Lecture 1 Affective Disorders Flashcards
Name examples of Affective (Mood) disorders
Depression
Bipolar
When does depression become abnormal
No clear and convenient division
Persistence
What is depression
An unpleasant emotion in which sadness or unhappiness predominates for at least 22 weeks
What is agitation
A state of restless overactivity, aimless or ineffective
What is anhedonia
Loss of ability to derive pleasure from experience
What is apathy
Loss on interest in own surroudings
What is anxiety
An unpleasant emotion in which thoughts of apprehension or fear predominate
What is retardation
A slowing or motor responses including speeh
What is stupor
A state of extreme retardation in which consciousness is intact
Describe the symptoms of depression- Somatic syndrome
Apathy Anhedonia Waking early Worse in morning Marked loss of appetite Marked loss of libido
Mild depression includes at least how many of these symptoms
- Loss of confidence or self esteem
- Unreasonable feelings of guilt or self reproach or excessive guilt
- Recurrent thoughts of death by suicide or any suicidal behaviour
- Decreased concentration
- Agitation or retardation
- Sleep disturbance of any sort
- Change in appetite
4
Moderate depression includes at least how many of these symptoms
- Loss of confidence or self esteem
- Unreasonable feelings of guilt or self reproach or excessive guilt
- Recurrent thoughts of death by suicide or any suicidal behaviour
- Decreased concentration
- Agitation or retardation
- Sleep disturbance of any sort
- Change in appetite
6
Severe depression includes at least how many from these list
- Loss of confidence or self esteem
- Unreasonable feelings of guilt or self reproach or excessive guilt
- Recurrent thoughts of death by suicide or any suicidal behaviour
- Decreased concentration
- Agitation or retardation
- Sleep disturbance of any sort
- Change in appetite
8
What are the differential diagnosis of depression
Normal reaction to life event SAD Dysthymia Cyclothymia Bipolar Stroke, tumour, dementia Hypothyroidism, Addisons Drugs
What is the treatment for mild depression
Monitoring, self help, CBT, exercise
What is the treatment for moderate depression
Anti-depressant (first line SSRI), CBT
What is the treatment for severe depression without psychotic features
Anti-depressant medication plus CBT
What is the treatment for severe depression with psychotic features
Anti-depressant + Antipsychotic
If there is treatment refractory in depression what is the next step
Switch anti-depressant or augment with lithium/antipsychotic
Name measurement tools for depression
SCID SCAN HDRS BDI-II HADS PHRQ-9
What is mania
A psychological condition that causes a person to experience unreasonable euphoria, very intense moods, hyperactivity, and delusions
What are the features hypomania
Lesser degree of mania
No psychosis
Elevation of mood, energy, sociability, talkativeness, libido
Decreased need for sleep
Normal life disrupted but ca still function
How long can mania last
At least 1 week
What are the features of mania
Severe disruption to ordinary work and social activities Elevation of mood, energy, sociability, talkativeness, libido Decreased need for sleep Disinhibition Grandiosity Alteration of senses Extravagant spending Psychotic symptoms
Wha is Bipolar Affective Disorder
Consist of repeated episodes of depression and mania or hypomania
What is the treatment for Bipolar in the acute phase
If they are on anti-depressants stop them
Anti-psychotics (Olanzapine, Quetiapine or Risperidone) for at least 2 years
If response to antipsychotics drugs in BP is inadequate what can be added
Lithium
Sodium valproate
What is Benzodiazepines used for
Useful in the initial stages of treatment for behavioural disturbance or agitation (short term)
