12- Mood Disorders Flashcards
What are the two broad classes of affective (mood) disorders?
Depressive and bipolar disorders
What are the core symptoms of a depressive disorder?
Low mood, lack of energy, lack of enjoyment/interest
What differences are there between depression and an adjustment reaction?
Adjustment reactions has more fluctuating symptoms less affecting energy or sleep generally not lasting as long and follow a traumatic event
What are features of mania?
Elated mood, increased energy, racing thoughts, decreased need for sleep, loss of normal social inhibitions, grandiose
What is hypomania?
Symptoms that are manic but dont reach full diagnostic criteria for mania
How is bipolar disorder diagnosed?
Following two episodes of a mood disorder from mania or hypomania
How does bipolar 1 differ to bipolar 2?
1- episodes of mania or mania and depression
2-episodes of hypomania or hypomania and depression
What are some potential physical differentials fro depression?
Hypothyroidism, B12, Chronic disease, Substance misuse, Hypoactive delirium
What are some physical differentials for mania?
Hyperthyroidism, hyperactive delirium, head injury, stimulant intoxication, iatrogenic (e.g steroid induced)
What is the main emotion circuit known as?
The papez circuit
What are some possible basal ganglia changes in unipolar depression?
Decreased basal ganglia volume, reduced activation between striatum, amygdala and prefrontal cortex
Where is serotonin in the CNS mostly produced?
Raphe nuclei in the brain stem
What does serotonin have rolled in?
Sleep, mood, appetite, impulse control
What are the levels of serotonin thought to be like in depression compared to normal?
Decreased serotonin in depression
What is some evidence supporting the role of serotonin in depression?
SSRI’s successfully treat it, tryptophan depletion causes depression, 5HIAA is low in CSF of patients with depression
What is tryptophan?
A precursor of serotonin
What is 5HIAA?
A metabolite of serotonin
Where is noradrenaline released from in the brain stem?
Locus coeruleus
what is noradrenaline important for?
Mood, arousal and memory
What is some supporting evidence that lower noradrenaline levels link to depression?
Drugs increasing noradrenaline treat depression, people. Recovered from depression with low levels are more likely to relapse
How is depression treated biologically?
SSRIs are first line, electroconvulsive therapy for severe cases
How is depression treated psychologically and socially?
Cognitive behaviour therapy and help with social stressors
How do you treat acute mania in bipolar disorders?
Biological- Antipsychotics and mood stabilisers
How do you treat acute bipolar depression?
Antidepressant with mood stabiliser cover and CBT
How do you maintain stability in bipolar disorders?
Mood stabiliser with or with antipsychotic, education, CBT, social support
