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MD2 Foundation > Depression and Medical Illness > Flashcards

Depression and Medical Illness Flashcards

1
Q

When do you become concerned about mental illness?

A

Impacts on roles

Sick > exaggerated experience/dysfunction related to injury

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2
Q

What are high prevalence mental illnesses?

A

Major depression

Anxiety disorders

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3
Q

What are the different types of anxiety disorders?

A

Panic disorder
Agoraphobia
Generalised anxiety disorder

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4
Q

How are mental illnesses diagnosed?

A

Syndrome identification > patterns in history, symptoms, and signs

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5
Q

What does “threshold of diagnosis” mean?

A

Many common mental illnesses on continuum with normal emotions
- Diagnosis based on study of threshold
Other mental illnesses like schizophrenia and delirium - clear separation from continuum

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6
Q

What are some examples of physical factors causing low mood?

A

Medications
Alcohol
Recreational drugs
Hormonal changes

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7
Q

What is major depression?

A

Abnormal sadness/clinical depression

  • Persistent lowering of mood
  • Interferes with person’s ability to function
  • Substantial distress
  • At least 2 weeks for most of day on most days
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8
Q

What are some questions that you can ask to elicit the symptoms of major depression?

A

Low energy?
Loss of interest?
Lost confidence in yourself?
Felt hopeless?

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9
Q

What are the DSM-V criteria for major depression?

A

At least 5 of following, of which must include 1st/2nd
- Depressed mood
- Markedly diminished interest/pleasure in all/most activities
- Significant weight/appetite change
- Insomnia/hypersomnia
- Psychomotor agitation/retardation
- Fatigue/loss of energy
- Feeling worthless/excessively guilty
- Diminished concentration/ability to think clearly
- Recurrent thoughts of death/suicidal ideation/plans
Symptoms present on most days for most of day, for at least 2 weeks

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10
Q

What factors should be excluded when considering a diagnosis of major depression?

A

Direct physiological effect
Exclude bereavement
Psychotic disorder

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11
Q

What does a mental state examination involve, briefly?

A 
Appearance
Behaviour and attitude to interview
Speech and language
Mood and affect
Thought process and thought content
Perception
Cognition
Insight
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12
Q

In an MSE, what features should you look out for in appearance and behaviour?

A 
Downcast demeanor and furrowed brow
Stooped posture
Slowed activity
Reduced spontaneity of movement and gesture
Tearfulness if milder
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13
Q

In an MSE, what features should you look out for in affect?

A

Little modulation

Flattened if severe

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14
Q

In an MSE, what features should you look out for in speech?

A

Monotone voice

Slow responses

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15
Q

In an MSE, what features should you look out for in thought content?

A 
Negative and pessimistic themes
Suicidal ideas/plans
Poor concentration
Lack of motivation
Guilt
Hopelessness
Helplessness
Worthlessness
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16
Q

What is the relevance of depression as a risk factor for cardiovascular disease?

A

Major depressive episode independent risk factor post AMI
Equivalent to smoking/raised cholesterol/hypertension
Increased risk of further heart-related incident, AMI, and sudden death

17
Q

How does physical illness impact recognising major depression?

A

Harder to interpret symptoms

Cognitive symptoms more reliable indicators

18
Q

Which sorts of disorders are depression and anxiety common in?

A

Nutritional disorders
Endocrine disorders
Neurological disorders
Any disorders causing disability

19
Q

What is anxiety?

A

Diffuse, unpleasant, vague sense of apprehension

Physical discomfort

20
Q

What are some of the cognitive symptoms of anxiety?

A

Fear
Embarrassment
Impending doom
Doubt

21
Q

What are some of the physical symptoms of anxiety?

A

Heart rate
Respiratory rate
Tremor
Sweating

22
Q

What are some of the behavioural symptoms of anxiety?

A

Avoidance

23
Q

What does the Yerkes-Dodson law state?

A

Relationship between arousal and performance

Some anxiety enhances performance, however too much impairs performance

24
Q

What is an anxiety disorder?

A

Anxiety out of proportion to danger in intensity and/or duration
Significant distress and/or impairs functioning

25
Q

What are the cognitive symptoms of panic attacks?

A

Feeling of impending death

26
Q

What are the cognitive symptoms of generalised anxiety disorder?

A

Global apprehensive expectation

27
Q

What are the somatic symptoms of anxiety?

A 
Dizziness
Light-headedness
Tachycardia
Sweating
Hyper-reflexia
Hypertension
Palpitations
Pupillary mydriasis
Restlessness
Tingling in extremities
Tremors
Upset stomach
Diarrhoea
Urinary frequency/hesitancy/urgency
28
Q

What are some questions you can ask to elicit a possible generalised anxiety disorder?

A

Have you felt keyed-up, and on edge?
Have you been worrying a lot?
Have you been irritable?
Have you had difficulty relaxing?

MD2 Foundation (42 decks)

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