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Psych > Mood disorders 1 > Flashcards

Mood disorders 1 Flashcards

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1
Q

What is the lifetime prevalence of depression?

A

10-20%

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2
Q

What percentage of depressed patients will commit suicide?

A

5-15%

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3
Q

What percentage of depressed patients will recover in 1 year?

A

50-60%

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4
Q

What percentage of depressed patients are still unwell at 2 years?

A

10-25%

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5
Q

What are the core symptoms of depressions? (remember this pls)

A

Depressed mood
Loss of interest/enjoyment
Reduced energy

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6
Q

What are the biological (somatic) symptoms of depression?

A

Reduced appetite
Weight loss (5% loss in the last month)
Psychomotor S+S
Loss of libido (often accompanied with guilt)
Loss of emotional reactivity
Early morning wakening (at least 2 hours before normal time)
Depression worse in the morning

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7
Q

What are the psychomotor S+S?

A

Agitation or Retardation

Agitation = can't sit still and fidgeting 
Retardation = slow movements, slow speech, blunted effect
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8
Q

What are the cognitive symptoms of depression?

A 
Reduced concentration and attention 
Reduced self esteem 
Guilt, unworthiness
Pessimism, bleak outlook
Suicidal thoughts, self harm
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9
Q

What are the psychotic symptoms associated with depression?

3 main ones to remember

A

Delusions - e.g. sin, poverty, impending disasters, guilt, nihilistic or persecutory

Hallucinations - e.g. defamatory or accusatory voices, smelling rotting filth or decomposing flesh

Depressive stupor - must differentiate from catatonia in schizophrenia. Extreme unresponsiveness and lack of voluntary movement (akinesia)

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10
Q

What is dysthymia?

A

very long standing MILD depression

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11
Q

What is cyclothermia?

A

persistent instability of mood
numerous periods of mild depression and mild elation
chronic course
no episodes fulfil criteria of bipolar or recurrent depression

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12
Q

How is a mild episode classified?

A

At least 2 core symptoms + at least 2 others
Minimum 2 weeks duration
May have some difficulty continuing ordinary work or social activities but won’t stop completely
+/- somatic syndrome

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13
Q

How is a moderate episode classified?

A

at least 2 core symptoms + at least 3-4 others
considerable difficulty continuing normal activities
+/- somatic syndrome

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14
Q

How is a severe episode classified?

A

all 3 core symptoms + at least 4 others
2 weeks no longer of value - high risk group
very unlikely to complete normal activities

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15
Q

What are the physical conditions that present with psychiatric symptoms?

NEUROLOGICAL

A 
MS
Parkinson's
Huntington's
Spinal Cord Injury 
CVA
Head injury 
Cerebral tumour
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16
Q

What are the physical conditions that present with psychiatric symptoms?

ENDOCRINE

A

Thyroid or parathyroid esp. hypothyroid

Cushing’s or Addison’s

17
Q

What are the physical conditions that present with psychiatric symptoms?

INFECTIOUS

A 
HIV/AIDS
Syphilis 
Typhoid
EBV
HSV
18
Q

What are the physical conditions that present with psychiatric symptoms?

IATROGENIC

A

Opiates
L-dopa
Steroids (corticosteroids and OC)
Anti HTNs

19
Q

What are the physical conditions that present with psychiatric symptoms?

OTHERS

A 
Malignancy 
SLE
RA
Renal failure
Porphyria
20
Q

How should you assess psychiatric physical conditions?

A

Hx
Neuro and endos system examination to exclude organic cause
Examinations and investigations to help assess baseline values for medications

21
Q

How do you manage depression?

A

Biopsychosocial approach

22
Q

What is the BIO aspect of management?

A

SSRIs = 1st line

Lithium, antipsychotic or triiodothyronine (T3) augmentation if treatment resistant

ECT

23
Q

What is the PSYCH aspect of managing depression?

A

Psychoeducation
CBT
Interpersonal therapy
Self-help materials

24
Q

What is the SOCIAL aspect of managing depression?

A 
CPN/OPD follow-ups
Work on social inclusion
Support for education, training and employment
Support with housing and benefits
Carer support
25
Q

What are the depression relapse rates? At 1 year and 10 years?

A

25% at 1 year

75% at 10 years

26
Q

What can be done to stop relapse?

A

Pharmacotherapy for 6 months after resolution of symptoms for 1 episode

Pharmacotherapy for 2 years if recurrent

Psych (7 decks)

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