affective disorders Flashcards
define major depressive disorders (MDD)
recurrent depressive episodes with no history of mania
define bipolar affective disorder (BPAD)
at least one manic episodes +- depressive episodes
diagnostic criteria 1 for MDD >1
- abnormal mood most of the day, nearly everyday for at least 2 weeks
- abnormal loss of all interest and pleasure, nearly everyday, at least 2 weeks
- if <18, abnormal irritable mood, nearly everyday, at least 2 weeks
diagnostic criteria 2 for MDD >5
- abnormal depressed mood
- abnormal loss of all interest and pleasure
- appetite and weight disturbance either increase or decrease
- sleep disturbance (insomnia or hypersomnia)
- activity disturbance
- abnormal fatigue or loss of energy
- feeling of worthlessness/ inappropriate guilt
- decrease ability to think or concentrate
- recurrent thoughts of death, suicidal ideation
does the patient with MDD fully recover?
no. 50% of patient will develop recurrence
aetiology and associated factors of MDD
- high socioeconomic costs
- high economic cost
- premature mortality
- reduced productivity
- absenteeism - sometimes genetically
- precipitated by other disease eg: stroke, dementia, cancer
- aging
- medications
criteria 1 for BPAD
- one manic episode and no past major depressive disorder
- manic episodes not schizoaffective and not superimposed on schizophrenia
- has multiple mood eg: hypomanic, manic, mixed, depressed, unspecified
criteria 2 for BPAD
- presence of >1 major depressive disorder
- presence of >1 hypomanic episode
- no history of manic or mixed episode
- mood episode of 1 and 2 are not superimposed with schizophrenia
- symptoms will cause distress/ impairment in social and occupational
associated factors of BPAD
- strong heritable risk
- environmental triggers
what serotonin and noradrenaline regulate?
- mood
- sleep cyle
- appetite
- motivation
- pain perception
- neuroendocrine function
explain monoamine oxidase inhibitors (MAOIs) -rarely used
- inhibit MAO from degrading serotonin and NA
- cause more serotonin and NA to be release
- 5HT and NA will no be degraded into carboxylic acid
examples of selective, reversible and competition inhibitor MAOIs
- moclobemide
- clorgyline
transient side effects of MAOIs
- postural hypotension
- dry mouth
- blurred vision
- urinary retention
- weight gain
- restlessness
- insomnia
examples of non-selective, irreversible, non-competition inhibitor MAOIs
- phenelzine
- tranylcypromine
what are the serotonin reuptake inhibitosr?
- non-selective tricyclic antidepressant (TCAs)
- selective serotonin reuptake inhibitors (SSRIs)
- serotonin-noradrenaline reuptake inhibitors (SNRIs)
