Mood (affective) Disorders

Question 1

1. Name the one and only Unipolar affective disorder.

2. Define the following: Bipolar I, Bipolar II, Bipolar III

Answer 1

1. Depression, where only episodes of depression alone occur.
2. Bipolar I: One or more manic or mixed episodes
   Bipolar II: A depressive episode with at least one episode of hypomania
   Bipolar III: Depressive episodes with hypomania only occurring when taking an anti-depressant.

Question 2

1. What are the three core symptoms of depression according to ICD10? How many of these are necessary for diagnosis?
2. For how long must symptoms have lasted before diagnosis is possible?
3. Identify some of the main precipitating factors to depression.

Answer 2

1. Depressed mood, Lack of interest/pleasure, Decreased energy.
2. At least 2 weeks.
3. Physical illness, Bereavement, Separation, Redundancy, Lack of confiding relationship, Interpersonal difficulties.

Question 3

1. Define Dysthymia.
2. Identify three Puerperal affective disorders
3. What is Cotard’s syndrome?

Answer 3

1. Mild or moderate depressive illness that lasts intermittently for 2 years.
2. Baby blues, Postpartum Psychosis, non-psychotic postnatal depressive disorder.
3. Severe depressive illness where patient has severe nihilistic delusions e.g. believes they are a walking corpse.

Question 4

1. When should depressive patients be admitted to hospital?
2. What psychological therapy is used?
3. What other non-pharmocological therapies are helpful?

Answer 4

1. Patients who are severely depressed or those who are actively suicidal.
2. Cognitive Behavioural Therapy.
3. Group exercise, good sleep-wake cycle, daily routine, counselling

Question 5

1. What is the difference between mania and hypomania?
2. What clinical features characterise mania?
3. Apart from symptoms how can the disease presentation vary?

Answer 5

1. Hypomania lasts a shorter space of time and is less severe. Distinguished from normal happiness by persistence and non-reactivity.
2. Euphoria, overactivity and disinhibition. Fast pressured speech, grandiose delusions, insomnia.
3. Can be rapid-cycling (Frequent mood swings), Mixed affective state (Features of depression and mania in same episode). Cyclothymia- spontaneous swings in mood

Question 6

1. Identify some differentials of mania.

2. What social consequences could come about?

Answer 6

1. Acute intoxication with recreational drugs amphetamines, amphetamine derivatives e.g. MDMA or ecstasy. Cocaine
2. Erratic behaviour could mean significant debt from overspending, promiscuity, lost employment.

Question 7

1. Identify the three main drugs or drug types used to treat manic episodes

Answer 7

1. Atypical antipsychotics, Lithium and Sodium Valproate.