second person reflect negative themes - derogatory
Describe the cognition in a depressed patient
Subjectively slow with poor memory, pseudo-dementia can occur compounded by anxiety
Describe the insight in a depressed patient
Typically preserved, aware of symptoms and abnormalities. Attribution often affected and blame their symptoms on past actions
What is the general criteria for depression?
Episode should last at least two weeks with no hypomania or manic symptoms at any time in the patients life
What are the three core features of depression? How many do you need for diagnosis?
- depressed mood most days for most of the day
- loss of interest or pleasure
- decreased energy/increased fatigue
2 required for diagnosis
What are the additional symptoms of depression and how many are needed for diagnosis?
- loss of confidence
- feelings of guilt
- suicidal thoughts
- concentration difficulties
- psychomotor activity (agitation or retardation)
- sleep disturbance
- change in appetite/weight
Define moderate depression
Two core features plus four additional = total of 5- 6
Define severe depression
All three core features plus five additional = total of 8 /(>7)
What is psychotic depression?
Paranoid, mood congruent or hypochondriacal, worry more, deserve disease due to past actions
What is cotards syndrome?
Nihilistic delusions, more common in elderly and often very extreme
Define dysthymia
Chronic depression present for 2 years
What is first line treatment for depression?
CBT - mild
SSRI - moderate/severe
Other than SSRI what other drugs can be used?
Atypical (second line)
SNRI
Tricyclics
What does chronic stress lead to?
Cortisol dysregulation and impairment of the HPA axis
What area of the brain is particularly susceptible to damage from cortisol?
Hypocampus
What process allows medications in depression to be effective?
Increased MAO-A activity which reduced monoamines circulating
