Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
27 Cards in this Set
- Front
- Back
|
Major depressive episode DSM-IV-TR
MI G SPACES |
At least five of the following symptoms present for two weeks, one of which must be either M or I.
M - Mood depressed I - Interest decreased G - Guilt excessive or inappropriate S - sleep (more or less) P - psychomotor agition or retardation A - appetite and or weight increase or decrease C - concentration difficulty E - energy more or less S - suicidal |
|
|
bereavement
|
constellation of depressive symptoms meeting criteria for a MDE appearing within 2 months of the death of a close friend or relative
|
|
|
Manic episode
DSM-IV-TR GST PAID |
a period of abnormally or persistently elevated, expansive, irritable mood lasting at least one week or less if hospitalised
during this period must have three of the following symptoms or four if the mood is only irritable G - grandiosity S - sleep, decreased need for T - talkative, pressured speech P - pleasure with painful consequences, e.g. spending all money, having sex with many peope A - activity, goal-directed I - ideas, flight of D - distractability symptoms do not meet criteria for mixed episode mood distrubance is severe enough to cause psychotic features, marked impairment or necessitate hospitalisation symptoms not substance induced or due to GMC |
|
|
mixed episode
|
criteria met for both manic episode and MDE nearly every day for one week
|
|
|
hypomanic episode
|
criteria A of mania but duration is less than 4 days
criteria B and E of mania change in functioning is present not severe enough to cause MARKED impairment in functioning or hospitalisation absence of psychotic features |
|
|
MDD - epidemiology
|
prevalence: male 2 - 4%, female 5 - 9%
mean age of onset = 30 years |
|
|
MDD - aetiology
|
genetic (higher concordance in monozygotic)
neutrotransmitter function at level of synapse (decreased activity of serotonin, noradrenaline, dopamine) psychodynamic, e.g. persistent low self-esteem, poor attachment as child, abuse cognitive, e.g. negative thinking |
|
|
MDD with melancholic features
|
severely depresed
mood is worse in morning early wakening severe weight loss excessive guilt psychomotor retardation |
|
|
MDD with atypical features
|
increased sleep
weight gain leaden paralysis chronic rejection sensitivity |
|
|
depression in the elderly - what should you know?
|
accounts fo 50% of acute psych admission in elderly
high suicide risk suicide peak in males 80 - 90, females 50 - 65 often presents with somatic complaints or anxeity symptoms rather than classic depression |
|
|
differential diagnosis for MDE
|
adjustment disorder with depressed mood
bereavement dementia GMC substance (steroids, alcohol, amphetamine crash) anxiety disorder |
|
|
dysthymia dsm-iv
|
A. depressed mood for most of the day, for more days than not, for at least two years
B. presence, while depressed of at least two of: - poor appetite or overeating - insomnia/hpersomnia - fatigue - low self-steem - poor concentration or difficult to make decisions - feelings of hopelessness C. never without depressed mood for more than 2 months at a time D. no evidence of past MDE, main, mixed, hypomainc episodes, cyclothymia E. symptoms do not occur with a chronic psychotic disorder F. not GMC or substance related G. causing social or occupation dysfunction |
|
|
baby blues - symptoms:
|
occurs in 50 - 80% of mothers, considered a normal emotional change
transient period of mild depression, mood instability, anxeity, decreased concentration, increased concern over own health and health of baby |
|
|
baby blues - onest and duration
|
begins in 2-4 days postpatum
48 hours (usual) to 10 days |
|
|
postpartum depression - diagnosis
|
sMDE
onset within four week postpartum typically lasts 2 to 6 months but residual symptoms can last up to one year |
|
|
post partum depression - always ask about?
|
suicidal and infanticial ideation
|
|
|
risk factors for PPD
|
previous history of a mood disorder
previous PDD psychosical factors: - stressful life events - unemployment - marital conflict - lack of support from spouse, family, friends |
|
|
PPD - SSRIs
|
short-term safety of maternal SSRIs for breastfeeding infants established, long-term unkonown
|
|
|
PPD - impact on child development
|
association with cognitive delay, especially in males and low SES groups
insecure attachment increased behavioural disturbance at five years |
|
|
post-partum psychosis - incidence
|
1-2 per 1000 childbirths, more common in primiparous women
|
|
|
postpartum psychosis - features
|
most often has an affective basis, usually manic, but can be depressive
mean onset 2-3 weeks postpartum ranges 2 days to 8 weeks may have suicidal or infanticidal ideation previous history or family history of psychosis increases risk |
|
|
postpartum psychosis treatments
|
SSRIs
mood stabilisers (not lithium because it is excreted into breast milk) ? ECT |
|
|
bipolar disorder - epidemiology
|
prevalence: 0.6 - 0.9% of population
equal M:F age of onset: teens to 20s slight increase in upper SES 60 - 65% have family history of major mood disorders |
|
|
cyclothymia
|
Cyclothymia is a persistent instability of mood characterised
by mild depression and mild elation, none of which are severe enough to qualify for a formal diagnosis of bipolar affective disorder or recurrent depressive disorder. |
|
|
dysthymia
|
characterised by the presence of chronic low
mood, which must be present for at least 2 years but not severe enough for a diagnosis of a depressive disorder. There may be intervening periods of normal mood but these do not last longer than a few weeks. |
|
|
best treatment for atypical depression
|
monoamine oxidase inhibitors
|
|
|
premenstrual syndrome
|
Premenstrual syndrome is a collection of psychological (mood
disturbance, insomnia, poor concentration) and physical (headache, bloating) symptoms occurring 24 hours after ovulation, and quickly relieved by menstrual flow. |
