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psychiatry > mood disorders > Flashcards

mood disorders Flashcards

1
Q

what %of mood disorders start before 30

A

50%

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2
Q

what % of mental disorders start before 14

A

50%

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3
Q

how long do depressive episodes have to occur for before meeting depression criteria

A

2 weeks

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4
Q

what are the 3 core features of depression

A
  1. Depressed mood -
  2. loss of interest or pleasure - anhedonia
  3. decreased energy -anergia
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5
Q

how many core symptoms must be present ?

A

2 core and 4 additional

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6
Q

what are examples of additional depressive symptoms

A

loss of confidence, guilt, suicidal, concentration trouble, agitation, sleep disturbance, appetite changes

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7
Q

how many core and additional features must be present to class as moderate depression

A

2 core and 4 others

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8
Q

how many core and additional features must be present to class as severe depressive episodes

A

3 core and 5 others

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9
Q

what is psychotic depression

A

sub type of depression , occassionally paranoid adn typically mood- congruent eg people put to get me , ive got cancer

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10
Q

what syndrome is an example of psychotic depression

A

cottards syndrome

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11
Q

what type of bipolar is more common 1 or 2

A

Bipolar 2

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12
Q

what is bipolar 1

A

met criteria for mania and depression

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13
Q

what is bipolar 2

A

hypomanis and depression

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14
Q

what is bipolar 3

A

hypomanic episodes occur following use of anti-depressants following depression

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15
Q

how long must mood elevation be sustained to class as hypomania

A

4 days

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16
Q

how long must elevated mood be sustained in order to class as mania

A

1 week

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17
Q

when does bipolar affective disorder usually present

A

late teens-early 20s

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18
Q

whats commoner depression or mania in BPAD

A

depression

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19
Q

what mental illness has the highest lifetime suicide risk

A

BPAD 4-8%

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20
Q

in terms of hydro and lipo philic/phobic what kinds cross the BBB

A

hydrophobic and liophilic

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21
Q

what are monoamine neurotransmitters

A

serotonin, noradrenaline dopamine

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22
Q

are monoamines increased or decreased in depression

A

decreased

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23
Q

what are serotonin and noradrenaline oxidised by

A

monoamine oxidase

24
Q

what nuclei do serotonergic pathways extend from

A

raphe nuclei

25
Q

what part of the midbrain is the orgin of most noradrenaline pathways in the brain

A

locus coerulus

26
Q

give example of monoamine oxidase inhibitors

A

Phenelzine- irreversible

Moclobemide - reversible

27
Q

what are side effects of MAO’s

A

cheese reaction - ingestion of foods with high tyramine. tyramine oxidised by monoamine oxidase so MAO’s can lead to hypertensive crisis as tyramine raises BP

insomnia
postural hypo
peripheral oedema

28
Q

TCA drug class?

A

monoamine reuptake inhibitors

5-HT and noradrenaline receptors

29
Q

examples of TCAS

A

imipramine, dosulepin, amitriptyline, lofepramine

30
Q

side effects of TCA

A

Anti- cholinergic - blurred vision, dry mouth, constipation, urinary retention
weight gain
sedation
CV- postural hypo, tachy, arrhythmias

31
Q

examples of SSRI’s

A

fluoxetine, citalopram, escitalopram , sertraline , paroxetine

32
Q

side effects of SSRI’s

A

nausea, headache, worsening anxiety, transient increase in self harm( if under 25), sweating, vivid dreams, sexual dysfunction, hyponatreamia in elderly

33
Q

examples of SNRI’s

A

duloxetine, venlafaxine

34
Q

examples of atypical anti-depressants

A

mirtazapine

35
Q

side effects of mirtazepine

A

weight gain and sedation

36
Q

in cases of SSRI side effects what should be added on to block side effects

A

Mirtazapine

37
Q

first line treatment in bipolar

A

lithium- given as lithium carbonate

38
Q

how long after giving first dose of lithium must bloods be taken

A

12 hours

39
Q

target range for lithium

A

0.4-1 mol/l

40
Q

side effects of lithium

A 
strange taste/dry mouth 
polydipsia/polyuria 
tremor
hypothyroid 
nephrotoxic 
weight gain
41
Q

symptoms of lithium toxicity

A

D&V ataxia/tremour, drowsiness, convulsions, coma

42
Q

why would dehydration cause lithium toxicity

A

lithium and sodium indistinguishable to kidneys therefore sodium reabsorption in dehydration causes lithium reabsorption

43
Q

what anti-convulsants can be used as mood stabilisers

A

sodium valproate, lamotrigene and carbamazepine

44
Q

side effects of lamotrigene

A

stevens johnson syndrome

45
Q

side effects of valproate and carbamzepine

A

drowsy ataxia CV effects , induces liver enzymes ana Na Valproate is tetrogenic

46
Q

2nd line in BPAD

A

anti convulsant or anti psychotic

47
Q

anti-psychotic drug class

A

dopamine and serotonin antag

48
Q

side effects of anti psychotics

A

wgt gain , sedation , metabolic syndrome

49
Q

examples of anti psychotics

A

quetiapine, olanzapine, aripiprazol, rispiridone and lurasidone

50
Q

how long after starting an anti-depressant should you review someone

A

1-2 weeks

51
Q

if someones had one depressive episode how long should they be on anti-depressants for

A

min 6 months without reducing dose

52
Q

if someones had 2 or more depressive episodes how long should they be on anti-depressants before reducing dose

A

1-2 years

53
Q

first line treatment in acute mania of bpad

A

anti psychotic

54
Q

first line treatment of acute depression in bpad

A

anti psychotic

55
Q

What should be monitored in a patient on lithium and how often

A

Li, U &E, ECG, TFTS, Ca (renal and cardio toxic )

monitored frequently to begin with and then 3-6 months later on

56
Q

if someone treated with ECT how often is it delivered and for how may times

A

delivered 2x weekly and 6-12 treatments

psychiatry (11 decks)

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