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Psychiatry - Phase II > Mood disorders > Flashcards

Mood disorders Flashcards

1
Q

Give an example of a unipolar mood disorder

A

Depression

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2
Q

What are the 3 core symptoms of Depression?

A

Persistent low mood
Anhedonia
Lack of energy
Need to be present for 2 weeks

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3
Q

What are the cognitive symptoms of Depression?

A 
Unnecessary feelings of guilt/self blame
Decrease in self esteem
Hopelessness
Hypochondriacal thoughts
Poor concentration/attention
Suicidal thoughts/thoughts of self harm
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4
Q

What are the biological symptoms of Depression?

A 
Early morning wakening
Reduced appetite
Weight loss
Psychomotor retardation
Loss of libido
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5
Q

What are the symptoms of Atypical depression?

A 
Variably depressed mood
Overeating
Oversleeping
Extreme fatigue/Heaviness of limbs
Pronounced anxiety
Psychomotor agitation eg restlessness, irritability
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6
Q

According to the ICD-10, what is mild Depression?

A

2 core symptoms + 2 other symptoms.

Patient can function

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7
Q

According to the ICD-10, what is moderate Depression?

A

2 core symptoms + 3/4 other symptoms.

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8
Q

According to the ICD-10, what is severe Depression?

A

3 core symptoms + 4

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9
Q

What psychotic symptoms can occur in Depression?

A

Hallucinations eg auditory

Delusions - guilt, persecutory. Mood congruent/egosyntonic

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10
Q

What is post natal depression?

A

Within 6 months of birth

Worries about babies’ health or ability to cope with new child

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11
Q

What are some of the risk factors for post natal depression?

A 
Personal history of depression or post natal depression
FH of depression
Older age
Single mother
Unwanted pregnancy
Poor social support
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12
Q

What are some of the risk factors for Depression?

A

2-3x increase in physical health conditions

Female

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13
Q

Give an example of a bipolar mood disorder

A

Manic depression/Bipolar disoder

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14
Q

What is Bipolar disorder?

A

Patient alternates between low mood and high mood (Mania, Hypomania). Need 2 episodes for ICD-10 classification
Thought to be due to changes in 5HT/Na in brain

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15
Q

What is Mania?

A 
A very noticeable elevation of mood for minimum of 1 week. Need elevated, expansive + irritable mood plus >3 of;
- Increased energy/agitation
- Grandiosity
- Pressured speech/Flight of ideas
- Decreased need for sleep
- Increased libido
- Increased sociability
- Decreased eating/drinking
Psychotic symptoms
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16
Q

What is Hypomania?

A

> 3 characteristic symptoms for a minimum of 4 days that are not severe enough to interfere with functioning;

  • Mildly elevated, expansive or irritable mood
  • Increased energy/activty
  • Increased self esteem
  • Sociability - over familiarity, talkative
  • Decreased concentration
  • Increased libido
  • Decreased need for sleep
17
Q

What are the differentials for Bipolar disorder?

A

Fluctuations in mood
Adjustment disorders eg stress, bereavement, PTSD
Dementia
Underlying physical illness
Personality disorders eg Emotionally unstable PD - BUT up/down on daily basis
Anxiety disorders

18
Q

What are the predisposing factors for mood disorders?

A

Genetics

Childhood experiences

19
Q

What are the precipitating factors for mood disorders?

A

Life events
Substance use
Iatrogenic

20
Q

What are the perpetuating factors for mood disorders?

A

Difficult relationships
Financial stressors
Substance misuse - alcohol can effect effectiveness of drugs

21
Q

What are the BioPsychoSocial factors for mood disorders?

A

Bio - Genetics, Brain/Physical illness
Psycho - Thinking/Personality traits, Childhood experiences, View of self/word
Social - Work, Housing, Finances, Relationships, Support

22
Q

What is the treatment for Bipolar disorder?

A
  • Mood stabilisers eg Lithium, Sodium valproate, Lamotrigine, Carbamazepine
  • Antipsychotics eg Olanzipine, Quetiapine (Used most as has mood stabilising effects too)
  • AVOID ANTIDEPRESSANTS - can precipitate mania. Use Anxiolytics instead eg Benzodiazepine
  • Psychoeducation, CBT, IPT
  • Housing, Family/financial help, General coping mechanisms
23
Q

What is the treatment for Depression?

A

SSRIs eg Cialopram, SNRIs eg Duloxetine, TCAs eg Amitryptilline, NASSA eg Mirtazepine, MAOi, SARIs eg Trazidone
ECT

24
Q

What are the ADRs of NASSAs? (Noradrenaline, Selective Serotenergic Antidepressant)

A 
*Mirtazepine*
Constipation
Dry mouth
Increased appetite
Somnolence
Weight gain
May cause dizziness/weakness
25
Q

What are the ADRs of SARIs? (Serotonin antagonist + reuptake inhibitor)

A

Trazodone
Sedation
QT prolongation/arrhythmias

26
Q

How long do patients with depression need to be on antidepressants?

A

If first episode - 6 months
If multiple episodes - 2 years
80% will have a further episode
10% will have severe unremitting depression

27
Q

What predicts poor prognosis in Bipolar disorder?

A

Severe episodes
Early onset
Cognitive deficits
80% relapse after 1st episode within 5-7 years, aim to prevent relapses

Psychiatry - Phase II (16 decks)

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