Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

brs (phase 1b) > (psych) depression > Flashcards

(psych) depression Flashcards

1
Q

what are the symptoms of depression categorised into?

A

core symptoms
biological symptoms
psychological symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the core symptoms of depression?

A

low mood (mood may be worse in the morning)

anergia (loss of energy)

anhedonia (loss of enjoyment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the biological symptoms of depression?

A

impaired sleep

lack of appetite

low libido

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the psychological symptoms of depression?

A

suicidal thoughts

feelings of guilt and remorse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is a mental state examination?

A

a structured way of observing and describing a patient’s current state of mind using a variety of domains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the components of a mental state examination?

A

appearance and behaviour

speech

mood and affect

thought

perception

cognition

insight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the purpose of a mental state examination?

A

obtains a description of the patient’s mental state, which when combined with the psychiatric history, allows the clinician to make an accurate diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how do you begin a mental state examination?

A

(wash hands and don PPE if required)

introduce yourself (name and role)

confirm patient identity

gain consent = ‘are you happy/alright to talk to me about how you been recently?’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how do you assess appearance in an MSE?

A

distinguishing features (e.g. self-harm)

clothing

personal hygiene

objects

weight

stigmata of disease (e.g. jaundice)

= provides an insight into the patient’s mental state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how do you assess behaviour in an MSE?

A

engagement and rapport

eye contact

facial expressions

body language

psychomotor activity (psychomotor retardation, restlessness)

abnormal movements (tremors, tics, lip smacking)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how do you assess speech in an MSE?

A

rate (slow/pressurised)

quantity (minimal/excessive)

tone (motononous/tremuolous)

volume

fluency and rhythm (stuttering, stammering/slurred)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

define mood

A

represents a patient’s predominant subjective internal state at any one time as described by them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

define affect

A

represents an immediately expressed and observed emotion

i.e. facial expression, overall demeanour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

differentiate between mood and affect

A

mood refers to the predominant internal state of a patient described by them themselves

affect refers to the immediately expressed and observed emotion

= affect is what you observe BUT mood is what the patient tells you

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how do you assess mood in an MSE?

A

ask questions such as:

how are you feeling?
what is your current mood?
have you been feeling low/depressed recently?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how do you assess affect in an MSE?

A

observe a patient’s facial expressions and overall demeanour

assess:
apparent emotion

range/mobility of affect (fixed/restricted/labile)

intensity of affect (heightened/blunted)

congruency of affect (congruent/incongruent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is incongruent affect?

A

when a patient’s affect does not align with the content of their thoughts (i.e. laughing when sharing distressing thoughts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how is thought assessed in an MSE?

A

assessed in three aspects: form, content and possession

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is thought form?

A

the processing and organisation of thoughts

asses:
1) speed of thoughts

2) flow and coherence of thoughts (flight of ideas, thought blocking, tangential/circumstantial thoughts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is thought content?

A

delusions

obsessions

compulsions

overvalued ideas

suicidal/homicidal thoughts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is thought possession?

A

thought insertion
thought withdrawal
thought broadcasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is perception?

A

the interpretation of sensory information to understand the world around us

(abnormalities in perception are a feature of severe mental health conditions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how is perception assessed in an MSE?

A

assess for the presence of:

hallucinations
pseudo-hallucinations
illusions
depersonalisation
derealisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how is cognition assessed in an MSE?

A

assess:

whether they are orientated in time, place and person

attention span and concentration levels

short term memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how can cognition be formally assessed?

A

separate tests (e.g. Addenbrooke’s cognitive exam III, MMSE etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is insight in the context of an MSE?

A

the ability of a patient to understand that they have a mental health problem and that what they’re experiencing is abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how is insight assessed in an MSE?

A

ask questions such as:

do you think you have a problem at the moment?

do you feel you need help with your problem?

what do you think is causing the problem?

28
Q

apart from an MSE, what other information would a clinical like to know about a patient?

A

!!! suicide risk !!!

history of presenting complaint

past psychiatric AND past medical history

family history

drug history (+ allergies and side effects)

social history (substance abuse, lifestyle factors, sexual health)

29
Q

what must you ALWAYS remember to also do when taking a psychiatric history?

A

(sensitively) ask about suicide risk

screening for and and asking about suicide does not increase the risk of attempting it (!!!)

30
Q

what do you want to know in terms of the history of the presenting complaint?

A

1) explore core, biological and psychological symptoms in more detail
2) (ODPARA - non-pain related)

Onset of symptoms (insidous/acute)

Duration of episodes (diurnal?)

Progression of symptoms

Aggravating factors (psychosocial stressors?)

Relieving factors (medication?)

Associated psychiatric disorders (bipolar disorder, schizophrenia, OCD etc)

31
Q

what do you want to know in terms of the past psychiatric history?

A

previous episodes of depression? how were they resolved?

previous conditions

previous treatments

previous admissions under the MHA or informal

collateral history

32
Q

what do you want to know in terms of the past medical history?

A

any existing medical conditions that can cause a mental disturbance via physiological mechanisms

(e.g. hypothyroidism can cause depression)

allergies + side effects to medications

33
Q

what do you want to know in terms of the family history?

A

any mental illness?

who e.g. first degree relative?

what are the family relationships like?

34
Q

what do you want to know in terms of the drug history?

A

any prescribed medication?

any over-the-counter medication?

(if yes, then note name, when, dose, frequency, duration, outcome, side effects, route and form)

35
Q

what do you want to know in terms of the social history?

A

general social situation: living situation, accommodation, who is at home/personal support network, help with ADLs

alcohol use/misuse

recreational drug use

smoking

36
Q

which types of history can also be taken during a full psychiatric history?

A

forensic history = arrests/cautions/MHA admissions/incarcerations etc

AND

collateral history = from a family member or friend or associate to corroborate the information given by the patient

AND

personal history = birth, early life, school, qualifications, employment, psychosexual history, premorbid personality

37
Q

what is a forensic history?

A

history of the patient’s criminal offences i.e. arrests, cautions, incarcerations, probations, MHA admissions etc

38
Q

what is a collateral history?

A

a history taken from a family member, friend or an individual close to the patient

useful when = cannot fully believe the information given by the patient OR when patient has memory loss/impaired cognition

39
Q

what is a personal history and why is it important?

A

history of the patient’s birth, early life, school qualifications, employment, premorbid personality etc

= can help work out triggers/causes of the mental health condition that the patient presents with

40
Q

which risk assessments must be carried out in a full psychiatric history?

A 
risk to self:
current suicide risk
previous suicide attempt(s)
self-harm
self-neglect

risk to others:
thoughts/plans to harm others?

risk from others:
vulnerability to exploitation

41
Q

differentiate between unipolar and bipolar depression

A

unipolar depression = several depressive symptoms (extremely low mood)

bipolar depression = several depressive + also manic symptoms (alternating between periods of extremely low mood with extremely euphoric/irritable mood)

42
Q

how do antidepressants affect unipolar and bipolar depression?

A

antidepressants are linked to an increase in manic/hypomanic episodes in bipolar depression

+ also mostly ineffective in acute bipolar depression compared to unipolar depression

43
Q

what can antidepressant cause in bipolar depression?

A

can cause hypomanic or manic episodes (or more mood episodes)

worsening the long-term course of bipolar depression

44
Q

what are personality disorders (PD)?

A

maladaptivepatterns of behaviour and cognition, deviating from those accepted by the individual’s culture

(develop early + inflexible + associated with significant distress or disability)

45
Q

define paranoid personality disorder

A

pattern of irrational suspicion and mistrust of others, interpreting motivations as malevolent

46
Q

define schizoid personality disorder

A

lack of interest and detachment from social relationships, apathy, and restricted emotional expression

47
Q

define schizotypal personality disorder

A

extreme discomfort interacting socially, and distorted cognition and perceptions

48
Q

define antisocial personality disorder

A

pervasive pattern of disregard for and violation of the rights of others, lack of empathy, bloated self-image, manipulative and impulsive behaviour

49
Q

define borderline personality disorder

A

pervasive pattern of abrupt mood swings, instability in relationships, self-image, identity, behavior andaffect, often leading to self-harm and impulsivity

50
Q

define histrionic personality disorder

A

pervasive pattern ofattention-seekingbehaviour and excessive emotions

51
Q

define narcissistic personality disorder

A

pervasive pattern ofgrandiosity, need for admiration, and a perceived or real lack of empathy

52
Q

define avoidant personality disorder

A

pervasive feelings of social inhibition and inadequacy, extreme sensitivity to negative evaluation

53
Q

define dependent personality disorder

A

pervasive psychological need to be cared for by other people

54
Q

what is obsessive-compulsive personality disorder?

A

rigid conformity to rules, perfectionism, and control to the point of satisfaction and exclusion of leisurely activities and friendships

55
Q

what are the 10 personality disorders listed in DSM-5?

A

cluster A =
paranoid PD
schizoid PD
schizotypal PD

cluster B =
antisocial PD
borderline PD
histrionic PD
narcissistic PD

cluster C =
avoidant PD
dependent PD
obsessive-compulsive PD

56
Q

what does cluster A of personality disorders in DSM-5 incorporate?

A

paranoid personality disorder

schizoid personality disorder

schizotypal personality disorder

57
Q

what does cluster B of personality disorders in DSM-5 incorporate?

A

antisocial personality disorder

borderline personality disorder

histrionic personality disorder

narcissistic personality disorder

58
Q

what does cluster C of personality disorders in DSM-5 incorporate?

A

avoidant personality disorder

dependent personality disorder

obsessive-compulsive personality disorder

59
Q

what is bipolar affective disorder?

A

i.e. manic depression

wide mood alterations with periods of depression and periods of mania

60
Q

compare BPAD (bipolar affective disorder) and schizophrenia

A

both have

  • hallucinations
  • cognitive impairment
  • depression and negative symptoms of schizophrenia (apathy, anergia, social isolation)

but BPAD
= episodic hallucinations and delusions

and schizophrenia
= chronic hallucinations and deluions

61
Q

compare BPAD (bipolar affective disorder) and ADD (attention deficit disorder)

A

both have

  • impaired concentration
  • impaired executive function
  • abnormal working and short term memory

but BPAD
= high heritability, recurrent depressive episodes

62
Q

what is attention deficit disorder?

A

basically ADHD (attention-deficit hyperactivity disorder) but with predominantly inattentive presentation

63
Q

what does bipolar disorder commonly present with?

A

commonly w anxiety disorders OR substance use disorders

64
Q

what are some organic causes of depression?

A

endocrine (hyper/hypothyroidism, hyper/hypoparathyroidism, hypoglycaemia, Cushing’s, Addisons’s)

infections (viral, SLE, HIV)

deficiencies (vvit B12 or folate)

neurological (Alzheimer’s, MS, Parkinson’s)

medications

65
Q

what are some organic causes of depression?

A

endocrine (hyper/hypothyroidism, hyper/hypoparathyroidism, hypoglycaemia, Cushing’s, Addisons’s)

infections (viral, SLE, HIV)

deficiencies (vvit B12 or folate)

neurological (Alzheimer’s, MS, Parkinson’s)

medications (steroids, beta-blockers, opiate painkillers, statins, antibiotics etc)

vascular depression

post-stroke depression

66
Q

what is vascular depression?

A

due to white matter hyperintensities that can impact cognitive function

need to minimise vascular risk factors (diabetes, hypertension, smoking, alcohol)

67
Q

what is post-stroke depression?

A

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

retardation in thinking and behaiour

brs (phase 1b) (71 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions