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Mood Disorders Flashcards

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1
Q

Biological symptoms of depression

A 
Early morning wakening
Symptoms worse in mornings
Loss of appetite and weight loss
Psychomotor retardation 
Loss of libido
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2
Q

Cognitive symptoms

A 
Brain processing functions
Reduced concentration and memory
Poor self esteem 
Guilt
Hopelessness
Suicide or self harm
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3
Q

Psychotic symptoms of depression

A

Delusions-> worthlessness, guilt, ill health
Hallucinations-> mood congruent, defamatory, accusatory
Ahenesis
Mutism

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4
Q

Somatic syndrome

A 
Markedly reduced appetite
Weight loss
Early morning wakening
Diurnal variation
Psychomotor retardation
Loss of libido
Marked ahedonia
Lack of emotional reactivity
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5
Q

Diagnosis of depression

A 
ICD AND 2 of:
Decreased concentration
Decreased self esteem
Guilt
Pessimistic
Disturbed sleep 
Reduced appetite
Self harm/suicide
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6
Q

Mild depression definition

A

> = 4 symptoms

Can maintain normal life

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7
Q

Moderate depression

A

> =5 symptoms

Great difficulty maintaining normal activities

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8
Q

Severe depression

A

> =7 symptoms

Unable to continue normal activity

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9
Q

Differentials of depression, psychiatric disorders

A 
Depressive episode 
Recurrent depressive disorder
Dysthymia
Bipolar
Cyclothmia 
Schizoaffective disorder
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10
Q

Medical differentials of depression

A

Neurological-> MS, Parkinson’s, huntingtons, trauma
Endocrine-> cushings, Addison’s, thyroid, menstrual
Infections-> hepatitis, glange, herpes, HIV, syphilis
Others-> cancer, pain, SLE, RA, vit deficiencies

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11
Q

Prescribed drugs which may causes depression

A 
Antihypertensives
Steroids
L-dopa
Opioids
Anti-psychotics
Interferon
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12
Q

Adjustment reaction

A

Reaction to a stressful event that lasts less than 6 months
Onset within 3 months
Significant impairment
Symptoms don’t persist long after stressor is resolved

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13
Q

Epidemiology of depression

A

M:F 1:2
10-20% life time prevalence
5% major

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14
Q

Prognosis of depression

A

50-60% recoverwithin 1 year
Chronic >2 years 10-25%
25% recurrence 1 year
75% recurrence in 10 years

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15
Q

Investigations of depression

A 
Collateral history 
Mood diary 
Exclude organic causes
Screen for physical aspects of neglect-> anaemia, hyponatremia
Urine dip
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16
Q

Social management of depression

A 
Avoid alcohol and substance use
Eat healthily
Exercise regularly
Good sleep hygiene
Social inclusion
Relationships
17
Q

Psychological management of depression

A 
1st line for mild depression 
Psychoeducation 
Self help materials
CBT
Interpersonal therapy
18
Q

Pharmacological management of depression

A 
Moderate to severe depression 
SSRI's 50% respond
Continue for 6m after resolution 
Lithium for resistant cases
Antipsychotic augmentation
19
Q

ECT indications in depression

A 
Poor response to adequate antidepressants 
Intolerance of antidepressants
Suicidal
Severe psychotic features
Severe self neglect
Previous good response to ECT
20
Q

Symptoms of mania

A 
Decreased need for sleep not associated with fatigue
Increased activity 
Reckless behaviour
Grandiosity 
Poor concentration
Accelerated thinking/pressure of speech
Flight of ideas
Disinhibition 
Increased sexual energy 
Elevated/expansile/irritable 
*mood congruent delusions (hallucinations)
*cirumstantiality and tangentiality
21
Q

Organic causes of mania

A 
Neurological-> brain lesion, huntingtons, MS, temporal lobe epilepsy 
Endocrine-> Cushings, hyperthyroidism, 
Inflammatory-> SLE
Renal failure
Vit b12 deficiency
22
Q

Drugs associate with mania

A 
Anabolic steroids
Anti-depressants
Corticosteroids
Dopamine agents
Amphetamines
Cocaine
Hallucinogens
Legal highs
23
Q

Epidemiology of bipolar

A

1% life time risk
M:F
Average age 21 years

24
Q

Aetiology of bipolar

A 
70% genetic
x 7 increase if first degree relative
Increased risk of depression and schizophrenia 
Substance missuse
Life events 
Interpersonal conflict
25
Q

Prognosis of bipolar

A

90% reoccurrence
8-10 episodes in a life time
Rapid cycling has a worse prognosis
10% suicide

26
Q

Reasons for relapse

A 
Non concordance 
Life events
Psychological stressors 
Circadian rhythm disruption 
Substance misuse 
Child birth
27
Q

Management of acute mania

A 
Biological
-stop antidepressants 
-antipsychotics 1st line
-lithium or valproate 
Psychological
-psychoeducation 
-supportive, calm environment
Social
-education/job
-finances
-housing
-social inclusion
-relationships/carers
28
Q

Management of bipolar depression

A 
Biological
-mood stabilisers
-2nd generation antipsychotics
-(antidepressants)
Psychological
-psychoeducation 
-CBT
Social
-education
-finances
-housing
-social interaction
-relationships
29
Q

Maintenance treatment of bipolar

A 
Treat for at least 2 years 
Biological 
-antipsychotics
-mood stabilers
-contraception
Psychological 
-psychoeducation
-CBT-> concordance and relapse prevention
-family therapy
Social
-education/job
-finances
-housing
-social inclusion
-relationship
30
Q

Core symptoms of depression

A

Depressed mood which varys little from day to day and is unresponsive to circumstances
Markedly reduced interests in usual activities with loss of pleasure
Lack of energy

Psych (23 decks)

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