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Psychiatry > Mood disorders > Flashcards

Mood disorders Flashcards

1
Q

What are the cardinal Sx of depression?

A
  1. Low mood
  2. Anhedonia
  3. Decreased energy
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2
Q

What is dysthymia?

A

Long-standing depression of mood, but do not satisfy the Dx criteria for recurrent depressive disorder

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3
Q

What are the management steps of treating depression with a pharmacological agent?

A

1st line = SSRI
2nd = different SSRI, SNRI, NaSSA
3rd = venlafaxine, mirtazapine, TCA
4th = augmentation, with Li, atypical antipsychotic or mirtazapine

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4
Q

What are the S/Es of SSRI?

A
  1. GI upset (first week)
  2. Sweating
  3. Insomnia
  4. Agitation
  5. Weight gain
  6. ED/anorgasmia
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5
Q

What are the features of serotonin syndrome?

A
  1. Confusion/delirium
  2. Shivering and/or sweating
  3. BP fluctuation
  4. Myoclonus
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6
Q

What are the features of discontinuation syndrome re:SSRIs?

A
  1. Flu-like symptoms
  2. Sleep disturbance
  3. Sensory and movement disturbance – imbalance, tremors, vertigo and electric-shock-like experiences in the brain, often described by sufferers as “brain zaps”.
  4. Mood disturbances
  5. Cognitive disturbances
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7
Q

In whom might ECT be indicated?

A
  1. Severe depression
  2. Prolonged or severe episodes of mania
  3. Catatonia
  4. Moderate depression that is refractory to all other treatments
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8
Q

What are the S/Es of ECT?

A
  1. Headache
  2. Memory impairment
  3. Mortality - 1 in 22000 (lower than antidepressants)
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9
Q

What are the sociodemographic RFs associated with completed suicide?

A
  1. Male
  2. Elderly
  3. Single/divorced/widowed
  4. Living alone/poor social support
  5. Unemployed/low socioeconomic status
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10
Q

What is bipolar affective disorder?

A

Characterised by recurrent episodes of altered mood and activity, involving both upward and downward swings in mood

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11
Q

What is cyclothymia?

A

Chronic mood fluctuations over AT LEAST 2 years, with episodes of both depression and hypomania (certainly not mania) of insufficient severity to meet diagnostic criteria

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12
Q

What are the Sx of mania?

A
  1. Increased psychomotor activity/energy
  2. Elevated mood
  3. Self-important ideas – grandiosity/inflated self-esteem
  4. Decreased social inhibition resulting in – patient may be overly-familiar/amorous or be sexually over-active
  5. Reckless behavior – e.g. gambling, shopping-sprees
  6. Reduced attention or easily distractible
  7. Irritability/aggression/suspiciousness
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13
Q

What are the psychotic elements of mania?

A
  1. Grandiose delusions – e.g. patient can talk to God, or has super-powers
  2. Persecutory delusions (developing from suspiciousness)
  3. Incomprehensible speech (developing from pressured speech)
  4. Violence
  5. Self-neglect (due to preoccupation with racing thoughts)
  6. Loss of insight
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14
Q

What are the Sx of PTSD?

A 
F = flashbacks
R = reminders – smell, hear, see
A = avoidance
N = numbness
C = concentrating difficulty
I = irritable
S = sleep difficulty
E = 'edgy', i.e. hypervigilance + exaggerated startle response
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15
Q

How may PTSD be managed?

A

EMDR - eye movement desensitisation and re-processing

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16
Q

Panic disorder Dx requires what?

A

> /=3 panic attacks over 3 weeks

17
Q

What drugs may be used to reduce autonomic arousal in ‘specific’ social phobia, e.g. performance anxiety?

A

Beta-blockers - e.g. atenolol

18
Q

What are the 5 sub-types of specific phobia?

A

1) Animal
2) Aspects of natural environment
3) Blood, injection, injury
4) Situational
5) ‘Other’

19
Q

How may specific phobias be managed?

A
  1. Exposure techniques (treatment of choice) – graded exposure and/or virtual reality exposure
  2. Flooding
  3. Coping strategies
  4. Cognitive restructuring
20
Q

What factors might increased Li levels?

A
  1. NSAIDs
  2. Diuretics
  3. Dehydration
  4. Low sodium
21
Q

What are the S/Es of Li?

A
  1. Impaired renal function
  2. Hypothyroidism
  3. Teratogenicity
  4. Cardiac conduction problems
  5. Dose-related effects - e.g. weight gain, polar/polydipsia, cognitive problems
22
Q

How often does hypothyroidism occur in Li treatment?

A

Appears after 6-18 months of treatment and occurs in 1 in 20 women who have been taking Li for 5 years

23
Q

What is the teratogenic effects of Li?

A

Ebstein’s anomaly

24
Q

What are the signs of Li toxicity?

A
  1. D&V
  2. Coarse tremor
  3. Ataxia
  4. Slurring of speech
  5. UMN signs
  6. Seizures
  7. Death

Psychiatry (10 decks)

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