Abnormal Mood

Question 1

What are the Appetitive/Approach Systems

Answer 1

Ascending dopamine systems - mesolimbic/cortical projection

Question 2

What are the Aversive/Defensive Systems?

Answer 2

Ascending serotonin systems

NA/CRF peptide transmitters

Question 3

Is depression more common in women or men or equal?

Answer 3

Twice as common in women

Question 4

What is depression associated with?

Answer 4

Disability and Quality of life

Disease

Question 5

What increases the risk in first degree relatives?

Answer 5

MDD (3X) or BDP (2X) in the proband

Question 6

What are endocrine changes associated with major depression regarding the adrenals?

Answer 6

Increased ACTH
Increased Cortisol
Elevated CORT in urine/saliva
Increased CRH in CSF
Blunted ACTH to CRH
Enlarged Adrenal Glands

Question 7

What are endocrine changes associated with major depression regarding the thyroid?

Answer 7

Increased TRH and CSF

TSH response blunted in 20-25% despite normal basal TSH, T3 and T4

Question 8

What is the Anterior Insular Cortex?

Answer 8

Dense connectivity with Anterior Cingulate Cortex
Long considered visceral sensory region
Co-activation of AIC and ACC during almost all studies of emotion

Question 9

What does the Anterior Insular Cortex send?

Answer 9

Parallel descending projections to sensory and motor nuclei in brainstem

Question 10

What is the Anterior Insular Cortex proposed as?

Answer 10

Limbic motor (ACC) and sensory (AIC) cortices that engender the feeling (awareness) and motivation (agency) associated with emotion