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psychiatric system > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

define bipolar affective disorder (BPAD)

A

a mental disorder characterised by periods of depression and periods of elevated mood (mania)

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2
Q

triggers of manic episodes in BPAD

A

stressful life events
physical illness
illicit substance misuse

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3
Q

clinical features of depression periods in BPAD

A 
withdrawn behaviour
tearful 
low mood 
poor sleep 
anhedonia 
self-harm thoughts/actions
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4
Q

clinical features of manic episodes in BPAD

A 
elevated mood 
irritability 
impulsive and dangerous decisions 
little regard to consequence 
reduced sleep need 
pressured speech 
flight of ideas
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5
Q

diagnostic criteria for BPAD by DSM

A

at least one episode of manic or hypomanic state and one major depressive episode

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6
Q

DSM definition of mania

A

distinct period of abnormal and persistently elevated, expansive or irritable mood lasting >1wk with three key symptoms

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7
Q

key symptoms included in DSM definition of mania

A 
elevated self-esteem 
reduced sleep need 
increased speech rate
flight of ideas 
easily distracted 
increased interest in goals/activities 
psychomotor agitation
increased pursuit of 'dangerous' activities
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8
Q

DSM definition of hypomania

A

an episode of mania severe enough to cause marked impairment in social or occupational function with NO psychotic features

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9
Q

DSM definition of major depressive episode

A

sudden or new onset of at least 4 key symptoms for minimum of 2wks

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10
Q

key symptoms included in DSM definition of major depressive episode

A

changes in appetite, sleep, weight or motor activity
decreased energy
feelings of worthlessness or guilt
trouble thinking, concentrating or making decisions
thoughts of death
suicidal plans or attempts

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11
Q

acute management of mania WITH agitation in BPAD

A

IM neuroleptic or benzodiazepine

urgent secure unit admission

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12
Q

acute management of mania WITHOUT agitation in BPAD

A

oral monotherapy with antipsychotic

sedation and lithium added if necessary

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13
Q

acute management of depression in BPAD

A

mood stabiliser +/- atypical antipsychotic +/- antidepressant

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14
Q

chronic management of BPAD

A

lithium
second line: valproate
psychological therapy (e.g. CBT or interpersonal)

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15
Q

chronic management of BPAD if treatment resistant

A

antipsychotic + anticonvulsants

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16
Q

DSM diagnostic criteria of depression

A

5 out of the 9 key features present nearly every day for >2wks

17
Q

key features of DSM criteria for depression

A 
depressed mood or irritable for most of the day
anhedonia 
significant weight change (5%) 
changes in sleep (insomnia)
changes in activity 
fatigue 
feelings of guilt/worthlessness
decreased concentration
suicidality
18
Q

risk factors of depression

A 
female gender 
PMHH of depression
significant physical illness
other MH problems 
social issues
19
Q

investigations of depression

A

thorough history
screening questionnaires
blood tests
thyroid function tests

20
Q

management of depression (Step One)

A

low intensity psychological intervention

group-based CBT

21
Q

management of depression (Step Two)

A

high intensity psychological therapy (e.g. CBT or IPT) or SSRIs

22
Q

management of depression (Step Three)

A

antidepressants AND high intensity psychological therapies

23
Q

treatment course of antidepressants

A

continued for 6mnths if benefit from medication

when stopping, reduce dose gradually over 4wk period

24
Q

management of severe depression

A

SSRIs and psychological therapy

can include lithium

25
Q

management of life-threatening depression

A

electroconvulsive therapy (ECT)

26
Q

side effects of ECT

A 
short: 
headache 
muscle aches/pains 
nausea 
temporary memory loss
confusion

long:
persistent memory loss

27
Q

key signs of hypothyroidism vs. depression

A 
weight gain 
hair loss 
'puffy' facial appearance 
long and heavy periods 
low mood

psychiatric system (6 decks)

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