Mood Disorders Flashcards
Depression Mania Bipolar
Risk factors for depression
Female
Past history of depression
Significant physical illness
Other mental health problems
Social issues
Tests for differentials of depression
Thyroid function test
Brain imaging
FBC
Metabolic panal
Organic differentials of depression
Neurological - dementia, parkinsons, MS
Endocrine - thyroid dysfunction
Drugs - alcohol, steroids, beta-blockers, benzos, methyldopa, isotretinoin
Diabetes and obstructive sleep apnoea
Neoplasms and cancer
Psychiatric differentials of depression
Bipolar
Schizophrenia
Dementia
SAD
Bereavement
Anxiety
Management of low depression
CBT is a first line psychological therapy
Management of moderate to severe depression
Psychological therapy in conjunction with a medication
First line drug for depression
SSRI such as Sertraline
How long should a patient continue on an antidepressant after remission
6 months
What is added if antidepressants do not work
Augmented with lithium
When is ECT recommended
For severe depressive episodes which are life-threatening or require a rapid response
What is the first line antidepressant in children
Fluoxetine
Diagnostic criteria for depression
Depressed mood for nearly every day
Decreased interest or pleasure (anedonia)
Significant weight change or change in appetite
Change in sleep (insomnia or hypersomnia)
Change in acivity
Fatigue
Guilt/worthlessness
Concentration diminished
Suicidality
5/9 features for nearly every day for 2 weeks or longer
What is bipolar affective disorder
Characterised by periods of depression and mania
Aetiology of bipolar
Thought to be genetic components and triggers for episodes
Signs of manic episodes
Elevated mood and irritability, impulsive and dangerous decisions with little thought for consequences. need for sleep often reduced, Pressured speech and exhibit flight of ideas, mood congruent delusions. Psychomotor agitation, easily distracted, elevated self-esteem.
Signs of depressive episodes
Withdrawn and tearful, low mood, poor sleep, anhedonia, suicidal thoughts or attempts
Definition of mania
Distinct period of abnormally and persistently elevated, expansive or irritable mood. Episode must last at least a week.
Definition of hypomania
Episode should not be severe enough to cause marked impairment in social or occupational functionning, or to necessitate hospitalisation, and there are no psychotic features
Management of acute mania with agitation
IM therapy, either a neuroleptic or benzodiazepine
Management of acute mania without agitation
Oral monotherapy can be attempted with an antipsychotic. Sedation and mood stabiliser lithium can be added if necessary
Management of acute depression
Mood stabiliser and/or atypical antipsychotic with appropriate psychosocial support
