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Mental Health > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

What are the core symptoms of depression?

A

Continuous low mood for at least 2 weeks
Lack of energy
Lack of enjoyment/ interest (anhedonia)

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2
Q

What are some somatic symptoms of depression?

A 
Sleep changes - EMW 
Appetite and weight changes 
Diurnal variation of mood (morning worse)
Psychomotor retardation/ agitation 
Loss of libido
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3
Q

Give examples of cognitive symptoms of depression

A 
Low self esteem
Guilt/self blame 
Hopelessness 
Hypochondrical thoughts
Poor concentration 
Suicidal thoughts
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4
Q

When is a symptom counted as significant?

A

If it is sufficiently severe and/ or persistent to be causing significant distress or functional impairment

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5
Q

Mild depression is diagnosed when…

A

2 core and 2 other symptoms present

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6
Q

Moderate depression is diagnosed when…

A

2 core and 3 or 4 others

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7
Q

Severe depression is diagnosed when…

A

3 core and at least 4 others

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8
Q

What percentage of women get postnatal depression (approximately)?

A

10-15%

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9
Q

In post natal depression what thoughts are common?

A

Worries about the baby’s health

Ability to cope adequately with the baby

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10
Q

What are some risk factors for post natal depression?

A 
Personal history of depression 
FH of depression 
Older age of mother
Single mother
Unwanted pregnancy 
Poor social support
Previous PND
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11
Q

What is the lifetime prevalence of depression?

A

10-20%

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12
Q

Where does depression rank in global burden of disease?

A

2nd

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13
Q

What is the ratio of depression in male and females?

A

1:2

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14
Q

For people with mild-mod depression or subthreshold depression what treatment should be offered?

A

Consider psychological intervention - refer or self refer to IAPT, following assessment the following may be offered:
Low intensity psychology interventions
Group based CBT
Addition of group based peer support programme if chronic physical health problem

AVOID routine use of antidepressants
Consider if history of moderate or severe depression
Subthreshold symptoms that have persistent for long period (> 2 years)

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15
Q

What are the symptoms of hypomania?

A

Mildly elevated, expansive or irritable mood
Increased energy/activity
Increased self esteem
Sociability, talkativeness, over familiarity
Increased sex drive
Reduced need for sleep
Difficulty focusing on one task alone

Need several of the above features with considerable interference with work/ social activity for at least several days

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16
Q

What are the symptoms of mania?

A

Elevated/ expansive/ irritable mood (1 week)
Increased energy/ activity
Heightened sense of abilities/ prestige, increased self worth
Pressure of speech reflecting fast thoughts
Flight of ideas/ racing thoughts
Distractible - switching from one activity to another without finishing either
Reduced need for sleep
Increased libido
Social inhibition lost - may include sexual behaviour, often compulsive actions such as gambling, spending lots of money, dangerous driving
Altered perceptions - perceiving colours as brighter and sounds louder
Psychotic symptoms - delusions and hallucinations (usually auditory, second person talking to the patient)

17
Q

What are 2 persistent mood disorders?

A

Cyclothymia

Dysthymia

18
Q

What is cyclothymia?

A

Cyclical mood swings with sub clinical features
Early onset/ chronic course
Common in relatives of BPD

19
Q

What is dysthymia?

A

Chronic low mood not fulfilling the criteria of depression

20
Q

What is mixed affective state?

A

Either a mixture or a rapid alternation (usually within a few hours) of hypomanic, manic and depressive symptoms

21
Q

What is bipolar I ?

A

At least 1 manic or mixed episode with or without depressive episodes

22
Q

What is bipolar II?

A

1 or more depressive episodes with at least 1 hypomanic episode

23
Q

What is the prevalence of bipolar mood disorder?

A

1-2%

24
Q

What is the median age of onset of bipolar disorder?

A

25 years old

25
Q

In bipolar disorder are males or females affected more?

A

Equal

26
Q

What percentage in relation to the normal pop is the suicide rate for bipolar disorder?

A

20 x normal population

27
Q

In bipolar II, what is the approx ratio of depressive to manic episodes?

A

5:1

28
Q

Is bipolar I or bipolar II more common?

A

Bipolar I

29
Q

What factors can precipitate an event in bipolar disorder?

A

Life factors leading to early morning waking can precipitate a manic episode
Positive life events can precipitate mania
Neg life events can precipitate both mania and depression
Pregnancy, CVA, steroids and stimulants can precipitate mania
Thyroid disease, antidepressants, steroids, alcohol, cannabis can cause rapid cycling mood

30
Q

How long should symptoms last for them to be classed as hypomania?

A

> 4 days but generally not as long lasting as a manic episode (which lasts 1-2 weeks or more)

31
Q

Some symptoms of bipolar disorder can increase risk to the patient, what are they?

A

Reckless behaviour
Aggression
Promiscuous sexual behaviour - STIs, pregnancy
Lack of self care - e.g in diabetes
Lack of insight particularly during manic episode

32
Q

What blood tests should be done when considering bipolar disorder? (Ruling out organic causes)

A 
FBC
U&E
TFTs
LFTs 
Urinary screen
33
Q

In an acute manic episode what pharmacological management should be offered?

A

Atypical antipsychotic- haloperidol, olanzapine, risperidone, quetiapine

Second line - valproate, lamotrigine or lithium

34
Q

How should bipolar depression be managed?

A

Offer a psychological intervention

Pharmacological:
Fluoxetine and olanzapine or quetiapine on its own
Or olanzapine on its own or lamotrigine on own

Be careful with antidepressants - can cause rapid cycling of mood

35
Q

What is advised for general maintenance of bipolar disorder?

A

Mood diary
First line - lithium
In cases of manic or depressive episodes first add an atypical antipsychotic and if response poor consider anticonvulsants

36
Q

What is there an increased risk of for women with bipolar disorder?

A

Perinatal psychiatric illness

37
Q

Is lithium teratogenic?

A

Yes, especially in first semester - cardiac abnormalities (Ebstein’s anomaly) , floppy baby syndrome, thyroid abnormalities

38
Q

DIG FAST is an acronym for symptoms of mania. What does it stand for?

A 
Distractibility 
Irresponsibility
Grandiosity 
Flight of ideas
Activity increased
Sleep deficit
Talkativeness

Mental Health (13 decks)

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