Mood Disorders

Question 1

Key causative factors for depression and bipolar disorder (biopsychosocial model)

Answer 1

Biological:
Genetic vulnerability or family history
Neurochemical imbalances (e.g., serotonin, dopamine)
Hormonal changes or medical conditions

Psychological:
Negative thinking patterns
Low self-esteem
Poor coping or problem-solving skills
History of trauma or abuse

Social:
Stressful life events (loss, relationship issues)
Social isolation or lack of support
Socioeconomic hardship

Question 2

Affect

Answer 2

Observable mood (subjective)

Question 3

Mood

Answer 3

How the patient feels (objective)

Question 4

Egocentric

Answer 4

The patient’s thoughts of themselves

Question 5

Elation

Answer 5

Great happiness or exhilaration

Question 6

Euthymic

Answer 6

Typical mood range

Question 7

Dysthymic

Answer 7

Lowered mood that is chronic

Question 8

Labile

Answer 8

Rapidly changing emotional state

Question 9

Impulsivity

Answer 9

Behavioural acts based on feelings that lack forethought

Question 10

Somatisation

Answer 10

Manifestation of psychological distress in the form of physical symptoms

Question 11

Pressure of speech

Answer 11

Rapid and often loud speech

Question 12

Anhedonia

Answer 12

Loss of interest in usually pleasurable activities

Question 13

Psycho-motor retardation

Answer 13

Slowing up of usually fluid physical movements

Question 14

Depression

Answer 14

Feelings of ‘blue’ to very severe extraordinary sadness, dejection, and inability to take part in life’s activities

Question 15

What are the DSM-5 diagnostic criteria for Major Depressive Disorder, and what key symptom must be present?

Answer 15

At least five of the following symptoms during the same 2-week period, with at least one being (1) depressed mood or (2) loss of interest or pleasure:

1. Depressed mood
2. Loss of interest or pleasure
3. Significant weight loss/gain
4. Insomnia or hypersomnia
5. Psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Feelings of worthlessness or guilt
8. Indecisiveness or difficulty concentrating
9. Recurrent thoughts of death or suicide

Question 16

Cyclothymia

Answer 16

Chronic Bipolar Affective Disorder (BPAD) with milder depressive symptoms

Question 17

Postpartum depression

Answer 17

**Depressive symptoms occurring after 2 weeks post-birth. **

Includes low mood, fatigue, irritability, anxiety, poor concentration, and difficulty bonding with the baby

Question 18

Grief

What are the stages? (4) S+P, P, D, R

Answer 18

A normal emotional response to loss, progressing through stages:
* Shock and protest – disbelief and emotional numbness
* Preoccupation – intense longing or focus on the deceased
* Disorganisation – difficulty functioning, sadness, withdrawal
* Resolution – gradual acceptance and re-engagement with life

Question 19

Medical Conditions

Answer 19

Examples:
- Parkinsons disease
- Dementia
- Multiple Sclerosis
- Anaemia
- Brain leisions
- Hypothyroidism
- Thyrotoxicosis
- Cushings syndrome
- Influenza
- Vitamin B12/folate deficiency

Question 20

Drug reactions

Answer 20

Precipitate Depression: Antihypertensives, corticosteroids, levodopa, digitalis, cytotoxic drugs, antimalarials, sulphonamides, antipsychotics, cholesterol-lowering drugs.

Precipitate Mania: Corticosteroids, antidepressants, levodopa, LSD, cocaine, amphetamines.

Question 21

DSM-5 Criteria for a manic disorder

Answer 21

A. Persistent and abnormal elated expansive or irritable

B. Increased energy of activity, of 3 or more of the following symptoms:

1 Inflated self-esteem or grandiosity
2 Decreased need for sleep
3 Pressure of speech
4 Flight of ideas or racing thoughts
5 Distractibility
6 Increase in goal directed activity
7 Excessive involvement in pleasurable activity

C. **Mood disturbances causing marked impairment to social or occupational functioning **
D. The episode is not due to substances or medical conditions

Question 22

Beliefs concerning people who are suicidal

Answer 22

Suicidal individuals are experiencing intense emotional pain or distress.
Suicide can be a cry for help, not always a desire to die.
Feelings of hopelessness, isolation, or entrapment are common.
Support and timely intervention can prevent suicide.

Question 23

Why do people find it difficult to talk about suicide?

Answer 23

Stigma and fear of judgment.
Shame, guilt, or hopelessness.
Fear of upsetting others or consequences of disclosure.
Lack of skills or words to express thoughts.

Question 24

Concerns regarding talking about suicide

Answer 24

Fear of saying the wrong thing or making the situation worse.
Anxiety about responsibility if the person acts on suicidal thoughts.
Feeling unprepared or lacking confidence/skills

Question 25

What should be included in a risk analysis plan? | C D H E P S S B S

Answer 25

Category of risk Details of historical risk information Health-related factors Environmental factors Planned intent Staff allocation Strengths Barriers Specific risk

Question 26

Stable risk factors associated with suicide risk

Answer 26

Age Gender Marital status History Family hx of suicide Childhood adversity Employment difficulties

Question 27

Dynamic risk factors associated with suicide risk

Answer 27

Mental state Isolation Recent loss Recent experience of suicide with a family/ friend Adversity or stress Access to means Unauthorised leave or failure to return from leave

Question 28

Protective risk factors associated with suicide risk

Answer 28

Help seeking behaviours Strong and dependable social supports Positive engagement with services Stable employment and accommodation Prolonged abstinence from substances

Question 29

Questions you would ask someone you suspect or know is dealing with suicidal ideation

Answer 29

* “Does it seem unbearable sometimes?” * “Have you had thoughts of hurting yourself?” * “Have you ever tried to hurt yourself?” * “Do you ever have thoughts of hurting someone else?” * “Have you ever had to protect yourself from others?”