Psychiatry - Mood Disorders Flashcards
intrusive symptoms in PTSD?
recollections
nightmares
flashback
fight/flight
avoidant symptoms in PTSD?
avoiding reminders
detached
numb
hyperarousal symptoms in PTSD?
anger
concentration probs
sleeping probs
startle response
how is PTSD diagnosed?
follows latency period from trauma
1 month of intrusive symptoms avoidance negative mood/cognition altered arousal and reactivity
Tx for PTSD?
CBT
EMDR
SSRis/MOAis/TCAs
features of GAD?
anxiety unrelated to an environment sweating dizzy palpitations epigastric discomfort feelings of doom
how is GAD diagnosed?
symptoms for most days for several weeks at a time of several months
Tx for GAD?
CBT anti depressants (SSRI/SNRI) benzos for crisis relief sleep hygiene exercise
features of panic disorder?
occur in attacks/unpredictable
no objective danger in the situations
free from symptoms between attacks
what are the 3 cardinal symptoms of depression?
depressed mood
loss of interest/enjoyment
reduced energy
features of depression?
reduced concentration reduced self esteem guilt unworthy sleep/appetite disturbed irritable
suicide
self harm
alcohol/drug abuse
what are somatic symptoms? how many needed for somatic diagnosis?
≥4
loss of interest/pleasure lack of emotional reactivity diurnal variation early morning waking psychomotor retardation wt loss loss of appetite loss of libido
what is cotard’s?
depression with the delusion of already being dead
how long should symptoms be present in depression for a diagnosis to be made?
2 weeks
how is depression graded?
mild = 2 typical, 2 others mod = 2 typical, 4 others severe = 3 and >4 others
Tx for depression?
CBT antidepressants benzos (catatonic state) antipsychotics ECT
what is st johns wort?
herbal MAOis
can cause serotonin syndrome/interact with OCP
how long should antidepressants be trialled for?
4 wks
why is suicidal risk thought to increase in initial period of Tx for depression?
giving someone the energy to do so
features of hypomania?
increased sociability increased libido decreased need for sleep irritable concentration impaired lasts days
NO hallucinations/delusions
doesn’t majorly disrupt life
features of mania?
elated increased energy inflated self esteem decreased need for sleep reckless spending aggression flight of ideas/pressured speech loss of social inhibitions
hallucinations
delusions
lasts around a week
what is a delusion?
belief maintained despite contradicted by reality or rational argument
what is a hallucination?
the apparent perception of something not present
Tx for bipolar?
Li
antipsychotics (olanzapine/quetiapine)
anticonvulsants (sodium valp/lamotrigine)
antidepressants (fluoxetine)
what should be checked before Li is started?
BMI U+Es Ca GFR TFTs FBC ECG
what should be checked before antipsychotics are started?
BMI pulse/BP PRL BM lipids
how does sodium valproate work? what should be checked before starting it?
increases GABA
BMI
FBC
LFTs
how does sodium lamotrigine? what should be checked before starting it?
binds to Na channels and stops glutamate release
FBC, U+Es, LFTs
monitor for rash
what do atypical antipsychotics have a higher risk of?
less dopaminergic
more CVS
in OCD what are obsessional thoughts?
ideas/images/impulses that enter mind over and over
recognised as own thought
in OCD what are compulsive acts?
rituals or stereotyped behaviour that is repeated but not enjoyed
Tx for OCD?
CBT
sertraline
