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Psychiatry > Low Mood > Flashcards

Low Mood Flashcards

1
Q

Describe the M:F ratio for depression

A

1:2

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2
Q

Describe the relationship between depression and physical health

A

Bidirectional - if feel more depressed, more likely to get a physical illness

pt. s with depression = 2-3 times higher rates chronic illness and = 5-10yrs reduced life expectancy
psych. co-morbidity common

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3
Q

What does the aetiology depression include?

A 
Individual vulnerability factors:
-genetics
-gender
-early life experiences
-social adversity
-personality factors
Current factors:
-stressful life events
-physical illness
-drugs
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4
Q

What is the diagnostic criteria for depression?

A 
Sx.  for at least 2 weeks = signif. incapacity
At least two core symptoms:
-anhedonia
-anergia
-low mood
Plus additional symptoms:
-loss confidence/self esteem
-self reproach/excessive guilt
-low conc.
-recurrent thoughts death/suicide/suicidal behavior
-change appetite
-sleep disturbance
-change in psychomotor activity
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5
Q

What is the diagnostic criteria for mild/moderate/severe depression

A

Mild: 2 core + others to total 4 or more
Moderate: 2 core + others to total 6 or more
Severe: 3 core + others to total 8 or more

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6
Q

What is the difference in function with mild vs moderate vs severe depression?

A 
Mild = distressed - continues most activities
Moderate = difficult continuing most activities
Severe = sx marked/distressing, suicidal thoughts/acts common, usually somatic symptoms
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7
Q

List 9 other symptoms assoc. with depression

A
  • anxiety
  • irritability
  • panic attacks
  • secondary obsessional symptoms
  • secondary phobic symptoms
  • depersonalisation
  • derealisation
  • psychotic symptoms
  • physical symptoms
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8
Q

Name some physical symptoms associated with depression

A
  • insomnia
  • poor appetite
  • wt loss
  • constipation
  • loss libido
  • erectile dysfunction
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9
Q

How to diagnose somatic syndrome?

A

4 of symptoms of somatic syndrome

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10
Q

What are the 8 different symptoms assoc. with somatic syndrome?

A
  • marked loss interest/pleasure in activities normally pleasurable
  • lack emotional reactions to events/activities normally produce emotional reac.
  • early morning wakening (2hrs B4 normal waking time)
  • diurnal variation (worse in morning)
  • objective evidence marked psychomotor retardation/agitation (reported by 3rd person)
  • marked loss appetite
  • weight loss
  • marked loss libido
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11
Q

Describe the speech assoc. with depression in MSE

A
  • decreased rate/vol/pitch, monotonous, increase in speech latency, limited content
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12
Q

Describe the mood and affect assoc. with depression in MSE

A
  • depressed/miserable/irritable
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13
Q

Describe the perceptions assoc. with depression in the MSE

A
  • Hallucinations in any modality, usually mood congruent
  • most commonly auditory hallucinations (2nd person - insulting patient and suggesting suicide)
  • illusions if severe
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14
Q

Describe the thoughts assoc. with depression in the MSE

A

Flow/Form/Content
-• Flow: slow/poverty of thought
• Form: unusual
• Content: negative cognitive distortions/obsession/ruminations/ death/guilt/delusions
o (usually mood congruent dilusions-guilt,nihilism,hypochondriasis)
o beck’s triad
o delusions of poverty and non-existence (nihilism) can occur particularly in the elderly with more severe forms of depression
o delusions of guilt, persecution and bodily disease are not uncommon

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15
Q

What is beck’s triad?

A

3 types of negative thoughts present in depression:

  • self (self is worthless)
  • world and environment (unfair world)
  • future (hopeless future)
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16
Q

What is the insight assoc. with depression

A

-typically preserved, can recog. symp., -ve cognition can afftect view on illness/tx/recovery
May lose insight in severe forms depression

17
Q

What is cognition assoc. with depression?

A

subjectively - slow thinking/poor memory
objectively - deficits in working memory/planning/attention
(psuedodementia)

18
Q

What is pseudodementia?

A

in severe forms of depression memory and concentration can be severely affected mimicking dementia

19
Q

How to diagnose recurrent depressive disorder?

A

-repeated episodes of mild/mod/severe depression
- no hypomanic/manic symptoms in lifetime
(discrete periods depression that come and go)

20
Q

What is mixed anxiety and depression?

A

Symptoms of anxiety and depression not significant enough to justify either diagnosis individually

21
Q

Describe dysthymia? Are demands of everyday life coped with?

A

chronic low mood that doesn’t fulfill criteria for recurrent depressive disorder

  • may have fulfilled criteria for mild depressive episode (not mild recurrant episode)
  • tired + depressed for months at a time
  • usually able to cope w/ demands
22
Q

What is a major problem in depression in old age?

A

10-15% elderly

-often undetected and untreated

23
Q

How can depression in old age present?

A

pseudodementia

24
Q

What kind of suicidal thoughts are particularly common in depression in old age?

A

passive thoughts of death common

suicidal ideation less common but prob. more high risk when it is.

25
Q

When a patient is suffering from a depressive episode, what are the 7 main diagnoses to consider in addition?

A 
1 - recurrant depressive disorder
2- bipolar disorder
3- schizoaffective disorder
4 - schizophrenia
5 - dementia
6- delirium
7- substance misuse
26
Q

What are the 5 main different diagnoses for low mood?

A 
1 - organic
2 - psychotic
3 - affective (mood)
4 - neurotic (anxiety)
5 - Personality disorder
27
Q

What are the organic causes for low mood?

A
  • neurological e.g. parkinsons
  • endocrine e.g. hypothyroid
  • metabolic e.g. hypoglycaemia
  • haematological e.g. anaemia
  • inflammatory causes e.g. SLE
  • infection e.g. syphilis
  • sleep disorder e.g. sleep apnoea
  • medication e.g. beta blockers
  • recreational drugs e.g. alcohol
28
Q

what are the affective causes for low mood?

A

¥ Bipolar disorder
¥ Cyclothymia
¥ Dysthymia

29
Q

What are the neurotic causes for low mood?

A

anxiety
PTSD
adjustment disorder

30
Q

What is the personality disorder cause for low mood?

A

emotionally unstable personality disorder`

31
Q

What are the psychotic causes for low mood?

A

schizophrenia/schizoaffective disorder

32
Q

age onset of depression

A

27yrs

Psychiatry (26 decks)

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