Depression and other psychological conditions Flashcards
forms of depression instruments designed to measure anxiety and depression the range of pharmacological and psychological treatments of depression and the evidence base for these the social context of Depression including the protective effect of social networks
what is a disease
objective physical pathology with known aetiology
what is an illness
subjective distress
what is the definition of a mental illness
Psychiatric conditions without organic cause - old definition
Defines a level of distress greater than normal human experience
what does neuroimaging show
that mental illnesses show physical changes therefore it is a mental illness or a physical illness?
how do we classify psychiatric disorders
the IDC- WHO international classification of diseases
diagnosis and statistical manual of mental disorders( DSM V)- used in the UK
what is the purpose of the IDC and DSM V
standardise diagnosis and enhance ability to research disorders and build EBP
what is another classification of psychiatric disorders
organic- physical disorders which leads to psychiatric symptoms tumours, injury,infection
functional
what can tumours lead to
psychiatric symptoms
what can injury lead to
can include trauma, anoxic/hypoxic brain injuries
what can degeneration lead to
dementia
what can metabolic and endocrine disease lead to
underactive thyroid
what are organic disorders due to
dementia delirium and other disorders
what are mental and behavioural disorders due to
psychoactive substance use
define psychosis
severe mental disturbance
loss of contact with external reality
define neurosis
mental distress
can still distinguish between symptoms originating in their own mind and external realtiy
what are the types of depression
single episode
recurrent at least 2 episodes- separated by months etc
dysthymic- persistant depressive mood that lasts + 2 years, lasts most days
what are the types of bipolar
bipolar disorder I
bipolar disorder II
cyclothymic
describe single episode depression
presence or history of one depressive episode when there is no history of prior depressive episodes.
what associated feelings are associated with depression
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.
describe recurrent depressive disorder
history or at least two depressive episodes separated by at least several months without significant mood disturbance
describe dysthymic disorder
characterized by a persistent depressive mood (i.e., lasting 2 years or more), for most of the day, for more days than not
how can dysthymic disorder perceive in adults and children
pervasive irritability
describe mixed depressive and anxiety disorder
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.
describe bipolar type I disorder
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
what associated feelings can occur with bipolar disorder I
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
describe bipolar type II
defined by the occurrence of one or more hypomanic episodes and at least one depressive episode.
what is a hypomanic mood in bipolar disorder type II
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
describe cyclothymic disorder
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
what are the core symptoms of depression
depressed mood almost daily diminished interest in activities for at least 2 weeks
what else can be accompanied with depression
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
what can depressive symptoms be masked by
Severe anxiety
Alcohol
Hypochondriacal symptoms
Irritability
what are biological clinical features of depression
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
what does becks cognitive triad include
negative and pessimistic thoughts about
yourself
the world
the future
what is included cognitively in depression
becks triad All or nothing’ thinking, ‘awfulising’ Reduced attention, concentration and decisiveness Guilt, worthlessness, death or suicide Delusions and hallucinations can occur
how many people suffer from depression
1 in 10 in their life
how many people are diagnosed with depression
3 million
how much more likely are women likely to suffer from depression than men
2x more likely
how many suicides are recorded annually in the uk
6000
what percentage of children in the uk are anxious or depressed
4%
what are some causes of depression
redundancy alcohol and drug abuse social isolation loneliness personality traits illness bereavement family history relationship problems stressful or life changing events
describe the baby blues
occurs in 50% of women post birth
onset 2-6 days post birth
low mood and no treatment required
describe postnatal depression
occurs in 10%
which women are more likely to suffer from postnatal depression
previous psychiatric history family history chronic social difficulties unwanted pregnancy first child ill baby often missed by professionals
describe puerperal psychosis
occurs in 0.5%
which women are at risk of puerperal psychosis
history of schizophrenia mania or severe depression
what is the highest risk groups in suicide
women
16-24 age group
men ages 55-64
why might statistics not be as reliable between men and women
as men are less coming forward about mental diseases than women
what is the screening test for depression
the two question test
- During the past month, have you often been bothered by feeling down, depressed or hopeless?
- During the past month, have you often been bothered by little interest or pleasure in doing things?
what are the results of the two question test
if yes to both 96-97% sensitivity
57-67% specificity
what perennates of cases are not detected in primary care
30-50%
what is sensitivity
detection of positives
what is specificity
correct diagnosis and therefore we can get false positives
what is HADS
hospital anxiety and depression scale
describe HADS
14 item self-rating scale for severity of depression and anxiety symptoms.
90% sensitivity, 86% specificity
what is PHQ-9
patient health questionnaire
describe the patient health questionnaire
9 item self rating scale measures proportion of time in past 2 weeks depressive symptoms present
80% sensitivity, 92% specificity
what is treatment of depression
cognitive behavioural psychotherapy antidepressants ECT- electroconvulsive therapy- enhances monoamine fucnction
what antidepressants can be prescribed
monoamine oxidase inhibitors- older drugs
tricyclics- older drugs
SSRIS- most common
SNRIS
why are monoamine oxidase inhibitors and tricyclics not used
due to the bad side effects
what are SSRI drugs
– Selective serotonin reuptake inhibitors
what are SNRI drugs
Serotonin Noradrenaline Reuptake Inhibitors
what is the monoamine deficiency theory
imbalance in brain neurotransmitters- monoamine
depression caused by deficiencies of serotonin dopamine and noradrenaline
what is a manic episode
extreme mood state lasting at least one week unless shortened by a treatment intervention
how may people suffer form bipolar
1 in 100 adults
which age range suffers from bipolar disorder
15-19 years and rarely after 40
men and women equally likely
what is the cause of bipolar disorder
mix of physical environmental and social factors: Chemical imbalance Genetics Triggers: Life-changing stressful events Overwhelming problems Physical illness Sleep disturbances
