week 1- altered mood Flashcards
What are mood disorders?
Disorders affecting mood e.g. depression and bipolar.
Meaning of anhedonia?
Loss of enjoyment/pleasure
Meaning of anergia?
Lack of energy
Meaning of amotivation?
Lack of motivation
What does diurnal variation mean?
Mood varies over the day
Describe early morning wakening
Wakening atleast two hours before the appropriate waking time.
What is psychomotor retardation?
Slowing of thoughts/ movement.
What is stupor?
The absence of relational functions e.g. action or speech.
Completely unresponsive- can’t talk and don’t respond.
What is euthymia?
Normal mood.
How would someone with depression present appearance/behavioral wise?
Reduced facial expression Brow is classically furrowed. Reduced eye contact Limited gesturing Rapport is often difficult to establish.
How would someone with depression present speech wise?
Reduced rate of speech Lowered pitch Reduced volume Reduced intonation- monotone Limited content. Increased speech latencies- longer time between them being asked a question and them answering.
How might someones thought be changed in depression?
The thought form is generally normal. However the content can be negative, self accusatory, failure, guilt, low self esteem, dellusional?
They may also be paranoid e.g. that person is talking about me.
How do pyschosis and depression differ in terms of paranoia?
Depressed people will have increased sensitivity to criticism, however psychotic patients will just be bizarre e.g. I’m being watched by aliens.
Depressed people are a lot more self conscious whereas psychotic patients have a lack of perception.
Insight is often lost in psychotic patients.
What will hallucinations be like in depression?
Almost always auditory.
Usually a second person and being derogatory- “you are a bad person… etc”
Typically reflect negative and depressive themes.
How is the cognition with patients with depression?
Typically slow and their memory is bad. Pseudo-dementia.
What is the patients insight like in depression?
Unlike other mood disorders- insight is typically good. People are generally aware of their symptoms.
What are the two tools used to classify depression?
ICD-10
DSM-5
Name the three core features of depression
Depressed mood- abnormal for the individual. Present for most of the day and almost every day. Uninfluenced by circumstances.
Loss of interest or pleasure- in activities that are normally pleasurable.
Decreased energy.
What additional symptoms can be seen in depression?
Loss of confidence or self esteem.
Unreasonable feelings of self reproach or unreasonable guilt.
Recurrent thoughts of death or suicide- or any suicidal behaviour
Complaints or evidence of diminished ability to think or concentrate
Change in psychomotor activity
Sleep disturbance of any type
Change in apetite.
How can severity of depression be assessed?
rating scales- either Hamilton rating scale, ICD-10 or Montgomary asperg
How is a moderate depressive episode classified?
At least two of the core symptoms and 4 others
How is a severe depressive episode classified?
All three core criteria and 5 others.
What is atypical depression?
Mood reactivity- mood brightens in response to actual or potential positive events
(2 or more of the following)
-weight gain
-hypersomnia
-leaden paralysis- heavy feelings in the hands and legs.
-Long standing pattern of interpersonal rejection sensitivity- results in significant personal or occupational impairment.
What is psychotic depression?
Occasionally paranoid, typically mood congruent (sustained emotion) or hypochondriacal.
e.g. “I’ve got cancer, I know I have, its because I deserve it”
