mood disorders tutorial

Question 1

What are the core symptoms of depression

Answer 1

anhedonia
anergia
low mood

Question 2

how do we organise important depression sympotms?

Answer 2

in triads, there is biological sympotm triad: libido, apetite, sleep

core symptom triad —

cognitive sympotm triad- thoughts on oneself, the future and the world

Question 3

what duration do the symptoms need to have for depression?

Answer 3

at least two weeks with most days during these times having the symptoms

Question 4

what are the main aspects of psych history

Answer 4

1) history of presenting complaint,
2) past psych history,
3) medical history to treat these things,
unique 4) substance misuse history,
unique 5) forensic history,
6) family history,
unique 7) personal history, -growing up ect.

Question 5

questions for presenting complaint, what is the difference with past psych history qs

Answer 5

all questions relevant to p.c. even if they touch on subject of other conditions it will be only if the other conditions are relevant to the p.c./ its about the present moment vs in past psych hist- you ask about OTHER psych conditions they have or other episodes.- PAST

onset - acute or insidious (gradual)
duration
diurnal variation

Suicidal ideation/plans/intent
Thoughts/acts of self-harm

Exacerbating and relieving factors: are they taking medication and is it helping? Psychosocial stressors/support?

Relevant physical health conditions: e.g. hypothyroidism, anaemia, Cushing’s, chronic pain (may be CAUSING or DRIVING depression)

Question 6

in what history section do you consider collateral history?

Answer 6

past psych history

Question 7

types of qs in past psych hist— for more like this go to ppt bc its copy paste

Answer 7

Previous episodes? How long did they last?
Did previous episode(s) resolve with or without treatment?
History of any other mental illness? – Important to rule out manic episodes
Previous admissions? (informal versus under the mental health act)
Collateral history (important if patient is being guarded/poor historian)
Medical notes if available
Previous self-harm or suicide attempts

Question 8

what does a risk assessment assess?

Answer 8

harm to self, others or from others (if they are particularly vulnerable bc of their psych diagnosis)

Question 9

how to distinguish between BPD (borderline personality disorder) and BPAD (bipolar affective disorder

Answer 9

BPAD mood changes over days/ weeks rather than BPD: hours/ days

BPAD - grandiosity VS BPD- feelings of emptiness, low self esteem, fear of abandonment, Hx self harm

BPAD- MORE HERITABILITY

environment influence: BAPD less affected by env + BPD Hx of trauma/ disrupted attachment

Question 10

what are common things between BPAD BPD

Answer 10

Suicidality
rapid mood changes
unstable interpersonal relationships
impulsive sexual relationships

Question 11

commmon between BPAD and schitzoaffective disorder

Answer 11

both can present with changes in mood symptoms and psychosis

Question 12

what are the differences between schitzoaffective disorder and BPAD

Answer 12

with schizoaffective disorder theres more 1) disorganisation of thought,
2) paranoid delusional beliefs and
3) a) auditory hallucnations, also
b) episodic hallucinations are more likely to be a long term/ residual symptom

Question 13

common points between BPAD and ADHD

Answer 13

hyperactivity
impulsivity
impaired concentration
impaired executive function
abnormal working and short term memory

Question 14

what are the unique features of BPAD that distinguish it from ADHD

Answer 14

not necessarily present in childhood
episodic
family history more relevant cz&raquo_space;> heritability
reccurrent depressive episodes
amphetamines worsen mania

Question 15

what is a type of differentials we should always consider for patients presenting with mood disorder symptoms?

Answer 15

organic/ iatrogenic causes

Question 16

organic causes categories to think about when mood disorder symptoms

Answer 16

endocrine
systemic
deficiencies
neurological (++ poststroke depression)
++
vascular depression

Question 17

what are some endocrine causes

Answer 17

hyper hypothyroidism and parathyroidism
hypoglycaemia
cushings and addisons )hyper and hypoadrenals)

Question 18

what are some systemic causes and why do systemic causes cause depression

Answer 18

infection, systemic lupus erythematosus, HIV infection, cancers, Cytokines manifested in systemic diseases are considered to be a cause of depression]

Question 19

what are some deficiencies that can cause mood disorders

Answer 19

b12, folic acid

Question 20

neurological causes of mood disorders

Answer 20

MS alzheimers, parkinsons

Question 21

iatrogenic causes of miid disorders

Answer 21

beta blockers, steroids, anti- Parkinsons, some antibiotics (eg ciprofloxacin) statins, oestrogen, opiates, acne meds

Question 22

what is another name for vascular depression

Answer 22

subcortical ischaemic depression

Question 23

what abnormal FINDING is vascular depression associated with and why does that process increase risk to mood disorders

Answer 23

white matter hyperintensities, because they impact on cognitive function making the individual more vulnerable to stressors

(CHAT GPT) White matter hyperintensities (WMHs) are areas of abnormal signal intensity seen on magnetic resonance imaging (MRI) scans of the brain

Question 24

what risk factors should be adressed in vascular depression

Answer 24

smoking and alchohol

Question 25

what is the presentation (roughly) of poststroke depression

Answer 25

retardation in thinking and behaviour is prominent

Question 26

damage to which brain regions during stroke are responsible for post stroke depression and what is the location/ severity trend

Answer 26

lesions in the left frontal lobe or basal ganglia are apt to cause depression

with the tendency that the more frontal the lesion the more severe the symptoms