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Neuro missing > 12- mood disorders > Flashcards

12- mood disorders Flashcards

1
Q

Symptoms depression

A

Low mood, lack of energy enjoyment and interest, depressive thoughts, somatic/biological symptoms eg. Early waking, psychotic symptoms

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2
Q

Adjustment vs deprssion

A

Sudden vs gradual, fluctuating vs constant, depression has sleep disturbances and weight loss

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3
Q

Mania features

A

Elated mood, increased energy, pressure of speech, decreased need for sleep, flight of ideas, normal social inhibitions lost, inflated self esteem, psychotic symptoms

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4
Q

Bipolar one

A

Discrete episodes of mania only or mania and depression

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5
Q

Bipolar two

A

Discrete episodes of hypo mania or hypo mania and depression

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6
Q

Physical differentials for depresion

A

Thyroid dysfunction, b12 deficiency anaemia, substance misuse, hypoactive delirium, chronic renal/cvs and liver failure

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7
Q

Mania physical differentials

A

Iatrogenic eg. Steroid induced. Hyperthyroidism, delirium, infection eg. Encephalitis/HIV/syphilis, head injury, stimulant intoxication

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8
Q

Which brain systems are involved in mood disorders

A

Limbic system, frontal lobe, basal ganglia

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9
Q

What determines mood

A

Abnormal Circuits or NT between limbic system, frontal lobe and basal ganglia.

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10
Q

What is affected buy limbic system

A

Emotion, memory/concentration, memory

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11
Q

Limbic changes that could cause depression (unipolar)

A

Decreased hippocampal volume, decreased cerebral blood flow and metabolism in amygdala

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12
Q

Limbic changes that can cause bipolar

A

Altered amygdala volume, increased amygdala activation and volume in mania, decreased volume in anterior Paralympic cortices and activation

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13
Q

Frontal lobe functions

A

Motor, language (broca’s), purposeful goal directed behaviours, attention, memory, mood, social and moral reasoning

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14
Q

Action of venteromedial prefrontal cortex and orbital prefrontal cortec

A

Venteromedial- generation of emotions

Orbital- emotional responses, possible connection fo amygdala

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15
Q

Unipolar depression frontal lobe changes

A

Decreased activity and blood flow in dorsolateral PFC and decreased volume of orbits frontal PFC

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16
Q

Bipolar changes in frontal lobe

A

Reduced dorsolateral PFC activation

17
Q

Basal ganglia changes in depression

A

Decreased basal ganglia volume, reduced activation between striatum, amygdala and PFC

18
Q

Basal ganglia changes in boipolar

A

Functional changes in striatum

19
Q

Two main neurotransmitters for derpession

A

Serotonin and noradrenaline

20
Q

Where is serotonin produced

A

Raphe nuclei in brainstem

21
Q

Rile of serotonin

A

Sleep, impulse control, appetite, mood

22
Q

Evidence that low serotonin causes depression

A
  • SSRIs, SNRI, TCAs and MAOis treat depression by increasing serotonin in synaptic cleft
  • 5HIAA (serotonin metabolite) is low in CSF of depresion patients
  • tryptophan (serotonin precursor) depletion causes depression
23
Q

How to treat mild depression

A

No anti depressants as they don’t work

24
Q

Who do antidepressants work best in

A

Severely depressed patients

25
Q

Where is noradrenaline produced

A

Locus coeruleus in pons

26
Q

Functions nordadrenaline

A

Mood, role in fight or flight, memory functions

27
Q

Evidence that noradrenaline is decreased in depression

A

SNRIs increase NA treat depression. Patients who recover who have low NA relapse more, using post mortems

28
Q

Treatment depression

A

1st line- SSRIs. Or SNRIs, TCAs if not improving after 6 weeks
If on 3rd treatment if 2 have failed- give lithium
Life threatening- ECT(electroconvulsive therapy)

CBT, social help

29
Q

Treatment manis

A

Antipsychotics or mood stabiliser
-long term psycho education on triggers and sign of relapse. Not good in short term

  • treat in space of safety where risk to self or others is minimal
30
Q

Treatment bipolar

A

Anti depression with mood stabiliser cover- lithium or sodium valproate.
Antipsychotic eg. Quetiapine, ECT/lithium

CBT

Social

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