Week 2 Flashcards
Define mood and affect
Mood = subjective feeling of sustained emotion (happy, sad)
Affect = objective immediate conveyance of emotion (blunt, flat, labile)
What is the neurochemical theory of depressions cause?
Thought to be due to low serotonin, noradrenaline, and dopamine
What is kindling theory in depression?
One episode of depression primes the brain for more with less stressful triggers
What are the main clinical features of depression?
- decreased mood
- anhedonia
Everyday for more than 2 weeks
What are the biological symptoms of depression?
- Fatigue
- sleep disturbance
- loss of appetite
- weight loss
- lowered libido
What are the cognitive symptoms of depression?
- lowered concentration
- negative thoughts
- guilt
- hopelessness
What are the psychotic symptoms of depression?
- delusions
- cotards syndrome
- hallucinations
What is agitated depression?
Usual depressive symptoms but highly restless, often agitated, pacing, psychotic
What is catatonic depression?
Severe depression leading to a state of stupor and inhibited motor activity.
Often life threatening as patients stop eating/drinking
What domains are assessed in the mental state exam?
- Appearance
- Behaviour
- Eye contact
- Speech
- Mood
- Thoughts
- Condition
- Insight
What is the HADS scale
Hospital Anxiety and Depression Scale
What are some organic causes of depression?
- Hypothyroidism
- Hyperglycaemia
- B12 deficiency
- Bushings syndrome
What is atypical depression?
Low mood like depression, but other symptoms are reversed. E.g. hypersonic instead of insomnia, increased appetite instead of decreased appetite
What are the 1st, 2nd, and 3rd line antidepressants?
1st = SSRIs
2nd = SNRIs
3rd = combination
What is the neuroanatomical aetiology of stress?
Chronic stress => neuronal change
This leads to decreased hippocampal volume
What is the neurotransmitter aetiology of anxiety?
Increased noradrenaline
Decreased serat9nin
? Decreased dopamine
? Decreased GABA
What is the anxiety learning theory?
Stimulus + unpleasant emotion = pairing
Avoiding that stimulus = reward = maintenance
What are the core types of anxiety?
- specific phobias
- Generalized anxiety disorder
- panic disorder
What are some anxiety associated disorders?
- OCD
- PTSD
Define phobias
Excessive anxiety brought on by defined situation, avoided with dread
Overview of generalised anxiety disorder
Excessive worry, not situational, everyday for 6 months
Clinical features of generalized anxiety disorders
- restless
- fatigued
- poor concentration
- irritability
- tension
- avoidance
Define panic attacks
Rapid interest fear with autonomic/physical symptoms
Define panic disorder
Recurrent panic attacks over a month (can exist by itself but usually associated with other anxiety dissorders)
Define obsessions and compulsions
Obsession = repeated intrusive ideas, images, impulses
Compulsions = Steteotyped ritualistic behaviours to combat obsessions
Define dissociation
Loss of normal integration of memories, identity, sensation
Define somatoform disorders
2yr complaints of physical symptoms with no sufficient cause.
Causes imparted functioning
Mechanism of action for anti anxiety drugs?
Increase noradrenaline and serotonin
What are the 1st, 2nd, and 3rd line medications for anxiety?
1st = SSRIs
2nd = SNRIs
3rd = Gabapentinoid
What is the MOA of pregabalin
Inhibits calcium channel, therefore has a GABA like effect on amygdala
What is the MOA of benzofiazapeines (for anxiety?)
GABA agonist, therefore inhibits the amygdala
What mnemonic can you remember to remember the domains of the mental state exam?
A Big Smart Monkey Ate Ten Pinapples, Chewing In Rythm
- Appearance
- Behaviour
- Speech
- Mood
- Affect
- Thoughts
- Perception
- Cognition
- Insight
- Risk
