Psychiatry Flashcards
What is the diagnostic criteria for depression ?
- Depressed mood or irritable most of the day
- Decreased interest or pleasure
- Significant weight change / change in appetitie
- Change in sleep
- Fatigue
- Guilt/worthlessness
- Lack of concentration
- Suicidality
5 or more of these are present nearly every day for 2 weeks or longer, a diagnosis can be made.
What is the diagnostic criteria for depression ?
- Depressed mood or irritable most of the day
- Decreased interest or pleasure
- Significant weight change / change in appetitie
- Change in sleep
- Fatigue
- Guilt/worthlessness
- Lack of concentration
- Suicidality
5 or more of these are present nearly every day for 2 weeks or longer, a diagnosis can be made.
What is the initial management of depression ?
Low intensity psychological interventions or group based CBT —> then pharmacological intervention/CBT
What is the first line of treatment of depression in adults and how long should it be continued ?
- SSRI like sertraline is first line for depression.
- Patients who benefit from antidepressants can be continued for up to six weeks after remission to reduce the risk of relapse. They should be swapped gradually over 4 weeks.
- Urgent referral if the patient is suicidal.
What is the first line of treatment of depression in children ?
- Depression in children →CAMHS and psychological therapy (first line)
- Fluoxetine (1st line antidepressant in children), followed by sertraline and citalopram.
- Admission may be required if there is a high risk of self harm, suicide or neglect.
What is Alzheimers disease ?
Degenerative condition of the brain that leads to memory loss and ultimately, global impairment of brain function. There is widespread cerebral atrophy.
What are the clinical features of Alzheimers (4 As)?
- Amnesia (recent memories are lost first), one of the early features of Alzheimers.
- Aphasia (word finding problems, muddled speech and disjointed)
- Agnosia (recognition problems)
- Apraxia (inability to carry out skilled tasks despite normal motor function)
What are the risk factors for developing schizophrenia ?
- Family history - More closely related, the greater the risk of developing.
- Environmental factors - Traumatic events in childhood ect.
What are the first rank features of schizophrenia ?
- Auditory hallucinations (third person commentary)
- Though disorders - Though insertion, though withdrawal and broadcasting.
- Delusional perception
- Passivity (external influence controlling thoughts and actions of a sufferer)
What are the negative symptoms of schizophrenia ?
Alogia (speech poverty)
Anhedonia (inability to derive pleasure)
Incongruity/blunting affect
Avolation (poor motivation)
What are the negative symptoms of schizophrenia ?
Alogia (speech poverty)
Anhedonia (inability to derive pleasure)
Incongruity/blunting affect
Avolation (poor motivation)
What factors are associated with a better prognosis in schizophrenia ?
- High IQ/education level
- Sudden onset
- Obvious precipitating factor
- Strong support network
- Positive symptoms predominant.
What scoring system is used to confirm a diagnosis of schizophrenia ?
ICD-11 (symptoms present for most of the time during a period of at least one month)
What is the first line treatment for schizophrenia ?
1st line - a typical antipsychotics like risperidone.
Lorazapam can be used if there is acute behavioral disturbance
What are some of the side effects of SSRIs ?
- GI upset
- Anxiety and agitation
- QT interval prolongation (citalopram)
- Sexual dysfunction
- Hyponatraemia
- Gastric ulcers.
