Mood Disorders Flashcards
What are the core symptoms of depression?
Continuous low mood for at least 2 weeks
Lack of energy
Anhedonia
Define anhedonia
Lack of enjoyment/interest from anything
What are some somatic symptoms of depression?
Sleep changes
Appetite and weight changes
Diurnal variation of mood
Psychomotor retardation/agitation
Loss of libido
What are some cognitive symptoms of depression?
Low self-esteem
Guilt/self blame
Hopelessness
Hypochondriacal thoughts
Poor concentration
Suicidal thoughts
To diagnose mild depression what symptoms are required?
2 core symptoms + 2 others
Patient is still able to function
To diagnose moderate depression what symptoms are required?
2 core + 3 (or 4) other symptoms
To diagnose severe depression what symptoms are required?
3 core + at least 4 others
What symptoms can sometimes accompany severe depression?
Psychotic symptoms
What psychotic symptoms can accompany depression?
Hallucinations (often auditory)
Delusions
What types of delusions can occur in psychotic depression?
Hypochondriacal
Guilt
Nihilistic
Persecutory
What type of depression often occurs after pregnancy?
Post-natal depression
What percentage of women suffer with post-natal depression after giving birth?
10-15%
Within what time frame do women who have given birth typically suffer from post-natal depression?
Typically within 1-2 months (can be later)
What thought content is often seen in women with post-natal depression?
Worries about the babies health
Worries about their ability to cope with the baby
What are some risk factors for post-natal depression?
Personal or family history of depression
Older age
Single mother
Unwanted pregnancy
Poor social support
Previous post-natal depression
What is the prevalence of depression?
10-20%
In what group of people encountered in health care is depression typically more common in?
2-3 times more common in people with chronic physical health conditions
What moods does bipolar disorder consist of?
Periods of:
Depression
Mania/hypomania
What was bipolar disorder previously known as?
Manic depression
What is hypomania/mania?
Elevated, expansive or irritable mood.
More extreme in mania, more mild in hypomania
When is an elevated mood classed as hypomania?
When several of a number of symptoms/features cause considerable interference with work/social activity for at least several days
What features can be seen in someone with hypomania?
Mildly elevated, expansive or irritable mood
Increased energy/activity
Increased self-esteem
Sociability, talkativeness, over familiarity
Increased sex drive
Reduced need for sleep
Difficulty in focusing on one task alone
What are some symptoms of mania?
Elevated/expansive/irritable mood (at least 1 week)
Increased energy/activity
Grandiosity/increased self-esteem
Pressure of speech
Flight of ideas/racing thoughts
Distractible
Reduced need for sleep
Increased libido
Social inhibitions lost
Psychotic symptoms
What are two types of persistent mood disorders?
Cyclothymia
Dysthymia
What is cyclothymia?
Mood changes between mild depression and hypomania cyclically
When does cyclothymia usually start?
Has an early onset
Who is cyclothymia common in?
Relatives of people with bipolar disorder
What is dysthymia?
Chronic low mood not fulfilling the criteria of depression
What is mixed affective state?
A mixture or rapid (usually within a few hours) of hypomanic, main and depressive symptoms
How does the ICD 10 classify bipolar disorder?
At least 2 episodes, one of which must be hypomanic, manic or a mixed episode
What is the median age of onset of bipolar disorder?
25 years
What is the suicide rate in people suffering from bipolar disorder?
20x normal population
What are some differential diagnoses for mood disorders?
Normal fluctuations in mood
Adjustment disorders/bereavement
PTSD
Dementia
Personality disorders
Anxiety disorders
What types of causes can cause mood disorders?
Biological
Psychological
Social
What biological causes are there for mood disorders?
Genetic
Brain illnesses
Physical illnesses
What psychological causes are there for mood disorders?
Childhood experiences
View of yourself and the world
Personality traits
What social causes are there for mood disorders?
Work
Housing
Finance
Relationships
Support (or lack of)
What are some biological treatments for the mood disorders?
Pharmacological treatments
ECT
What pharmacological treatments are available to treat depression?
Antidepressants
Mood stabilisers
Antipsychotics
Anxiolytics
What is the monoamine hypothesis of depression?
That neurotransmitter changes are responsible for depression, in particular nor-adrenaline and serotonin
What are some classes of antidepressants?
SSRI’s
SNRI’s
TCA’s
NASSA’s
MAOI’s
What are some mood stabilisers?
Lithium
Valproate
Carbamazepine
Lamotrigine
What is ECT?
A treatment involving sending an electric current through the brain to trigger an epileptic seizure
What are the indications for ECT?
Severe depressive illness where other treatments have not been effective
Life threatening illness (not eating/drinking)
Prolonged and severe manic episode
Catatonia
High suicide risk
Stupor
Severe psychomotor retardation
What drugs are indicated in bipolar disorder?
Mood stabilisers
Antipsychotics
What should be avoided in bipolar disorder?
Use of anti-depressants
What psychological treatments can be used treat mood disorders?
Psychoeducation
CBT
IPT
Psychodynamic
Mindfulness
What can be targeted by social interventions for mood disorder?
Family
Housing
Finance
Employment
General coping strategies
What suggests a poor prognosis in bipolar disorder?
Severe episodes
Early onset
Cognitive deficits
When is treatment more effective in bipolar disorder?
Earlier in the illness course
What percentage of bipolar patients relapse within 5-7 years?
80%
