Mood Disorders Flashcards
How are mood disorders defined?
According to particular types of mood episodes and their pattern over time
Outline depressive episode
Can be mild, moderate or severe
Low mood, anhedonia, anergia or diminished interest
ICD duration of depressive episode
Most of the day, nearly every day for at least 2 weeks
Other symptoms of depressive mood
Poor concentration, inattention, memory
Diurnal variation in mood
Reduced sleep with early morning waking
Change in appetite
Psychomotor changes
Reduced libido
Feeling of guilt, hopelessness, worthlessness
Poor self-esteem
Suicidal ideation
Psychotic features - usually mood congruent
What is a hypomanic episode?
Similar to a manic episode but milder
Change from baseline but not markedly impaired
No psychotic symptoms
Features of a manic episode
Euphoria, irritability or expansiveness
Increased activity or subjective increased energy
Additional features of a manic episode
Increased talkativeness (pressured speech)
Reduced need for sleep
Increased self-esteem or grandiosity
Flight of ideas
Distractibility
Increased sexual drive, sociability or goal-directed behaviour
Impulsive reckless behaviour
Mood lability
Are psychotic symptoms present in mania and hypomania?
Mania: sometimes
Hypomania: no
Duration of a manic or hypomanic episode
At least 7 days
What is a mixed episode?
Several manic and depressive symptoms, occurring simultaneously or in rapid alternation (day to day or within same day)
What is bipolar disorder 1?
One or more manic or mixed episodes
What is bipolar disorder 2?
One or more hypomanic episodes and at least one depressive episode
No history of manic or mixed episodes
What is rapid cycling bipolar disorder?
Multiple (4 or more) discreet episodes within 12 months
Usually hypomaniac and major depressive episodes
May switch spontaneously or during treatment for current episode
Acute management of bipolar disorder
Stop any antidepressant
Antipsychotic (haloperidol, olanzapine, quetiapine or risperidone)
If antipsychotic not sufficient, consider adding lithium
Maintenance management of bipolar disorder
Lithium most effective
Alternatively valproate, carbamazepine
Antipsychotics: olanzapine, quetiapine
What is unipolar depression?
No history of hypomanic or manic episodes
Outline bipolar depression
Depressive episode in bipolar illness
Higher frequency and severity
Rapid onset, shorter duration
Increased likelihood of psychotic symptoms
What is serotonin syndrome?
How is it caused?
Excessive serotonin activity
Excessive antidepressant use
Symptoms of serotonin syndrome
Headache, agitation, hypomania, mental confusion, hallucinations, coma
Shivering, sweating, hyperthermia, hypertension, tachycardia, nausea, diarrhoea
Myoclonus, hyperreflexia, tremor
Psychological therapy for depression
CBT - addresses maladaptive cognitions and behaviours that can influence depressive symptoms
Interpersonal therapy
Solution-focussed therapy
Counselling
What is bipolar affective disorder?
Two or more episodes of mood disturbance, the disturbance consisting on some occasions of mania or hypomania and on others depression
Define dysthmia
A chronic depression of mood which does not currently fulfil the criteria for recurrent depressive disorder
Define cyclothymia
A persistent instability of mood, involving numerous periods of mild depression and mild elation
