Theme 1. Affective disorders.
1. The definition of “emotion” and “mood”.
2. The Classification Of Affective Disorders.
3. Cyclothimia and dysthimia. Massked depressions.
4. Clinical Features of depressive disorders:
-The Symptoms and Signs of Moderately Severe Depressive
Disorder
-Additional Symptoms of Severe Depressive Disorder
("Psychotic Depression")
-Additional Features of Mild ("Neurotic") Depressive
Disorder
5. Clinical Features of Mania
-manic triad;
-additional psychiatric symptoms;
-physical symptoms.
6. Course and Prognosis
7. The treatment of affective disorders.
8. Prevention of Relapse and Recurrence
Tests
1. What of the listed below symptoms is not the feature of the "masked depression"?
a) complaints of weight loss
b) complaints of sleep disturbance
c) complaints of depressive mood
d) complaints of amenorrhea in women
e) nothing listed
2. What of the listed below symptoms is not the feature of the moderately severe
depressive disorder?
a) psychomotor retardation
b) constipation
c) self-blame
d) nihilistic delusion
e) suicidal ideas
3. How is the depressive disorder in which restless and senseless activity are
prominent called?
a) masked depression
b) agitated depression
c) moderately severe depression
d) severe depression
e) retarded depression
4. How is the depressive disorder in which may be psychotic symptoms called?
a) masked depression
b) agitated depression
c) moderately severe depression
d) severe depression
e) retarded depression
5. What of the listed treatment are most adequate for prevention of recurrence in case
of bipolar disease?
a) antidepressant medication
b) lithium carbonate
c) clopixol-depot
d) cognitive therapy
e) electroconvulsive
6. A systematic scheme for the description of affective disorders include all listed
categories, except:
a) type
b) course
c) severity
d) pathogenesis
e) aetiology
7. What of the listed below symptoms is the characteristic of the "masked
depression"?
a) weight loss is not conspicuous
b) sleep disturbance is not conspicuous
c) depressive mood is not conspicuous
d) amenorrhea in women is not conspicuous
e) all listed
8. What of the listed below symptoms is the characteristic of the severe depressive
disorder?
a) psychomotor retardation
b) constipation
c) self-blame
d) nihilistic delusion
e) suicidal ideas
9. How is the depressive disorder in which slowing of movement and poverty of
speech are prominent called?
a) masked depression
b) agitated depression
c) moderately severe depression
d) severe depression
e) retarded depression
10. What of the listed below symptoms is not the feature of the neurotic depressive
disorder?
a) anxiety
b) phobias
c) obsessive symptoms
d) early-night insomnia
e) mood worse in the morning
11. What of the listed treatment are most adequate for prevention of relapse in case of
unipolar depressive disorder?
a) antidepressant medication
b) lithium carbonate
c) carbamazepine
d) cognitive therapy
e) electroconvulsive therapy
12. How is the depressive disorder in which symptoms are caused by factors within
the individual person and are independent of external stressors called?
a) bipolar disorder
b) neurotic depression
c) secondary depression
d) reactive depression
e) endogenous depression
Clinical task 1.
A 29-year-old woman is brought to the emergency department by her husband. She
is extremely talkative, and her speech is disorganized and rapid. She claims to be an
"agent of God" who has been sent to deliver a coded message to the leaders of the
world. She says that she speaks with God almost constantly and that she hasn't slept in
several days, as she has "too much to do." The patient is easily distracted, frequently
interrupts psychiatrist’s questions, and jumps from one topic to another without
pausing when speaking. The patient's husband says she has never acted this way before
and that her symptoms came on gradually over the past 2 weeks. The changes began
with the patient becoming unusually energetic and having a decreased need for sleep.
She started to talk more and more, though she is usually a fairly quiet and introspective
person. A few days ago. she suddenly became preoccupied with religious ideas. The
man claims that his wife has no medical problems, takes no medications, and does not
use alcohol or illicit drugs.
1. What symptoms does the patient have?
2. What psychopathological syndromes does the patient have?
3. What disease can you think of?
4. Prescribe treatment to the patient.
Clinical task 2.
A 37-year-old woman is concerned because she "feels lousy" all the time. She
almost always feels tired and overworked and often has trouble concentrating. She says
that her symptoms began about 10 years ago, but she has never sought psychiatric help.
The patient reports feeling depressed just about every day, and hardly ever feels as
though things are going well in her life. She denies suicidal ideation, weight loss, or
any discrete episodes of particularly severe symptoms. She is an accountant and has
been with the same company for 12 years; she believes she has been able to perform
her work duties adequately. Family history is significant for depression in her father
and one of her paternal uncles. During interview the patient is alert, oriented, and
intelligent. Her mood is depressed, but she is not tearful. She is pessimistic and seems to
have a fairly low self-esteem. Her cognitive and reasoning abilities are intact, and she
denies hallucinations or delusions. Her thoughts and speech are organized and logical.
Her weight is normal for height.
1. What symptoms does the patient have?
2. What psychopathological syndromes does the patient have?
3. What disease can you think of?
4. Prescribe treatment to the patient.
Clinical task 3.
A 29-year-old woman has experienced a 12-year history of periods of feeling great
followed by periods of feeling lousy. During her feeling-great periods, she
experiences increased sexual drive, euphoric mood, and increased irritability. During
her feeling lousy periods, she experiences insomnia, fatigue, and low self-esteem. 7
years ago she was graduated from a medical university and successfully work since.
Family history is significant for depression in her maternal grandmother.
1. What symptoms does the patient have?
2. What psychopathological syndromes does the patient have?
3. What disease can you think of?
4. Prescribe treatment to the patient.
List of recommended literature
1.
2.
3.
4.
5.
6.
Basic literature.
Concise Oxford Textbook of Psychiatry. M. Gelder, D. Gath, R.Mayou. –
Oxford; New York; Tokyo; Oxford University Press, 2007. – 953 p.
Modern Synopsis of Psychiatry. A.M. Freedman, H.I. Kaplan, B.J. Sadock. –
USA, 1982. – 433 p.
Psychiatric Dictionary / 5th ed. R.J. Campbell. – Oxford; New York; Oxford
University Press, – 1981. – 693 p.
Psychopatology and addictive Disorders / Ed. By Meyer. - New York; London,
1986. – 283 p.
Psychiatry: course of lecture /Ed.by V.S. Bitensky. – Odessa, 2005. – 336 p.
Zimbardo Ph.G. Psychology and Life. - USA, 19991. – 189 p.
Additional literature.
1.
2.
3.
4.
5.
6.
7.
8.
9.
Brundtland G.H. Mental health in the 21st century // Bulletin of the World Helth
Organization. – 2000. - №87. – Р. 411.
Desjarlais R., Eisenberg L., Good B. et al. World Mental Health: Problems
and Priorities in Low-Income Countries. – New York: Oxford University Press,
1995. – 144 p.
Marsella A., Kleinman A., Good B. Cross-cultural studies of depressive
disorders. An overview. Culture and depression. – Berkley: University of
California Press, 1985. – 213 p.
Mulrow C.D., Williams J.W. Jr., Trivedi M., et al. Treatment of depression:
newer pharmacotherapies. Rockville, MD: Agency for Health Care Policy and
Research, 1999. – 253 р.
Murray C.J.L., Lopez A.D. The global burden of disease: a comprehensive
assessment of mortality and disability from disease, injuries and risk factors in
1990 and projected to 2020. Cambridge, MA: Harvard University Press, 1996. –
68 p.
Kielholz P. Masked Depression. — Berne, 1973. – 97 p.
Lopez-Ibor J. J. The Present Status of Psychotropic Drugs / Ed. by A. Cerletti,
F. J. Bove. - New York, 1999. - 519 p
Preskorn, S.H. Outpatient management of depression: A guide for the Primarycare practitioner/ S.H. Preskorn. - Wichita; Kansas: Professional
Communications,Inc., 1994. - 147 p.
Ustun T.B., Sartorius N. Mental Illness in General Health Care. An
International Study. – Chichester: John Willey @ Sons Ltd, 1995. – 336 p.