Depression and other psychological conditions

Question 1

what is a disease

Answer 1

objective physical pathology with known aetiology

Question 2

what is an illness

Answer 2

subjective distress

Question 3

what is the definition of a mental illness

Answer 3

Psychiatric conditions without organic cause - old definition
Defines a level of distress greater than normal human experience

Question 4

what does neuroimaging show

Answer 4

that mental illnesses show physical changes therefore it is a mental illness or a physical illness?

Question 5

how do we classify psychiatric disorders

Answer 5

the IDC- WHO international classification of diseases

diagnosis and statistical manual of mental disorders( DSM V)- used in the UK

Question 6

what is the purpose of the IDC and DSM V

Answer 6

standardise diagnosis and enhance ability to research disorders and build EBP

Question 7

what is another classification of psychiatric disorders

Answer 7

organic- physical disorders which leads to psychiatric symptoms tumours, injury,infection
functional

Question 8

what can tumours lead to

Answer 8

psychiatric symptoms

Question 9

what can injury lead to

Answer 9

can include trauma, anoxic/hypoxic brain injuries

Question 10

what can degeneration lead to

Answer 10

dementia

Question 11

what can metabolic and endocrine disease lead to

Answer 11

underactive thyroid

Question 12

what are organic disorders due to

Answer 12

dementia delirium and other disorders

Question 13

what are mental and behavioural disorders due to

Answer 13

psychoactive substance use

Question 14

define psychosis

Answer 14

severe mental disturbance

loss of contact with external reality

Question 15

define neurosis

Answer 15

mental distress

can still distinguish between symptoms originating in their own mind and external realtiy

Question 16

what are the types of depression

Answer 16

single episode
recurrent at least 2 episodes- separated by months etc
dysthymic- persistant depressive mood that lasts + 2 years, lasts most days

Question 17

what are the types of bipolar

Answer 17

bipolar disorder I
bipolar disorder II
cyclothymic

Question 18

describe single episode depression

Answer 18

presence or history of one depressive episode when there is no history of prior depressive episodes.

Question 19

what associated feelings are associated with depression

Answer 19

daily depressed mood or diminished interest in activities lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue.

Question 20

describe recurrent depressive disorder

Answer 20

history or at least two depressive episodes separated by at least several months without significant mood disturbance

Question 21

describe dysthymic disorder

Answer 21

characterized by a persistent depressive mood (i.e., lasting 2 years or more), for most of the day, for more days than not

Question 22

how can dysthymic disorder perceive in adults and children

Answer 22

pervasive irritability

Question 23

describe mixed depressive and anxiety disorder

Answer 23

characterized by symptoms of both anxiety and depression more days than not for a period of two weeks or more
The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Question 24

describe bipolar type I disorder

Answer 24

episodic mood disorder defined by the occurrence of one or more manic or mixed episodes. A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterized by euphoria, irritability, or expansiveness, a

Question 25

what associated feelings can occur with bipolar disorder I

Answer 25

a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behavior, and rapid changes among different mood states (i.e., mood lability). A mixed episode is characterized by either a mixture or very rapid alternation between prominent manic and depressive symptoms on most days during a period of at least 2 weeks

Question 26

describe bipolar type II

Answer 26

defined by the occurrence of one or more hypomanic episodes and at least one depressive episode.

Question 27

what is a hypomanic mood in bipolar disorder type II

Answer 27

is a persistent mood state characterized by euphoria, irritability, or expansiveness, and excessive psychomotor activation or increased energy, accompanied by other characteristic symptoms such as grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, and impulsive or reckless behavior lasting for at least several days

Question 28

describe cyclothymic disorder

Answer 28

characterized by a persistent instability of mood over a period of at least 2 years, involving numerous periods of hypomanic (e.g., euphoria, irritability, or expansiveness, psychomotor activation) and depressive (e.g., feeling down, diminished interest in activities, fatigue) symptoms that are present during more of the time than not

Question 29

what are the core symptoms of depression

Answer 29

depressed mood almost daily diminished interest in activities for at least 2 weeks

Question 30

what else can be accompanied with depression

Answer 30

``` Difficulty concentrating Feelings of worthlessness, excessive or inappropriate guilt, hopelessness Changes in appetite or sleep Psychomotor agitation or retardation Reduced energy or fatigue Recurrent thoughts of death or suicide ```

Question 31

what can depressive symptoms be masked by

Answer 31

Severe anxiety Alcohol Hypochondriacal symptoms Irritability

Question 32

what are biological clinical features of depression

Answer 32

Altered sleep patterns – usually decreased Early morning wakening with mood typically worse am Appetite reduced with weight loss Libido reduced or absent Motor activity agitation or retardation, including speech

Question 33

what does becks cognitive triad include

Answer 33

negative and pessimistic thoughts about yourself the world the future

Question 34

what is included cognitively in depression

Answer 34

``` becks triad All or nothing’ thinking, ‘awfulising’ Reduced attention, concentration and decisiveness Guilt, worthlessness, death or suicide Delusions and hallucinations can occur ```

Question 35

how many people suffer from depression

Answer 35

1 in 10 in their life

Question 36

how many people are diagnosed with depression

Answer 36

3 million

Question 37

how much more likely are women likely to suffer from depression than men

Answer 37

2x more likely

Question 38

how many suicides are recorded annually in the uk

Answer 38

6000

Question 39

what percentage of children in the uk are anxious or depressed

Answer 39

4%

Question 40

what are some causes of depression

Answer 40

``` redundancy alcohol and drug abuse social isolation loneliness personality traits illness bereavement family history relationship problems stressful or life changing events ```

Question 41

describe the baby blues

Answer 41

occurs in 50% of women post birth onset 2-6 days post birth low mood and no treatment required

Question 42

describe postnatal depression

Answer 42

occurs in 10%

Question 43

which women are more likely to suffer from postnatal depression

Answer 43

``` previous psychiatric history family history chronic social difficulties unwanted pregnancy first child ill baby often missed by professionals ```

Question 44

describe puerperal psychosis

Answer 44

occurs in 0.5%

Question 45

which women are at risk of puerperal psychosis

Answer 45

history of schizophrenia mania or severe depression

Question 46

what is the highest risk groups in suicide

Answer 46

women 16-24 age group men ages 55-64

Question 47

why might statistics not be as reliable between men and women

Answer 47

as men are less coming forward about mental diseases than women

Question 48

what is the screening test for depression

Answer 48

the two question test 1. During the past month, have you often been bothered by feeling down, depressed or hopeless? 2. During the past month, have you often been bothered by little interest or pleasure in doing things?

Question 49

what are the results of the two question test

Answer 49

if yes to both 96-97% sensitivity | 57-67% specificity

Question 50

what perennates of cases are not detected in primary care

Answer 50

30-50%

Question 51

what is sensitivity

Answer 51

detection of positives

Question 52

what is specificity

Answer 52

correct diagnosis and therefore we can get false positives

Question 53

what is HADS

Answer 53

hospital anxiety and depression scale

Question 54

describe HADS

Answer 54

14 item self-rating scale for severity of depression and anxiety symptoms. 90% sensitivity, 86% specificity

Question 55

what is PHQ-9

Answer 55

patient health questionnaire

Question 56

describe the patient health questionnaire

Answer 56

9 item self rating scale measures proportion of time in past 2 weeks depressive symptoms present 80% sensitivity, 92% specificity

Question 57

what is treatment of depression

Answer 57

``` cognitive behavioural psychotherapy antidepressants ECT- electroconvulsive therapy- enhances monoamine fucnction ```

Question 58

what antidepressants can be prescribed

Answer 58

monoamine oxidase inhibitors- older drugs tricyclics- older drugs SSRIS- most common SNRIS

Question 59

why are monoamine oxidase inhibitors and tricyclics not used

Answer 59

due to the bad side effects

Question 60

what are SSRI drugs

Answer 60

– Selective serotonin reuptake inhibitors

Question 61

what are SNRI drugs

Answer 61

Serotonin Noradrenaline Reuptake Inhibitors

Question 62

what is the monoamine deficiency theory

Answer 62

imbalance in brain neurotransmitters- monoamine | depression caused by deficiencies of serotonin dopamine and noradrenaline

Question 63

what is a manic episode

Answer 63

extreme mood state lasting at least one week unless shortened by a treatment intervention

Question 64

how may people suffer form bipolar

Answer 64

1 in 100 adults

Question 65

which age range suffers from bipolar disorder

Answer 65

15-19 years and rarely after 40 | men and women equally likely

Question 66

what is the cause of bipolar disorder

Answer 66

``` mix of physical environmental and social factors: Chemical imbalance Genetics Triggers: Life-changing stressful events Overwhelming problems Physical illness Sleep disturbances ```