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46 Cards in this Set
- Front
- Back
What are mood disorders? |
Mood disorders are when a patient has the wrong mood for the situation. i.e they have continuously low mood every day when there is no real reason to. *often associated with anxiety* |
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What is the most common group of mental disorders? |
Mood disorders are the most common group of mental disorders. |
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What 4 things indicate that depressive symptoms have become depression? |
Persistance of symptoms - 2 weeks Pervasiveness of Symptoms - symptoms continuos throughout the day Degree of impairment - makes it difficult for a person to function Presence of specific symptoms or signs |
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Change in mood is one of the main symptoms of depression. What changes to mood commonly occur in depression? |
Anxiety Perplexity - patient bewildered/overwhellmed Anhedonia - when patient no longer feels pleasure in things they used to |
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In depression what changes in thought process can commonly occur? |
Guilt Hopelessness Worthlessness Neurotic symtomology - agoraphobia, obsessions, compulsions Delusions Hallucinations - commonly sense of smell or auditory |
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What are the physical changes that can occur in the body in a patient who suffers from depression? |
Fatigue Sleep cycle disturbed - early morning wakening most common Appetite change - normally loss Labido Constipation Pain Psychomotor change - agitation/retardation |
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What affect can depression have on a patients social sphere? |
Loss of interests Irritibilty Apathy Withdrawal Loss of confidence/Indecisiveness Loss of concentration/registration/memory *often all of these things have knock on effect on relationships, work and study* |
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One of the more extreme symptoms of Depression is stupor, what is Stupor? |
Stupor is a state of extreme retardation where consciousness is still intact. |
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Somatic Syndrome is a form of depression, what are the psychological, physical and social changes that occur in a patient with Somatic syndrome according to the ICD-10 guidelines? |
Marked loss of interest or pleasure in activities that are normally pleasurable
Lack of emotional reaction to events or activities that normally produce an emotional response Waking 2 hours before the normal time Depression worse in the morning Marked loss of appetite Weight loss Marked loss of Labido |
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For a patient to be diagnosed with mild, moderate or severe depression they need to fulfil at least two symptoms from the 3 main categories, what are these 3 main symptoms of depression? |
Three main symptoms of depression (patient needs to have 2 for diagnosis): Depressed mood that is abnormal most of the day, at least everyday for the past two weeks - largely uninfluenced by circumstances Loss of interest or pleasure Decreased energy or fatiguability |
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Beyond the 3 main symptoms of depression, what are the 8 additional symptoms which distinguish wether the patient has mild, moderate or severe depression? |
Loss of confidence or self esteem Unreasonable feelings of guilt Recurrent thoughts of death by suicide Decreased concentration Agitation or retardation Sleep disturbances of any sort Change in appetite *mild = any 4, moderate = any 6, severe = all 8* |
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How many days following childbirth is a mother at increased risk of psychiatric admission for? |
Mothers are at increased risk of Psychiatric admission for 30 days post childbirth - called the baby blues. |
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What percentage of woman experience some form of the baby blues after childbirth? |
75% of women experience some form of the baby blues within 2 weeks of childbirth. |
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What percentage of woman develop a MDD (major depressive disorder) within 3-6 months of childbirth? |
10% of woman experience a MDD within 3-6 months of child birth. |
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List 5 other possible differential diagnosis for a patient presenting with depressive symptoms |
Normal reaction to life event Stroke Dementia Tumour Endocrine - Hypothyroid, addisons Infections - influenza, hepatitis
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What is Dysthymia and Cyclothymia? |
Dysthymia - low mild depression lasting for at least 2 years Cyclothymia - mood disorder that causes highs and lows, more mild version of bipolar |
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What is the first line pharmacological treatment for a patient presenting with new onset depression? |
SSRIs are commonly the first line drug treatment for depression. e.g Citalopram, Fluoxetine |
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Along with pharmacological treatments, Psychological therapy is also used to treat mood disorders - what are the common first line Psychological treatments? |
Psychological treatments for depression: CBT - Cognitive behavioural therapy IPT - Interpersonal therapy Individual dynamic psychotherapy Family therapy |
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Often as a last resort physical treatments can be used to treat depression, what are these physical treatments? *only used when all other treatments have failed* |
Physical treatments:
ECTs PhyscosurgeryDBS - Deep brain stimulation |
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Name the 2 most common measurements tools used to assess the improvements or changes in a patients depression |
Measurement tools for assessing depressive disorders: SCID - StructuredClinical Interview for DSM disorders SCAN - Schedules for Clinical assessment in Neuropsychiatry |
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What is Mania Disorder? |
A mood which is predominantly elevated, expansive or irritable and definitely abnormal for the individualconcerned. This mood change must be prominent and sustained for at least a week. Different from bipolar due to the absence of lows. Often recognised first by family members. Manic highs can be money, work and life threatening. *highs are similar to the effects cocaine would have on the brain* |
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According to ICD-10, what are the two types of mania disorders?
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2 types of mania disorders: Mania (with or without psychosis) Hypomania - lesser degrees of mania, no psychosis |
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What are the symptoms of Hypomania? |
Lesser degree of manic moments Mild elevation of mood for 4 days or less W Increased energy and wellbeing Increased sociability, sex drive Reduced need for sleep May be irritable New interests, mild overspending |
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What are the symptoms of Mania (with or without psychosis)? |
1 week extreme manic episodes Enough to disrupt work, social life ect Disinhibition Gradiosity, extreme spending Can be irritable rather than elated |
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Name 2 psychiatric and 2 medical differential diagnosis for a patient who presents with the symptoms of Manic disorder? |
2 psychiatric: Schizophrenia ADHA 2 medical: Stroke MS |
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What 3 tools could you use to measure the severity of a patient who presents with Mania? |
SCID SCAN YMRS - Young mania rating scale |
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What 2 types of drugs are commonly used to treat Manic disorder? |
Antipsychotics - e.g Olanzapine Mood stabilisers - Sodium Valproate |
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What differentiates Bipolar Affective Disorder from depression mania or hypomania? |
Bipolar disorder is the combination of repeated episodes of depression AND mania/hypomania Not simply one or the other and has to be alternating. What makes it Bipolar is that its a combination of the the two syndromes. |
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What sex and age group is bipolar disorder most common in? |
Bipolar disorder is equally common in males and females. Common onset is 21. |
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What sex and age group is Depression most common in? |
Depression is more common in women at a ratio of 2:1 Mean age of onset is 18-44 |
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How long do episodes of major depression typically last for? |
Typically episodes of major depression last for 4-6 months. Almost half recover at 56 weeks. 80% have future episodes. |
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How long do manic episodes typically last for in Bipolar disorder? |
Manic episodes in bipolar disorder typically last for 1-3 months. |
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What are the three core symptoms of depression? |
Low mood Anhedonia - loss of interest Low energy |
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What are the 8 sub symptoms of depression? |
Loss of confidence/esteem Unreasonable feelings of guilt Recurrent thoughts of death or suicide Decreased concentration Agitation or retardation Sleep disturbances Change in appetite Low labido |
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What are the 4 types of hallucinations that involve the 4 different senses? |
Auditory hallucinations - most common. e.g earning voices that aren't there Visual hallucinations Tactile hallucinations - e.g spiders crawling over skin Olfactory hallucinations - second most common Gustatory Hallucinations |
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When performing a mental state examination on a depressed patient what two features may you be looking for in their behaviour? |
Mental retardation or agitation Reduced eye contact |
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When performing a mental state examination on a depressed patient what two features may you be looking for in their thought? |
For thought you are looking for the CONTENT and the STREAM of their thought. ie. Does it make sense what they are saying = Content Does there sentences make sense = Stream |
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What 3 things might you expect to see in the speech of a patient who presents with depression? |
Slowed speech Quite volume Monotonous tone |
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Suggest two treatments for if the perceived cause of the depression is biological? |
If the depression is biological then treat with... 1st Line - Antidepressants 2nd line last resort - ECT |
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Suggest two treatments for if the cause of depression is Psychological? |
If the underlying cause of depression is psychological then treat with... CBT or IPT (interpersonal psychotherapy) |
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How long is antidepressant medication commonly continued for? |
Antidepressants are commonly continued for 6-12 months
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In what circumstance would antidepressants be continued long term? |
Long term continuation of antidepressants if... Patient has chronic depression They have psychotic symptoms/suicidal thoughts |
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Name three complications that commonly occur in untreated depression |
Untreated depression can lead to: Psychosis Suicide Social and occupational dysfunction - e.g relationship and work problems |
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What is the most appropriate 1st line treatment for mild depression? |
For new onset mild depression most appropriate treatment is: Psychotherapy - e.g CBT and IPT |
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What are the 9 criteria for mania which a patient has to have 3 of to be diagnosed with Mania (without psychotic symptoms)? |
Increased activity and physical restlessness Increased talkitivness (pressure of speech) Ideas feel like they are racing Loss of normal social inhibition Decreased need for sleep Inflated self esteem or grandiosity Distractibility or restlessness Activity which is devoid of risk considerations Marked sexual energy or indiscretions |
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What are the psychotic symptoms that are seen in people who have Mania with psychotic symptoms? |
Most commonly related to dellusional ideas of grandiose, self referential (speaking about oneself in the 3rd person), erotic or persecutory. |