Elevated and Depressed Mood Flashcards
at what age do mood disorders peak
usually peak in 30s
what is anhedonia
loss of enjoyment/pleasure
mood affective disorders are typically worse at what time of day
first thing when patient wakes up
how does appearance and behaviour present in someone with depression
reduced facial expression
reduced eye contact and gesturing
rapport is difficult to establish
how does speech present in someone with depression
reduced rate, pitch and volume
monotony
increased speech latency –> longer pauses when asked a question
limited content of speech
how does mood and affect present in a depressed patient
describe mood as low, down, unhappy, numb
limited reactivity and may report emotional paralysis - ask how they would feel if they lost someone close to them
how is thought described in the mental state examination
form, flow and content
describe the form, flow and content of a depressed persons thoughts
form is normal
flow is reduced or absent
content is usually negative, pessimistic with suicidal thinking
describe perception in a depressed patient
perception is typically normal, if hallucinations are present they are usually auditory and with negative themes
describe cognition in a patient with depression
slowing of thoughts
perform poorly on cognition tests
pseudo-dementia may be present
what is insight like in a patient with depression
insight is usually preserved, they are aware of their condition
how long must depressive symptoms be present for before a diagnosis is confirmed
at least 2 weeks with no remission
what are the 3 core symptoms of depression of which 2 must be present for diagnosis
depressed mood that is uninfluenced by circumstances
loss of interest/enjoyment
decreased energy/increased fatiguability
THINK MEE (mood, enjoyment, energy)
what are the 7 additional symptoms of depression of which 4 must be present for diagnosis
loss of confidence unreasonable guilt suicidal thoughts/behaviours reduced ability to think/concentrate change in psychomotor activity sleep disturbance changes in appetite
what qualifies for a moderate depressive episode
2 core symptoms with 4 additional symptoms
what qualifies for a severe depressive episode
3 core symptoms with 5 additional symptoms
describe mild depression
most common type, commonly managed in primary care
do not require antidepressants and instead manage through CBT etc
what is bipolar I
has to have met criteria for mania
what is bipolar II
has experienced a past or current hypomanic or depressive episode but has never met criteria for mania
what is bipolar III
hypomania after commencing antidepressants
describe the difference between depression and bipolar
depression is a unipolar disease of only low mood whereas bipolar there will be a combination of elevated and depressed mood
how long is mood elevated in a hypomanic episode
4 days
list some of the signs present in a hypomanic episode
increased activity increased talking difficulty concentrating decreased need for sleep increased sexual energy mild spending sprees
how long is mood elevated in a manic episode
1 week
list some of the differences in elevated mood between hypomania and mania
loss of social inhibition
inflated self-esteem
pressure of speech
sexual indiscretions
describe the thoughts of a person with mania
increased flow
flight of ideas, loosening of associations
grandiosity as content
list the comorbidities for bipolar
anxiety disorder alcohol and drug misuse personality disorder eating disorder schizophrenia
list some predictors of poor outcome for bipolar disorder
early onset low socio-economic status subsyndromal mood symptoms rapid mood fluctuation psychosis comorbid disorders
