12.1.1 Mood Disorders Flashcards
What are the two classes of mood disorders?
Depressive disorders
Bipolar disorders
What is another term for mood disorders?
Affective disorders
How long must you have symptoms before diagnosing a depressive disorder?
At least 2 weeks
What are the core symptoms of depressive disorders?
Low mood
Lack of energy
Lack of enjoyment and interest
What type of depressive thoughts may a person with depressive disorder have?
Suicidal ideation
What are some biological symptoms of depressive disorders?
Lack of appetite
Pain
What may be experienced in severe cases of depressive disorders ?
Psychotic symptoms e.g. delusions
What is the difference between depression and adjustment reaction?
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- Adjustment reaction typically occurs after a traumatic event, fewer somatic features
- Adjustment reactions do not last as long as depression and tend to have a fluctuating course
What are the clinical features of mania?
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- Elevated mood and energy levels with racing thoughts
- Psychosis may be a feature
Manic people are quite easy to identify
Hypomania refers to symptoms that are still clearly manic but don’t necessarily reach full criteria for mania
How can you diagnose bipolar affective disorders?
Can diagnose following two episodes of a mood disorder, one of which must be either mania or hypomania
Can be diagnosed with bipolar without ever having been diagnosed with depression
Bipolar disorder is essentially fluctuations in mood
What are the two types of bipolar disorder?
Bipolar 1- episodes of mania or mania and depression
Bipolar 2-episodes of hypomania or hypomania and depression
What physical differentials are there for depression?
Hypothyroidism
B12 deficiency
Chronic disease
Substance misuse
Hypoactive delirium
What physical differentials are there for mania?
Hyperthyroidism
Delirium (hyperactive type)
Iatrogenic (e.g. steroids)
Infection (encephalitis or HIV)
Head injury
Intoxication (stimulants e.g. cocaine)
What regions of the brain may have pathology in mood disorders?
Limbic system
Frontal lobe
Basal ganglia
All interact with each other
What are the important functions of the limbic system?
Emotion
Memory
Motivation
What is the main circuit in the limbic system?
Papez circuit
Outline the Papez circuit
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- Various cortical areas send input to the hippocampus
- Hippocampus projects to the mamillary bodies via the fornix (white matter output pathway of the hippocampus)
- Mamillary bodies project to the thalamus and hypothalamus
- Thalamus projects back to the cortex and the hypothalamus projects to pituitary and autonomics mediating some of somatic effects
Amygdala is another part of the limbic system, can be grouped with hippocampus in terms of connections
What part of the brain is also very important for the papez circuit?
Hypothalamus
What is the Papez circuit also responsible for?
Memory consolidation where the hippocampus is able to induce long term potentiation in the cortex to lay down long term memory
What happens structure size of the limbic system and hypothalamus in depression and bipolar disorders?
Change in size and activity
What is the frontal lobe responsible for?
Higher cognition
Impulse control
Voluntary muscle control
Social and moral reasoning
Speech- Broca’s
Memory, mood and attention
HIV Serious Stuff, Might Mean AIDS
Why is the frontal lobe involved in generation and expression of emotions?
Inferior portions of the anterior part of the frontal lobe are connected with the amygdala
What is the role of the basal ganglia?
Motor and cognitive
Also has important roles in emotion, thought and behaviour ergo changes in basal ganglia volume and activity are seen in mood disorders
What does deep brain stimulation do in OCD?
Subthalamic nucleus is stimulated, leads to increased excitation of globus pallidus internus and substantia nigra
