Week 12 - Mood Disorders Flashcards
What is the leading cause of disability worldwide?
Major depressive disorder
- 2 week history of depressed mood
- At least 5 of the following:
>Depressed mood all day everyday
>Loss of interest or pleasure
>Significant weight change
>Significant increase of decrease in sleep
>Fatigue or loss of energy
Major depressive episode
SAD-A-FACES
- Sleep
- Appetite (weight)
- Dysphoria (low mood)
- Anhedonia (inability to experience pleasure)
- Fatigue
- Agitation
- Concentration reduced
- Esteem low
- Suicidal thoughts
If depressive symptoms occur within the first two months of bereavement, does the person have depression?
No
If depressive symptoms occur after the first two months of bereavement, does the person have depression?
Yes
- Emotional or behavioural symptoms in response to an identifiable stressor (within 3 months of onset of stressor)
- Distress
- Impairment
Adjustment disorder
Treatment for all types of depression
- Psychoeducation
- Identify stressors
- Mobilise support
Treatment for mild MDD
- GP management
- Problem solving or CBT
- Medication (anti-depressants)
Treatment for moderate MDD
- Medication
- CBT
- Review weekly
Treatment for severe MDD
- Medication
- ECT
- Psychotic anti-depressant
Other things that may help MDD
- Exercise
- Bright lights
- Structured activities
- Sensory modulation
- Sleep deprivation
Effectiveness of ECT
70%
Use of ECT
- Depressed patients who are suicidal
- Delusions or hallucinations
- Stopped eating or drinking
How long should someone stay on medication if they only have one episode?
- 12-18 months
How long should someone stay on medication if they have more than one episode?
- 3 years
How long do you have to have depression for to be diagnosed with chronic depression?
At lease 2 years
Ratio of manic:depressive episodes in BPAD I
1:3
- At least one manic episode
- One week or more of mania (3 or more of):
>increased self-esteem
>decreased need for sleep
>increased talkativeness
>flight of ideas
>distractible
>increased goal directed activity
Bipolar I disorder
- At least 1 hypomanic episode AND 1 major depressive episode
- No mania
- Hypomania:
>3-7 days of elevated or irritable mood & 3 -4 of mania symptoms
Bipolar II disorder
Non-pharmacological Bipolar treatment
- Psychoeducation
- CBT
pharmacological Bipolar treatment
- Mood stabiliser
Most common bipolar disorder relapse trigger
Sleep disturbances
- For at least 2 years there are multiple periods of hypomanic symptoms that don’t meet all of the criteria for hypomania or MDD
Cyclothymia
