Low Mood Flashcards

1
Q

Biological factors in depression?

A

Endocrine, immune, neurotransmitter, physical disorders

sleep, genetics, diet, physical health

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2
Q

Psychological factors in depression?

A

Negative thinking patterns
Deficits in coping
Judgement problems
Impaired emotional intelligence

sleep, self-esteem, attitudes/beliefs, trauma

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3
Q

Social factors in depression?

A

Traumatic situations
Early separation
Lack of social support
Harassment

trauma, financial security, family circumstances, diet

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4
Q

Symptoms of depression?

A

Indecisiveness
Disturbed sleep
Fatigue
Increased appetite
Persistent sadness
Anhedonia
Agitation or slowing of movement
Feelings of worthlessness or inappropriate guilt
Suicidal thoughts or acts
Somatic symptoms (like unexplained pain)

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5
Q

DSM?

A

Diagnostic and Statistical manual of mental disorders

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6
Q

ICD

A

International Criteria of Diseases

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7
Q

DSM-V criteria

A

1 or more key symptom
AND
5 or more total symptoms

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8
Q

Key symptoms? (DSM)

A
  1. Persistent sadness or low mood
  2. Marked loss of interest or pleasure
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9
Q

Associated symptoms? (DSM)

A
  1. Disturbed sleep
  2. Decreased or increased appetite and/or weight
  3. Fatigue or loss of energy
  4. Agitation or slowing of movements
  5. Poor concentration or indecisiveness
  6. Feelings of worthlessness or excessive or inappropriate guilt
  7. Suicidal thoughts or acts
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10
Q

PHC-9?

A

Patient health questionnaire - 9 question depression screen

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11
Q

Suicide most common in?

A

Males aged 40-59

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12
Q

Self harm most common in?

A

Females aged 17-19

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13
Q

Risks…

A

To self
To others
From others

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14
Q

ACEs?

A

Adverse childhood experiences

Potentially traumatic events that can have negative, lasting effects on health and well-being

BRFSS test asks about these (references experiences prior to 18)

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15
Q

ACE categories?

A
  1. Abuse
  2. Family destruction
  3. Neglect
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16
Q

Behaviours that have significant association with ACE scores?

A

Binge drinking
Heavy drinking
Smoking status
High risk HIV behaviour
Depression
Disability caused by poor health
Use of special equipment because of disability

17
Q

P value

A

Below 0.05 = statistically significant

18
Q

Bias

A

Systematic error is introduced into sampling or testing by selecting or encouraging one outcome or answer over others

19
Q

Statistical significance

A

Looking at the reliability of a study through numbers from statistical tests

vs clinical significance - clinicians decision

20
Q

What do SSRIs work on?

A

Blocks serotonin transporter so serotonin continues bouncing around in synapse and acting on receptors

must be serotonin released for it to work

21
Q

What do serotonin receptor agonists act on?

A

Binds to serotonin receptor and activates it

22
Q

Serotonin autoreceptors?

A

Negative feedback - serotonin binds to receptor and switches off further neurodepolarisation
Inhibitory receptor for serotonin - antagonist would prevent this inhibition

23
Q

Tryptophan hydroxylase antagonist?

A

Tryptophan hydroxylase is the rate limiting step in serotonin production, so blocking enzyme will be pro-depressive

24
Q

Monoamine oxidase inhibitors?

A

Monoamine oxidase metabolises serotonin which slows down transportation
Blocking it slows down transporter, more serotonin remains in synapse, and acts on receptors
Anti-depressive

25
Q

Anti-depressant prescription - what to tell patients

A
  1. Take several weeks to work
  2. Symptoms may worsen initially
  3. Need to continue for 6 months after remission of symptoms
  4. Need to wean drugs gradually
  5. Interact with other drugs

book follow up appointment and give suicide hotline numbers

26
Q

Drug interactions of anti-depressants?

A

Sertaline and acalabrutinib can increase risk of bleeding
Sertaline and aceclofenac can increase risk of bleeding and risk of hyponatraemia

27
Q

Severity and anti-depressant relationship?

A

More severe depression = bigger improvement from drugs vs placebo
not much research

28
Q

Non-pharmacological interventions for depression

A

Support groups, art therapy, financial help, exercise groups

29
Q

Social prescribing

A

Connects people to activities, groups and services in their community

30
Q

CBT?

A

Talking therapy
Explores thoughts, feelings and behaviour
Outside of sessions - diary,

31
Q

TF-CBT

A

Trauma focused CBT for PTSD