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Psychiatry > Depression > Flashcards

Depression Flashcards

1
Q

Peak of depression in terms of life span?

A

2nd,3rd and 4th decade

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2
Q

What is anhedonia?

A

Loss of enjoyment/ pleasure

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3
Q

What is anergia?

A

Lack of energy

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4
Q

Describe the diurnal variation of depression?

A

Worse in the morning and gets worse as the days go on

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5
Q

What is stupor in terms of depression?

A

The absence of relational functions i.e. action and speech

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6
Q

What is psychomotor retardation in terms of depression?

A

Subjective or objective slowing of thoughts and/or movement

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7
Q

What is euthymia?

A

Normal mood

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8
Q

What is the phenomenology of depression in terms of appearance and behaviour?

A 
Reduced facial expression
Brow is classically furrowed 
Reduced eye contact 
Limiting gesturing; movement may be slowed, or absent
Rapport is often difficult to establish
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9
Q

What can be seen in the speech category of the MSE in depression?

A 
Reduced rate of speech 
Lowered in pitch 
Reduced in volume
Reduced intonation 
Increased speech latencies
Limited content
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10
Q

What encompasses mood as part of the MSE?

A

Prolonged prevailing state or deposition; typically associated with what the patient describes; subjective
“How do you feel”

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11
Q

What encompasses affect as part of the MSE?

A

Mood applied to things; events, people etc
Objective observation
How patient reacts to event changes

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12
Q

What is the mood like in an MSE for depression?

A 
Low, miserable, unhappy, sad 
Flat
Empty
Black 
Numb
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13
Q

Describe the affect in depression in an MSE?

A

Depressed; low
Reduced range; stays low throughout
Limited reactivity; affect doesn’t respond or react to changes in subject, context, or emotion
May report emotional paralysis

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14
Q

Describe the form of thought seen in depression

A

Normal

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15
Q

Describe the flow of thought in depression?

A

Thoughts are slowed, pondering

Can be absent; subjectively or objectively

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16
Q

Describe the content of thought in depression?

A 
Negative, self accusatory 
Failure
Guilt 
Low-self esteem
Pessimism
Delusions; guilt, poverty, nihilism, hypochondriasis
17
Q

Is there commonly a perceptual disturbance in depression?

A

No

18
Q

What hallucinations can occurs in depression?

A

Almost always auditory
Usually 2nd person and derogatory
Typically are mood congruent and reflect the negative and depressive themes

19
Q

Is there paranoia in depression?

A

Increased sensitivity to criticism of others; often tied to guilt/ self blame
More self-conscious and self-aware
Feeling of being under scrutiny

20
Q

Is there paranoia in psychosis?

A

May have a bizarre quality
Other symptoms; persecutory ideas/delusions, altered perceptions
Insight lost

21
Q

What is the cognition like in depression?

A

Cognition is slow with complaints of poor memory
Pseudo-dementia
Deficits in working memory, attention and planning
Compounded by anxiety

22
Q

Is insight preserved in depression?

A

Yes
Aware of symptoms however attribution can often be affected by the illness; symptoms may be blamed on sins, physical illness, personal failings and weakness

23
Q

What systems are used to classify depression?

A

ICD-10

DSM-5

24
Q

How does the DSM-5 classify depression?

A

Depressive disorders; major depressive disorder

Persistent depressive disorder

25
Q

How does ICD-10 classify depression?

A

Mania
Bipolar
Depressive disorder
Dysthymia

26
Q

What is the general criteria for the diagnosis of depression?

A

A; depressive episode should last at least 2 weeks

B; no hypomanic or manic symptoms sufficient to meet criteria (this would classify it as bipolar disorder)

27
Q

What are the core features of depression?

A

At least 2 out of 3:

  1. Depressed mood to a degree that is definitely abnormal for the individual, present for most of the day and almost every day largely uninfluenced by circumstances and sustained for at least 2 weeks
  2. Loss of interest or pleasure in activities that are normally pleasurable
  3. Decreased energy or increased fatigability
28
Q

What are common additional symptoms of depression?

A 
Loss of confidence or self-esteem 
Guilt 
Suicidal behaviour 
Lack of concentration 
Agitation or retardation 
Sleep disturbance
Change in appetite
29
Q

How can the severity of depression be assessed?

A

Rating scales e.g.:
Hamilton rating scale for depression
Montgomery-Asberg depression rating scale
Beck depression inventory
ICD-10 rates severity according to the number of symptoms

30
Q

How is a moderate depressive episode defined?

A

2 core symptoms + 4 others = score of at least 6

31
Q

How is a severe depressive episode defined?

A

All 3 core symptoms + 5 other = total of at least 8

32
Q

Are mild depressive episodes treated?

A

NO; antidepressants no better than placebo and generally is self-limiting

33
Q

What needs to be present to diagnose somatic syndrome depression?

A

4 of the following:
Marked loss of interest or pleasure in activities that are normally pleasurable
Lack of emotional reactions to events or activities that normally produce an emotional response
Waking in the morning 2 hours or more before the usual time
Depression worse in the mornings
Retardation or agitation
Marked loss of appetite
Weight loss
Marked loss of libido

34
Q

What is atypical depression?

A

A; mood reactivity (mood brightens in response to actual or positive events)
B; two or more:
Significant weight gain
Hypersomnia
Leaden paralysis
Long-standing pattern of interpersonal rejection sensitivity

35
Q

What is cotards syndrome?

A

Subtype of psychotic depression;
More common in elderly
Nihilistic delusions

36
Q

Is chronic treatment treatment-refractory?

A

No, not necessarily

37
Q

What is the criteria for the diagnosis of chronic depression?

A

MDD for at least 2 years

38
Q

What are the 5 R’s of depression?

A 
Response
Remission
Relapse
Recovery
Recurrence
39
Q

What is dysthymia?

A

Chronic depression of mood lasting at least several years, which is not sufficiently severe to justify a diagnosis of severe, moderate or mild recurrent depressive disorder

Psychiatry (35 decks)

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