PSYCH 1 Flashcards
risk factors for depression core symptoms of depression minor symptoms of depression dx of mild depression episode dx of mod deposition episode dx of severe dep
FH, head injury, physical illness, unemployed, poverty, history of depression/suicide, other mental health conditions
depression for two weeks, loss of interest/pleasure, decreased energy/increased fatigue
loss of confidence/self esteem, self reproach/guilt, suicide/death thoughts, decreased concentration, sleep change, appetite change, psychomotor agitation/depression
two core and two minor
2 core and 3/4 minor
3 core and 5 or more minor
treatment for mild
treatment for mod/severe
pharmacology treatment
info and support follow up in 2 weeks
pharma and high intensity psychotherapy
SSRI usually citalopram
trial for 6 weeks unless SE
wait 1 week before switching to alternative with fluoxetine as it has a long half life
DEP TREATMENT
increased agitation/suicial ideation in <18 with SSRIs
resistant or recurrent depression
dep and obesity
dep and sexual dysf
how long should patient be kept on drug
when should they be reviewed and what happens next
Fluoextein
Phenalzine
fluoxetine
Mitaziepine/bupropion
keep patient on drug for 6m. review. at least 2 years if risk of relapse
diagnosis of somatic depression 4 of
treatment
marked loss of interest/pleasure in previous enjoyable activities
lack of emotional reactions in events/activities
depression worse in morning
psychomotor agitation/retardation
loss of apetite
weight loss 5% or more in the past month
loss of libido
ECT. pharma
atypical depression diagnosis
associated with what
treatment
low mood but reactive and 2 or more of : significant weight gain/increased apetite hypersomnia leaden paralysis oversensitivity to perceived paralysis
assoc w anxiety
MAOI - phenalzine
pyshocitc depression symptoms
treatment
hypochondriac: people are out to kill me i’m being poisoned for my sins, i’ve got cancer but i deserve it
carter syndrome - believe they are dead
nihilistic- I’m dead the world around me does not exist
ECT
post stroke depression
1/3 patients
commonest neuropsych complication of stroke
post MI
62% have depression symptoms
15–2% have major depression
BPD in who if over the age of 60 type 1 type 1 cormobidity
late teens/early 20s. FH
underlying structural cause
recurrent episodes or mood disturbance with at least 1 being mania 1%.
commonest
hypomania (without mania)
anxiety, alcohol/drug misuse, personality disorder, eating disorder, schiz
acute manic treatment BPD
oral antipsychotic/valproate
lithium if non immediate
Bad for sedation if required
acute depression treatment BPD
SSRI and lithium/val/antipsychotic
avoid in rapid cycling
long term treatment for BPD
if hypomania present
if mania present
- lithium. 2. valproate
olanzapine/quetipine
psychotherapy for depressive sympt
routine referral to CMHT
urgent referral
hypomanic episode time period
what other features
mood elevated or irritable to a degree that is abnormal for the patient and sustained for for 4 consecutive days increased activity/physical restlessness increased talk increased sexual bhav decreased concentration increased sleep overfamiliarity mild spending sprees and reckless behaviour
manic episode time period
other symptoms
elevated for 7 days increased activity increased talktativeness flights of ideas inappropriate behaviour grandiosity distractibility reckless behaviour marked sexual activity/ sexual indiscretions inflated self esteem
BPD episode with psychotic symptoms
grandiose, self referential, erotic, persecutory content
