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SSRD- social sciences relating to dentistry > Depression and other psychological conditions > Flashcards

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

1
Q

what is a disease

A

objective physical pathology with known aetiology

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2
Q

what is an illness

A

subjective distress

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3
Q

what is the definition of a mental illness

A

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

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4
Q

what does neuroimaging show

A

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

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5
Q

how do we classify psychiatric disorders

A

the IDC- WHO international classification of diseases

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

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6
Q

what is the purpose of the IDC and DSM V

A

standardise diagnosis and enhance ability to research disorders and build EBP

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7
Q

what is another classification of psychiatric disorders

A

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

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8
Q

what can tumours lead to

A

psychiatric symptoms

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9
Q

what can injury lead to

A

can include trauma, anoxic/hypoxic brain injuries

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10
Q

what can degeneration lead to

A

dementia

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11
Q

what can metabolic and endocrine disease lead to

A

underactive thyroid

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12
Q

what are organic disorders due to

A

dementia delirium and other disorders

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13
Q

what are mental and behavioural disorders due to

A

psychoactive substance use

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14
Q

define psychosis

A

severe mental disturbance

loss of contact with external reality

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15
Q

define neurosis

A

mental distress

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

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16
Q

what are the types of depression

A

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

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17
Q

what are the types of bipolar

A

bipolar disorder I
bipolar disorder II
cyclothymic

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18
Q

describe single episode depression

A

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

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19
Q

what associated feelings are associated with depression

A

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.

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20
Q

describe recurrent depressive disorder

A

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

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21
Q

describe dysthymic disorder

A

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

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22
Q

how can dysthymic disorder perceive in adults and children

A

pervasive irritability

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23
Q

describe mixed depressive and anxiety disorder

A

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.

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24
Q

describe bipolar type I disorder

A

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

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25
Q

what associated feelings can occur with bipolar disorder I

A

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

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26
Q

describe bipolar type II

A

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

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27
Q

what is a hypomanic mood in bipolar disorder type II

A

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

28
Q

describe cyclothymic disorder

A

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

29
Q

what are the core symptoms of depression

A

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

30
Q

what else can be accompanied with depression

A 
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
31
Q

what can depressive symptoms be masked by

A

Severe anxiety
Alcohol
Hypochondriacal symptoms
Irritability

32
Q

what are biological clinical features of depression

A

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

33
Q

what does becks cognitive triad include

A

negative and pessimistic thoughts about
yourself
the world
the future

34
Q

what is included cognitively in depression

A 
becks triad 
All or nothing’ thinking, ‘awfulising’
Reduced attention, concentration and decisiveness
Guilt, worthlessness, death or suicide
Delusions and hallucinations can occur
35
Q

how many people suffer from depression

A

1 in 10 in their life

36
Q

how many people are diagnosed with depression

A

3 million

37
Q

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

A

2x more likely

38
Q

how many suicides are recorded annually in the uk

A

6000

39
Q

what percentage of children in the uk are anxious or depressed

A

4%

40
Q

what are some causes of depression

A 
redundancy 
alcohol and drug abuse 
social isolation 
loneliness 
personality traits 
illness 
bereavement 
family history 
relationship problems 
stressful or life changing events
41
Q

describe the baby blues

A

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

42
Q

describe postnatal depression

A

occurs in 10%

43
Q

which women are more likely to suffer from postnatal depression

A 
previous psychiatric history 
family history 
chronic social difficulties 
unwanted pregnancy 
first child 
ill baby 
often missed by professionals
44
Q

describe puerperal psychosis

A

occurs in 0.5%

45
Q

which women are at risk of puerperal psychosis

A

history of schizophrenia mania or severe depression

46
Q

what is the highest risk groups in suicide

A

women
16-24 age group
men ages 55-64

47
Q

why might statistics not be as reliable between men and women

A

as men are less coming forward about mental diseases than women

48
Q

what is the screening test for depression

A

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?
49
Q

what are the results of the two question test

A

if yes to both 96-97% sensitivity

57-67% specificity

50
Q

what perennates of cases are not detected in primary care

A

30-50%

51
Q

what is sensitivity

A

detection of positives

52
Q

what is specificity

A

correct diagnosis and therefore we can get false positives

53
Q

what is HADS

A

hospital anxiety and depression scale

54
Q

describe HADS

A

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

55
Q

what is PHQ-9

A

patient health questionnaire

56
Q

describe the patient health questionnaire

A

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

57
Q

what is treatment of depression

A 
cognitive 
behavioural 
psychotherapy 
antidepressants 
ECT- electroconvulsive therapy- enhances monoamine fucnction
58
Q

what antidepressants can be prescribed

A

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

59
Q

why are monoamine oxidase inhibitors and tricyclics not used

A

due to the bad side effects

60
Q

what are SSRI drugs

A

– Selective serotonin reuptake inhibitors

61
Q

what are SNRI drugs

A

Serotonin Noradrenaline Reuptake Inhibitors

62
Q

what is the monoamine deficiency theory

A

imbalance in brain neurotransmitters- monoamine

depression caused by deficiencies of serotonin dopamine and noradrenaline

63
Q

what is a manic episode

A

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

64
Q

how may people suffer form bipolar

A

1 in 100 adults

65
Q

which age range suffers from bipolar disorder

A

15-19 years and rarely after 40

men and women equally likely

66
Q

what is the cause of bipolar disorder

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

SSRD- social sciences relating to dentistry (15 decks)

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