Mood disorders Flashcards
What are the core symptoms of depression?
- Persistent low mood for at least 2 weeks
- Low energy
- Lack of interest / enjoyment in doing things (Anhedonia)
What are the somatic symptoms of depression?
- Sleep changes
- Early morning wakening
- Hypersomnia
- Appetite & weight changes
- Diurnal variation in mood
- Psychomotor retardation/agitation
- Loss of libido
What are the cognitive symptoms of depression?
- Low self esteem
- Guilt / self blame
- Hopelessness
- Hypochondriacal thoughts
- Poor concentation/attention
- Suicidal thoughts
What is pseudo-dementia?
People with severe depression may present as if they have primary memory problem or cognitive decline.
This is resolved once depression is treated
How is mild depression classified?
2 core symptoms + 2 other symptoms
Retains ability to function
How is moderate depression classified?
2 core + 3/4 others
How is severe depression classified?
3 core symptoms + at least 4 others
Aside from the core, cognitive and somatic symptoms of depression - what symptoms are seen in psychotic depression?
- Hallucinations (typically auditory)
- Delusions
- Hypochondriacal
- Guilt
- Nihilistic
- Persecutory
What thought content is common in post-natal depression?
Worries about baby’s health or that mother is inadequate / can’t cope
What are the risk factors for postnatal depression?
- Personal / Family Hx of depression
- Older mothers
- Single mothers
- Unwanted pregnancy
- Prev postnatal depression
- Socioeconomic deprivation
What are the symptoms of hypomania?
- Mildly elevated / expansive / irritable mood
- Increased energy / activity
- Increased self-esteem
- Sociability, talkativeness, over familiarity
- Increased sex drive
- Reduced need for sleep
- Difficulty on focussing on one task
What are the symptoms of mania?
- Elevated / expansive / irritable mood (1 week)
- Increased activity / energy (inc agitation)
- Grandiosity / increased self-esteem
- Pressure of speech
- Flight of ideas / rapid thoughts
- Distractible
- Reduced need for sleep
- Increased libido
- Socially disinhibited (leading to impaired judgement & potentially exploitation)
- Psychotic symptoms (Hallucinations / Delusions)
What are the 2 persistent mood states?
- Cyclothymia
- Mild elation and depression that doesn’t meet criteria to be diagnosed as BPD. Period of stability in between episodes. Needs to be present for 2 years to make diagnosis. Common in those with BPD relatives.
- Dysthymia
- Chronic low mood, not fulfilling the criteria for depression
What is mixed affective state?
Mixture / rapid alternation (usually few hours) between hypomanic, manic and depressive symptoms.
How is bipolar 1 classified?
At least 1 manic / mixed episode +/- depressive episode(s)
How is bipolar 2 classified?
At least one depressive episode(s) + at least 1 hypomanic episodes
How many episodes are required before a diagnosis of BPD can be reached, according to ICD-10 ?
At least 2 episodes, one of which being manic, hypomanic or mixed
What are the differentials for mood disorders?
- Normal fluctuations in mood
- Adjustment disorders / bereavement
- PTSD
- Dementia & other brain disorders
- Personality disorders
- Anxiety disorders
What are the causes of mood disorders?
Biological
- Genetics
- Brain illnesses (e.g. dementia)
- Physical illness (e.g. chronic illness)
Psychological
- Childhood experiences (e.g. abuse)
- View of yourself (e.g. self-esteem) & world
- Personality traits (e.g. obsessive / dependent)
Social
- Working, housing, finance, etc.
- Relationships, support, etc.
What are the biological treatments of mood disorders?
- Pharmacological (e.g. antidepressants, mood stabilisers, antipsychotics, anxiolytics)
- ECT
- rTMS = Repetitive transmagnetic stimulation
- Electrode placed on brain to stimulate brain with magnetic field.
- tDCS = Transcranial Direct Current Stimulation
What is ECT?
Treatment that involves sending an electric current through the brain to stimulate an epileptic seizure.
What is the indication for ECT?
- Catatonia
- Severe depressive illness that is resistant to treatment
- Life-threatening illness
- Prolonged, severe manic episodes
- High suicide risk
- Stupor / sever psychomotor retardation
What are the psychological treatments of mood disorders?
- Psychoeducation (about illness, medication, relapses)
- CBT
- IPT (Inter person therapy)
- Psychodynamic therapy
- Mindfulness
What are the social treatments of mood disorders?
Targeted interventions:
- Family
- Housing
- Finance
- Employment
- General coping strategies
What suggests poor prognosis in bipolar?
- Severe episodes
- Early onset
- Cognitive deficits
What is the epidemiology of unipolar despressive disorders?
Greater prevalence in:
- Females (F:M = 2:1)
- Urban areas ( > rural areas)
- Low socioeconomic status
- Physical illness (esp. chronic illness)
- 1st degree relatives
