20 Mood Disorders Flashcards
What are the symptoms of depressive disorders? (core symptoms+addtional symptoms)
Core symptoms:
- Low mood
- Lack of energy
- Lack of enjoyment and interest
+
- Depressive thoughts
- Somatic/biological symptoms (eg not sleeping, loss of appetite, not drinking)
- SEVERE: psychotic symptoms
Differentiate between an adjustment reaction and clinical depression. (eg following a bereavement)
What are the features mania?
(opposite of depression)
- 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
What is the definition of bipolar disorder?
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
What are the 2 different types of bipolar disorder?
Bipolar 1 =
- discrete episodes of mania only
- mania and depression
Bipolar 2 =
- discrete episodes of hypomania
- hypomania and depression
Give some physical health differentials for depression. (ie what could an underlying cause be?)
- Hormone disturbance eg thyroid dysfunction
- Vitamin deficiencies eg Vitamin B12
- Anaemias
- Substance misuse eg alcohol
- Hypoactive delirium
Give some physical health differentials for mania. (ie what could an underlying cause be?)
- Iatrogenic eg steroid induced
- Hyperthyroidism
- Delirium
- Infection eg encephalitis, HIV, syphylis
- Head injury
- (intoxication with stimulant)
Give 3 brain structures which are involved in mood disorders.
Limbic system, frontal lobe, basal ganglia
What are the main functions of the limbic system?
- Emotion
- Motivation
- Memory
What are the possible limbic system changes for unipolar depression.
What are the possible limbic changes in bipolar affective disorder?
What are the functions of the ventromedial prefrontal cortex and orbital prefrontal cortex thought to be?
Ventromedial prefrontal cortex: Generation of emotion
Orbital prefrontal cortex: Emotional responses
What are the possible frontal lobe changes thought to be for unipolar depression and bipolar affective disroder.
Name 3 neurological illnesses which may be partially caused by malfunctions of the basal ganglia. (has motor, emotion, cognition and behaviour functions) )
- Parkinson’s disease
- Wilson’s disease
- Huntington’s disease
What are the possible basal ganglia changes for unipolar depression.
Useful summary for circuits in brain involved in depression:
What 2 neurotransmitters are we concerned about when looking at depression?
Serotonin
Noradrenaline
(both= monoamines)
Where is serotonin produced? What is it thought to have roles in? (4)
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
Where is noradrenaline produced? What functions is it thought to have in brain?
(thought to be decreased in depression)
Produced:
- Locus coeruleus (pons)
- projects to limbic system and cortex
Functions:
- Mood
- Behaviour- arousal and attention (fight or flight)
- Memory functions
What is the evidence supporting the idea that noradrenaline is decreased in depression?
How is depression treated? (think biological, psychological, social)
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Tricyclic Antidepressants (TCAs)
Why do we need to be so careful when treating bipolar disorder?
Difficult to find balance- if treating too aggressively- will tip them the other way
How is mania treated? (think biological, psychological, social)
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
What biological treatment should we consider for bipolar disorder?
- Antidepressant- ONLY with mood stabiliser cover
- Electroconvulsive therapy
- Lithium (mood stabiliser-antivonvulsant)
Give some examples of mood stabilisers.
Lithium
Sodium valproate
Antipsychotic- eg Quetiapine used as modd stabiliser
