Mood disorders Flashcards
How do you classify primary and secondary mood disorders
Primary:
Unipolar - depressive disorders, dysthymia
Bipolar - bipolar affective disorder 1 or 2, cyclothymia
Secondary:
Physical e.g hypothyroidism and anaemia
Psychiatric e.g personality disorder
Drug induced e.g corticosteroids
Core symptoms of depression
Chronic low mood (>2 weeks)
Anhedonia
Lack of energy
What are the cognitive symptoms of depression
Becks triad: negative views of oneself, the world and the future
Lack of concentration
Excessive guilt and feelings of worthlessness
Suicidal ideation
What are the biological symptoms of depression
Early morning wakening Diurnal variation in mood Loss of libido Reduced appetite and weight loss Psychomotor retardation
ICD classification of depression severity
Mild: 2 core + 2 other
Moderate: 2 core + 3-4 others
Severe: 3 core + >4 others
Psychotic: severe depression + psychosis
Diagnostic questionnaires for depression and anxiety
PHQ-9 for depression
GAD-7 for anxiety
Management of mild to moderate depression
BIOPSYCHOSOCIAL MODEL
Exercise, self help programmes, CBT, support groups, antidepressants
Management of severe depression
Psychiatry referral Mental health act may need to be implemented Antidepressants Psychotherapy e.g CBT Social support
Criteria for electroconvulsive therapy
Severe depression which is: Life threatening Rapid response needed Severe psychomotor retardation Psychosis Failure of other treatments
Symptoms of mania
I DIG FASTER irritability Disinhibition Increased libido Grandiose delusions Flight of ideas Activity increased Sleep decreased Talkative (pressure of speech) Elevated mood Reduced concentration
ICD classification of severity of manic mood disorders
Hypomania:
Mildly elevated mood for at least 4 days, no severe disruption with work and social life, partial insight
Mania:
Manic symptoms for >1 week, severe disruption with work and social life
Mania with psychosis:
Severely elevated mood, delusions and hallucinations which are mood congruent
Bipolar 1 vs 2
1 - severe mood episodes, at least 1 manic/mixed with or without at least 1 depressive
2 - milder mood episodes, hypomania AND periods of depression
ICD 10 criteria for diagnosis of mania and bipolar affective disorder
Mania: at least 3 manic symptoms
Bipolar affective disorder: at least 2 mood episodes. One must be mania or hypomania.
Management of bipolar affective disorder
BIOPSYCHOSOCIAL MODEL
CBT Support groups Mood stabilisers Alert DVLA Mental health act may need implementation
Pharmacological management of bipolar affective disorder
1st line: atypical antipsychotics e.g quetiapine
2nd line: mood stabiliser e.g lithium, valproate, lamotrigine
