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Affective Disorders

1. Constipation is a good discriminatory feature between major depression & primary Anorexia Nervosa. F
2. Early morning wakening is a good discriminatory feature between major depression & primary Anorexia Nervosa. F
3. A cold extremity is a good discriminatory feature between major depression & primary Anorexia Nervosa. T
4. Distorted body image is a good discriminatory feature between major depression & primary Anorexia Nervosa. T
5. Low self-esteem is a good discriminatory feature between major depression & primary Anorexia Nervosa. F
6. Cognitive errors in depression include Regression F
7. Cognitive errors in depression include Dichotomous thinking T
8. Cognitive errors in depression include Over generalisation T
9. Cognitive errors in depression include Personalisation T
10. Cognitive errors in depression include Selective abstraction T
11. Features of depression in individuals who have a learning disability include poverty of speech T
12. Features of depression in individuals who have a learning disability include diurnal variation of behaviour T
13. Features of depression in individuals who have a learning disability include loss of appetite T
14. Features of depression in individuals who have a learning disability include psychomotor retardation T
15. Features of depression in individuals who have a learning disability include behavioural changes T

16. In affective disorders the life time risk in first degree relatives of a patient with BPAD is twice that in those of a patient with unipolar illness T
17. Father to son transmission has been shown in BPAD T
18. Genetic heterogeneity for bipolar illness has been demonstrated T
19. The relatives of patients with bipolar illness show higher rates of unipolar illness T
20. A strong family Hx means that fewer life events are are needed to induce a depressive episode F

21. Failure to ask direct questions may hinder detection of depression in a clinical interview T
22. Failure to use appropriate scales may hinder detection of depression in a clinical interview F
23. Lack of empathy from interviewer may hinder detection of depression in a clinical interview T
24. Presence of psychosis may hinder detection of depression in a clinical interview T
25. Failure of the interviewer to follow non verbal cues may hinder detection of depression in a clinical interview T

26. On a first interview with a severely depressed patient, it is appropriate to ask about total number of previous partners F
27. On a first interview with a severely depressed patient, it is appropriate to ask about decreased sexual interest T
28. On a first interview with a severely depressed patient, it is appropriate to ask about masturbation fantasies F
29. On a first interview with a severely depressed patient, it is appropriate to ask about homosexual experience F
30. On a first interview with a severely depressed patient, it is appropriate to ask about relationship with current partner T
31. Bereavement will often be associated with depression in the elderly T
32. Dementia will often be associated with depression in the elderly T
33. Strong genetic component will often be associated with depression in the elderly F
34. Physical illness will often be associated with depression in the elderly T
35. Poor outcome will often be associated with depression in the elderly T
Although short term outcome is good in the longer term up to 50% do not
show complete recovery & show higher death rates than their non
depressed peers. Depression arising denovo in the elderly has far smaller
genetic component than in younger age groups. Physical illness & prescribed
medications can be a cause.

36. Dysthymia rarely fulfils the criteria for depression T
37. Dysthymia is not included in ICD 10 F
38. Life time prevalence of dysthymia according to epidemiological catchment area survey ECA is 0.5% F 3%
39. Dysthymia rates are increased in women T
40. Dysthymia rates are increased in widows F

41. Mutism is a feature of severe depression T
42. Cotard syndrome is a feature of severe depression T
43. Absence of sadness is a feature of severe depression T
44. Agitation is a feature of severe depression T
45. Visual hallucination is a feature of severe depression T

46. Memory changes after ECT occur in about 50% of patients F all
47. Memory changes after ECT are the same after unilateral & bilateral ECT F
48. Memory changes after ECT are the same despite the quantity of current used F
49. Memory changes after ECT include brief retrograde amnesia T
50. Memory changes after ECT disappear with in a few weeks of finishing treatment T

51. Depression in the elderly may be precipitated by diuretic treatment T
52. Depression in the elderly may be precipitated by going in to residential home care T
53. Depression in the elderly may be precipitated by bereavement T
54. Depression in the elderly may be precipitated by myocardial infarction T
55. Depression in the elderly may be precipitated by dementia T

56. 27% of the population are reported to have depressive symptoms
57. Depressive symptoms are more common in low socio-economic class T
58. The annual incidence of BPAD is between 9 & 25 /100000 in males T
59. The annual incidence of BPAd is between 45 & 90 /100000 in females F
60. Life time risk of BPAD is 5% F <1%

61. Clinically significant depression is associated with part time employment F
62. Clinically significant depression is associated with the 5th day post partum F
63. Clinically significant depression is associated with the early phase of senile dementia T
64. Clinically significant depression is associated with treatment with flupenthixol F
65. Clinically significant depression is associated with Parkinson’s disease T

66. A man of 65 suffering his first episode of depression has a normal life expectancy F
67. A man of 65 suffering his first episode of depression may be having early dementia T
68. A man of 65 suffering his first episode of depression has a better prognosis than a man of the same age who had several episodes T
69. A man of 65 suffering his first episode of depression is likely to respond to antidepressants T
70. A man of 65 suffering his first episode of depression should not be treated with ECT F

71. Anhedonia Is pivotal for diagnosis of BPAD in ICD 10 F
72. Anhedonia occurs in schizophrenia T
73. Anhedonia is the same as boredom F
74. Anhedonia rarely occur in depression F
75. Patients can easily recall the onset of anhedonia F

76. The apparent absence of a depressed mood is a feature of depressive pseudodementia T
77. Recent onset of expressive aphasia is a feature of depressive pseudodementia F
78. Increased confusion when under pressure is a feature of depressive pseudodementia F
79. Marked apathy is a feature of depressive pseudodementia T
80. Early morning wakening is a feature of depressive pseudodementia T
81. Diurnal variation of behaviour suggests the presence of depression in a patient with learning disability T
82. Repeated non suicidal DSH suggests the presence of depression in a patient with learning disability T
83. Aphonia suggests the presence of depression in a patient with learning disability T
84. Reduced appetite suggests the presence of depression in a patient with learning disability T
85. Early morning wakening suggests the presence of depression in a patient with learning disability T


86. Moving to a residential home Is likely to precipitate depression in the elderly T
87. Isolation Is likely to precipitate depression in the elderly T
88. Dementia Is likely to precipitate depression in the elderly T
89. Use of diuretics Is likely to precipitate depression in the elderly T
90. Bereavement Is likely to precipitate depression in the elderly T

91. Depression of mood may be caused by Propranolol T
92. Depression of mood may be caused by Reserpine T
93. Depression of mood may be caused by Clonidine T
94. Depression of mood may be caused by Frusemide T
95. Depression of mood may be caused by Digoxin T

96. Irritability suggests the diagnosis of mania rather than schizophrenia
97. Brief episodes of depression suggest the diagnosis of mania rather than schizophrenia T
98. Delusions of grandiosity suggest the diagnosis of mania rather than schizophrenia T
99. Somatic passivity suggests the diagnosis of mania rather than schizophrenia F
100. Stereotypy suggests the diagnosis of mania rather than schizophrenia F

101. Labile mood is seen in Delirium T
102. Labile mood is seen in Pseudobulbar palsy T
103. Labile mood is seen in Hysteria T
104. Labile mood is seen in Simple schizophrenia F
105. Labile mood is seen in Severe depression F
106. Mania in the elderly is as common as unipolar depression in this age group F

107. Mania in the elderly is less likely to present as a pure state than as a mixed affective picture T
108. Mania in the elderly will have always been preceded by an earlier episode of depression F

109. Mania in the elderly will have always been preceded by an earlier episode of mania F

110. Mania in the elderly is commoner in females T

111. Inflated self esteem is a characteristic feature of hypomania T

112. Periods of transient depressive mood is a characteristic feature of hypomania T

113. A feeling of extreme despair is a characteristic feature of hypomania F

114. Parsimony is a characteristic feature of hypomania F

115. Reduced concentration is a characteristic feature of hypomania F

116. Weight loss belongs to the typical clinical picture of depression T

117. Disturbed sleep belongs to the typical clinical picture of depression
118. Urinary incontinence belongs to the typical clinical picture of depression F
119. Forgetfulness of recent events belongs to the typical clinical picture of depression T
120. Feeling of unworthiness belongs to the typical clinical picture of depression T
121. A manic episode never occurs for the first time in over 65s F
122. A manic episode may present as a confusional stateT
123. A manic episode is very liable to recur T
124. A manic episode gives rise to primary delusions F

125. Emotional lability in a newly admitted excited man of 30 supports a diagnosis of schizophrenia rather than mania F
126. Aggressive outbursts ina newly admitted excited man of 30 support a diagnosis of schizophrenia rather than mania F
127. Paranoid ideas in a newly admitted excited man of 30 support a diagnosis of schizophrenia rather than mania F
128. Occasional depreciatory auditory hallucinations a newly admitted excited man of 30 support a diagnosis of schizophrenia rather than mania
129. Thought broadcast in a newly admitted excited man of 30 support a diagnosis of schizophrenia rather than mania F
130. Characteristic features of mania include primary delusions F
131. Characteristic features of mania include brief episodes of depressed mood T
132. Characteristic features of mania include Irritability T
133. Characteristic features of mania include response to lithium treatment within 3 days F
134. Characteristic features of mania include disinhibition T
135. On MSE anger outbursts suggest mania T
136. On MSE over familiarity suggests mania T
137. On MSE choreoform movements suggest mania F
138. On MSE mannerism suggests mania F
139. On MSE suggest mania Stupor T
140. The Beck’s depression inventory is a 21 item scale T
141. Mania in elderly is commoner in women than men T
142. In depressive illness overactivity indicates that the diagnosis should be changed to a mixed affective state F
143. The diagnosis of mania is compatible with easily provoked tearfulness T
144. With regard to depressive disorders unipolar disorders are twice as common in females as in males T
145. Unipolar depression has an earlier age of onset than BPAD F
146. The median duration of a manic episode is about 4 months T
147. Made impulses are more suggestive of mania than schizophrenia F
148. Motor over- activity differentiates frontal lobe syndrome from mania F
149. Disinhibition differentiates frontal lobe syndrome from mania F
150. In psychoanalytic model of depression the therapist’s alliance is analogous to the secure base T
151. A sense of dread suggests a diagnosis of depression rather than anxiety F
152. Hypochondriasis is an important presentation of depressive illness T
153. Reminiscence treatment is useful in the treatment of depression F
154. Patients with bipolar disorder have more episodes of illness than patients with unipolar depression T
155. Elderly patients with depression have a higher mortality rate than those without depression T
156. Bipolar disorder can be differentiated from schizophrenia on the bases of response to neuroleptics F
157. The prevalence of depression is greater in rural than urban areas F
158. Rapid cycling bipolar disorder requires the presence of at least 3 affective episodes in 12 months F
159. Prolactin response to infusion of L- tryptophan is increased in depressed patients F decreased
160. Depressive disorders are more common in higher social classes F BPAD is more common in higher social classes
161. Schneider’s first rank symptoms can be seen in mania T
162. The most common cause of atypical chest pain without an organic cause is depression F panic disorders
163. Retardation of thinking is a characteristic feature of depression T
164. The presence of psychosis in a depressed patient predicts poor response to ECT F psychosis & biological features predict good response
165. The most important predictor to response to lithium treatment is a family history of bipolar illness F though this is a predictor of good response the most important predictor is compliance with treatment
166. Paranoid features in mania indicate poor response to lithium T
167. Following a psychotic episode 25% of patients suffer from depression T
168. According to ICD 10 one episode of mania is sufficient to make a diagnosis of BPAD F 2 episodes
169. Relatives of patients with BPAD have a greater genetic predisposition to develop mood disorders than relatives of patients with unipolar depression T
170. In BPAD with increased episodes of the illness the period of remission between episodes become shorter T
171. In bipolar disorder lithium is more effective in preventing relapse of manic than depressive episodes T
172. Post natal depression is present following 10-15 % of all deliveries T
173. Retardation or agitation are common presenting features of depression in elderly T
174. To diagnose a depressive disorder features of depression should have been present for at least 2 weeks T
175. Depression is a feature of chronic fatigue syndrome T
176. Attention & concentration are impaired in depression T
177. Mania followed by depression has a better response to lithium than depression followed by mania T
178. The mean age of onset of bipolar illness is 28 year F
179. The earlier the age of onset of depression the greater the risk of recurrence
180. Early morning awakening is a feature of generalised anxiety disorder F
181. Insomnia is a characteristic feature of seasonal affective disorder F hypersomnia
182. Mania in the elderly more often present with irritability & agitation than elation of mood T
183. The rate of major depression does not differ across races T
184. Beck’s depression inventory is a self-rating scale T
185. Hamilton’s depression rating scale HAD-D is a self rating scale F observer rated


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