20 Mood Disorders Flashcards

1
Q

What are the symptoms of depressive disorders? (core symptoms+addtional symptoms)

A

Core symptoms:

  1. Low mood
  2. Lack of energy
  3. Lack of enjoyment and interest

+

  • Depressive thoughts
  • Somatic/biological symptoms (eg not sleeping, loss of appetite, not drinking)
  • SEVERE: psychotic symptoms
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2
Q

Differentiate between an adjustment reaction and clinical depression. (eg following a bereavement)

A
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3
Q

What are the features mania?

(opposite of depression)

A
  • Elated mood
  • Increased energy
  • Pressure of speech (speaking fast)
  • Flight of ideas
  • Loss of normal social inhibitions
  • Attention can’t be sustained
  • Self esteem= inflated–> often grandiose
  • Psychotic symptoms eg having beliefs that aren’t real
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4
Q

What is the definition of bipolar disorder?

A

Bipolar diagnosis= 2 episodes of a mood disorder at least one of which is mania or hypomania

Don’t have to have a diagnosis of depression to be given diagnosis of bipolar disorder

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5
Q

What are the 2 different types of bipolar disorder?

A

Bipolar 1 =

  • discrete episodes of mania only
  • mania and depression

Bipolar 2 =

  • discrete episodes of hypomania
  • hypomania and depression
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6
Q

Give some physical health differentials for depression. (ie what could an underlying cause be?)

A
  • Hormone disturbance eg thyroid dysfunction
  • Vitamin deficiencies eg Vitamin B12
  • Anaemias
  • Substance misuse eg alcohol
  • Hypoactive delirium
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7
Q

Give some physical health differentials for mania. (ie what could an underlying cause be?)

A
  • Iatrogenic eg steroid induced
  • Hyperthyroidism
  • Delirium
  • Infection eg encephalitis, HIV, syphylis
  • Head injury
  • (intoxication with stimulant)
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8
Q

Give 3 brain structures which are involved in mood disorders.

A

Limbic system, frontal lobe, basal ganglia

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9
Q

What are the main functions of the limbic system?

A
  • Emotion
  • Motivation
  • Memory
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10
Q

What are the possible limbic system changes for unipolar depression.

A
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11
Q

What are the possible limbic changes in bipolar affective disorder?

A
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12
Q

What are the functions of the ventromedial prefrontal cortex and orbital prefrontal cortex thought to be?

A

Ventromedial prefrontal cortex: Generation of emotion

Orbital prefrontal cortex: Emotional responses

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13
Q

What are the possible frontal lobe changes thought to be for unipolar depression and bipolar affective disroder.

A
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14
Q

Name 3 neurological illnesses which may be partially caused by malfunctions of the basal ganglia. (has motor, emotion, cognition and behaviour functions) )

A
  • Parkinson’s disease
  • Wilson’s disease
  • Huntington’s disease
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15
Q

What are the possible basal ganglia changes for unipolar depression.

A
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16
Q

Useful summary for circuits in brain involved in depression:

A
17
Q

What 2 neurotransmitters are we concerned about when looking at depression?

A

Serotonin

Noradrenaline

(both= monoamines)

18
Q

Where is serotonin produced? What is it thought to have roles in? (4)

A

Serotonin

Produced:

  • Brain stem (Raphe nuclei)
    • –> transported to cortical areas and limbic system

Roles in:

  • Sleep
  • Impulse control (link with suicide)
    • Low levels of serotonin= associated with higher rates of suicide
  • Appetite
  • Mood
19
Q

Where is noradrenaline produced? What functions is it thought to have in brain?

(thought to be decreased in depression)

A

Produced:

  • Locus coeruleus (pons)
    • projects to limbic system and cortex

Functions:

  1. Mood
  2. Behaviour- arousal and attention (fight or flight)
  3. Memory functions
20
Q

What is the evidence supporting the idea that noradrenaline is decreased in depression?

A
21
Q

How is depression treated? (think biological, psychological, social)

A

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Tricyclic Antidepressants (TCAs)

22
Q

Why do we need to be so careful when treating bipolar disorder?

A

Difficult to find balance- if treating too aggressively- will tip them the other way

23
Q

How is mania treated? (think biological, psychological, social)

A

Biological

  • First line: antipsychotics
  • Alternative: mood stabiliser

Psychological (not helpful in short term)

  • Long term: Psychoeducation re. triggers, signs of relapse

Social:

  • Treat in safe place
  • Consider implications of mania eg excessive spending
24
Q

What biological treatment should we consider for bipolar disorder?

A
  • Antidepressant- ONLY with mood stabiliser cover
  • Electroconvulsive therapy
  • Lithium (mood stabiliser-antivonvulsant)
25
Q

Give some examples of mood stabilisers.

A

Lithium

Sodium valproate

Antipsychotic- eg Quetiapine used as modd stabiliser