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3rd year > Psych - mood, anxiety and eating disorders > Flashcards

Psych - mood, anxiety and eating disorders Flashcards

1
Q

what is the criteria for depression

A

last >2 wks
no hypomanic or manic symptoms
interfere with normal function

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2
Q

what are the symptoms of depression? how many must you have?

A

2 of:
Depressed mood to an abnormal degree present for most of the day, every day >2 weeks
Loss of interest/pleasure in activities
Decreased energy or increased fatigability

at least 4 of:
loss of confidence or self esteem
unreasonable feelings of self-reproach or excessive and unreasonable guilt
recurrent thoughts of death or suicide, or any suicidal behaviour
complaints or evidence of diminished ability to think or concentrate
sleep disturbance of any type
change in appetite with corresponding weight change

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3
Q

what are the symptoms of atypical depression

A

mood reactivity
2 or more of:

 significant weight gain or increase in appetite
 hypersomnia
 leaden paralysis = heavy, leaden feelings in arms or legs
 long-standing pattern of interpersonal rejection sensitivity (that results in significant social or occupational impairment

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4
Q

what are the symptoms of psychotic depression

A

occasionally paranoid, hypochondriacal, or ‘mood-congruent’

cotard’s syndrome = extreme nihilistic delusions

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5
Q

what is classed as moderate depression

A

2 core symptoms + 4 additional

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6
Q

what is classed as severe depression

A

all 3 core symptoms + 5 additional

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7
Q

what is the treatment of mild depression

A

CBT

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8
Q

what is the medical treatment of the 1st episode of depression

A

continue antidepressants for 6 months after full recovery

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9
Q

what is the medical treatment of the <1st episode of depression

A

continue antidepressants for 1-2 yrs after full recovery

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10
Q

what is bipolar disorder

A

2 or more episodes in which the patient’s mood and activity levels are significantly disturbed

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11
Q

what are the types of bipolar

A 
I = mania + depression (classic)
II = hypomania + depression (more common)
III = hypomanic episode following use of antidepressants for depression
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12
Q

what are the symptoms of a hypomanic episode

A

mood is elevated for at least 4 consecutive days

3 of the following:
 increased activity or physical restlessness;
 increased talkativeness;
 difficulty in concentration or distractibility;
 decreased need for sleep;
 increased sexual energy;
 mild spending sprees, or other types of reckless or irresponsible behaviour;

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13
Q

what are the symptoms of a manic episode

A

mood is predominately elevated sustained for at least 1 week

3 of the following:
 Increased activity or physical restlessness;
 Increased talkativeness (‘pressure of speech’);
 Flight of ideas or the subjective experience of thoughts racing;
 Loss of normal social inhibitions resulting in behaviour which is inappropriate to the circumstances; Disinhibition
 Decreased need for sleep;
 Inflated self-esteem or grandiosity;
 Distractibility or constant changes in activity or plans;
 Behaviour which is foolhardy or reckless and whose risks the subject does not recognize e.g. spending sprees, foolish enterprises, reckless driving;
 Marked sexual energy or sexual indiscretions.

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14
Q

what is the treatment for acute mania/hypomania

A

stop antidepressants
max antimanic dose if on maintenance
antipsychotics

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15
Q

what is the 1st line antipsychotic for acute mania/hypomania/ depression

A

olanzapine, quetiapine, risperidone

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16
Q

what is the treatment for acute depression

A

antipsychotics

antidepressant + antimanic

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17
Q

what is the long-term maintenance of bipolar disorder

A 
lithium = gold standard
valproate = primarily manic
lamotrigine = primarily depression
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18
Q

what is the non-pharmalogical treatment of mood disorders

A

ECT
CBT
interpersonal therapy

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19
Q

what are the contraindications to ECT

A

MI within 3 months
recent cerebrovascular accident
intracranial mass
phaeochromocytoma

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20
Q

what are the side effects of ECT

A

headache, short-term memory loss

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21
Q

when is ECT commonly used

A

recurrent depression without psychosis

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22
Q

what does ECT do? how is it given?

A

achieves a seizure lasting 15-20sec

usually 2x a week bilaterally

23
Q

what is anorexia nervosa

A

deliberate weight loss that is induced and sustained by the patient

24
Q

what are the symptoms of anorexia nervosa

A

self-induced weight loss
body image disturbance
BMI 17.5 or less
amenorrhoea

25
Q

what is bulimia nervosa

A

repeated bouts of overeating an excessive preoccupation with control body weight leading to a pattern of overeating followed by vomiting/purging

26
Q

what are the symptoms of bulimia nervosa

A

persistent preoccupation with eating

binges and attempts to counter effects of binges

27
Q

what are the physical signs of bulimia nervosa

A

calluses on knuckles = Russell’s signs
parotid hypertrophy
dental caries

28
Q

what are the physical signs of anorexia nervosa

A 
muscle wasting 
hair loss, lunar hair 
cold, blue peripheries 
dry skin 
hypercarotenaemic = jaundice-like yellowing of skin (palms and soles)
29
Q

what are the complications of bulimia nervosa

A 
oesophageal reflux
oesophageal tears/rupture 
hypokalaemia
subconjuctival haemorrhage 
seizures - metabolic abnormalities
30
Q

what is the cause of refeeding syndrome

A

depletion of already inadequate stores of nutrients which are quickly used up as body starts to repair itself

31
Q

what is an anxiety disorder

A

anxiety that is more extreme than normal causing significant distress and impairment of functions

32
Q

what is generalised anxiety disorder

A

this is generalised and persistent but not restricted to any particular environment

33
Q

what is the criteria for generalised anxiety disorder

A

long-lasting = most days for at least 6 months
not controllable
causing significant distress/impairment in function

34
Q

what are the symptoms of generalised anxiety disorder

A 
Persistent nervousness/restlessness/keyed up/on edge 
Trembling/Muscular tensions
Sweating
Palpitations
Light-headedness/dizziness
Epigastric discomfort 
Sleep disturbance
35
Q

what is the treatment of generalised anxiety disorder

A

CBT
SSRIs/SNRs
pregablin

36
Q

what is the first line antidepressants used in generalised anxiety disorder

A

fluoxetine and sertaline

37
Q

what is panic disorder

A

recurrent attacks of severe anxiety which is not restricted to a particular situation

38
Q

what is the symptoms of panic disorder

A

anxiety symptoms
secondary fear of dying/losing control/going mad
+/- agoraphobia

39
Q

what is the treatment of panic disorder

A

CBT

SSRIs/SNRs/tricyclics

40
Q

what is a specific phobia

A

marked and persistent fear that is excessive or unreasonable cued by the presence or anticipation of a specific object/situation

41
Q

what are the symptoms of a specific phobia

A

Exposure to phobic stimulus provokes immediate anxiety response akin to panic attack
Recognition that fear is excessive or unreasonable
Avoidance of phobic situation
Normal functioning is impaired by the avoidance, anxious anticipation, or distress

42
Q

what is the treatment of  a specific phobia

A

behaviour therapy = exposure, add CBT if needed

SSRIs/SNRIs if needed

43
Q

what is social phobia? what is it also known as?

A

aka social anxiety disorder

persistent fear of one or more social/performance situations in which the person is exposed unfamiliar people or possible scrutiny by others

44
Q

what are the symptoms of social phobia

A

blushing or shaking
fear of vomiting
urgency or fear of micturition or defaecation
exposure to the feared situation provokes anxiety which may lead to a panic attack
behaviour inhibition

45
Q

what is OCD

A

recurrent obsessional thoughts and/or compulsive acts

46
Q

describe obsessional thoughts in OCD

A

Ideas, images or impulses entering the mind in a stereotyped way
Recognised as the patient’s own thoughts
But unpleasant, resisted and ego-dystonic

47
Q

describe compulsive acts in OCD

A 
Repeated rituals or stereotyped behaviours 
Not enjoyable or functional
Often viewed as “neutralising”
Recognised as pointless
Resistance may diminish over time
48
Q

what is the diagnostic criteria of OCD

A

obsessional symptoms/compulsive acts must be present for most days for at least 2 weeks AND must cause distress and interfere with activities

49
Q

what is PTSD

A

a delayed or protracted response to a stressful event or situation of an threatening/catastrophic nature

50
Q

what is the diagnostic criteria for PTSD

A 
duration of 1 month 
traumatic event 
distress and impairment in functioning
1 or more intrusive symptoms 
3 or more avoidance symptoms 
2 or more increased arousal symptoms
51
Q

what are the intrusive symptoms of PTSD

A

recurrent distressing recollections
nightmares
flashbacks
physiological reactions

52
Q

what are the avoidance symptoms of PTSD

A 
avoidance of thinking about/talking about event 
avoidance of reminders
loss of interest in activities 
amnesia of trauma
detachment/numbing
53
Q

what are the increased arousal symptoms of PTSD

A 
sleep disturbance 
irritability/anger
concentration difficulties 
hyper vigilance 
exaggerated startle response

3rd year (12 decks)

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