Mood Disorders Flashcards
Give an overview of the different mood disorders?
Dysthymia (low mood but not as severe as depression typically lasts a long time 2 years, can then have a depressive episode aka a double depression)
Depressive episode. (minor, moderate, severe, severe wit psychosis)
Recurrent Depression.
Cyclothymia (mood swings)
Bipolar affective disorder: periods of depression and mania.
Bipolar 1 = mania and depression
Bipolar 2 = mostly depressive episodes and hypomania more difficult to treat.
Describe the core symptoms of depression?
Low mood
Anhedonia
Anergia
Describe the biological and other cognitive/thought symptoms of depression?
Cognitive/thought:
Feelings of low self esteem, guilt and worthlessness Thoughts of suicide
Difficulty concentrating
Biological:
Diurnal mood variation
Early morning waking (2hrs earlier than normal)
Weight changes (usually loss)
Loss of libido
Psychomotor retardation/agitation
Reduced affect
Describe the extra symptoms in psychotic depression?
Delusions:
Mood congruent
Worthlessness /guilt / ill health / poverty / imminent disaster
Nihilistic delusions (Cotard’s syndrome) belief they are dead, dying
May have persecutory delusions
Hallucinations
2nd person auditory - defamatory/accusatory
Olfactory - filth/rotting/decomposing flesh
Describe the symptoms of hypomania?
Mild elevation of mood or irritability Increased energy
Mild overspending or risk taking
Sociability or over familiarity
Increased sexual energy
Decreased need for sleep
Describe the symptoms of mania?
Elevated mood and irritability, Increased energy, Reduced need for sleep
Overspending, Reckless behaviour, Sexual promiscuity, Social Inhibition
Distractable
Grandiose ideas
Flight of ideas
May also have psychosis
Describe the sorts of psychosis patients with mania may suffer from?
Delusions:
Often mood congruent
Inflated self-esteem and ideation may develop into fully formed grandiose delusions
Irritability and suspiciousness may become delusions of persecution
Hallucinations:
Not as common; often 2nd person hallucinations
Mood congruent
What is an important differential to consider when you believe someone is in low mood?
Adjustment reaction to a life event.
Usually occurs within 3 months of the event and last less than 6 months.
However it is worth noting a patient may have a life event which then triggers a depressive episode.
Describe the barriers which may prevent patients with depression or mania from presenting to a health care professional?
Depression:
May not think they are actually ill.
Stigma regarding seeking help feel it makes them weak. Poor rapport with Dr.
Apathy, (don’t think it’ll help)
Co-morbid mental health (anxiety, PD) Alcohol or substance abuse.
Mania: Lack of insight. They enjoy the way they’re feeling Medical staff may be involved in their delusion
Describe the epidemiology of depression, which gender it affects more, lifetime prevalence, prevalence of major depression, % referred to psychiatry and % admitted.
1:2 M:F
Lifetime prevalence of depressive symptoms: 10-20%
Current prevalence of major depression 5% 10% of whom are seen by psychiatry and 0.1% of whom are admitted.
Describe the Bio-psycho-social aetiology of Depression?
Describe the prognosis of depression?
50-60% recover within a year
10-25% have chronic depression more than 2 years
Recurrence:
1 year later - 25% will have had another episode
10 years later - 75% will have had another episode
Suicide 5-15%
Describe the epidemiology of Bipolar disease?
M:F equal prevalence
1% prevalence
Average age of onset 21yo
Describe the aetiology?
Biological:
Genetics ~70%
Substance misuse
Social:
Adverse life events
More prevalent in urban areas
Interpersonal conflicts
Describe the prognosis of Bipolar?
Average patient will have 8-10 episodes in their lifetime. May be more or less.
Following a manic episode 90% of patients will have a further episode.
Manic epidsodes tend to follow depressive episodes.
30% will have residual symptoms in between episodes.
10% will commit suicide.
