Chapter 16 - Mood Disorders Flashcards
What is clinical depression characterized by (6)?
Unhappy mood Pessimism Restless agitation Lack of concentration Loss of energy and interest Changes in sleep patterns, appetite, weight
Clinical depression affects what % of the population?
13-20% (at one time or another)
What % of depressed patients commit suicide? What % is this of all suicides?
15%, 80%
What is the % concordance of depression in monozygotic twins? Dizygotic twins?
60%, 20%
In functional imagining (PET), what is observed with patients with depression?
Increased blood flow to frontal cortex and amygdala
Decreased blood flow to posterior temporal lobe and anterior cingulate
[Neurochemistry] What is depression associated with?
Decreased activity at monoamine synopsis (5HT and NE)?
Antidepressants (increase/decrease) monoamine synapses?
Increase
Prevent breakdown, prevent re-uptake
In suicide victims, what is observed?
Low 5-HT levels in brain
Variant of the 5-HT2A receptor
What is electroconvulsive therapy? What does it do?
Induces large scale seizure
Rapidly reverses severe depresses by enhancing monoamine neurotransmission
What do antidepressant treatments increase?
Neurogenesis in the hippocampus
Does latency match therapeutic lag for antidepressant treatments?
Yes
Does latency match therapeutic lag for antidepressant treatments?
Yes
When you block neurogenesis, what is also blocked?
The behavioural effects of antidepressants
Cushing’s Syndrome involves high levels of what?
Circulating glucocorticoids
True or false? People with depression have higher cortisol levels than other people.
True
What is dexamethasone?
Synthetic corticoid
What does dexamethasone prevent?
Normal morning rise in ACTH, and therefore of cortisol
What is the purpose of the dexamethasone Suppression Test?
Relieve depression
What is the purpose of the Dexamethasone Suppression Test?
Diagnose Cushing syndrome
Relieve depression
How are sleep patterns different in depressed patients (3)?
Insomnia
Decrease in slow wave sleep
Decreased REM latency
What happens in patients with bipolar depression?
Alternation between depressed and manic moods
What characterizes mania?
Over-activeness
Talkative increased energy
Strange grandiosity
Between the different states in bipolar depression, what is observed in the brain?
Functional differences
Patients with bipolar depression have (larger/smaller) ventricles?
Larger
What is used to treat patients with bipolar depression?
Lithium
What is used to treat patients with bipolar depression?
Lithium
What is seasonal affective disorder?
Depression that hits every winter
What is linked to seasonal affective disorder?
Lack of sunlight exposure during the winter (indoor lighting insufficient)
What are the causes of of seasonal affective disorder?
Circadian
Hormonal
What are potential treatments for seasonal affective disorder?
Lengthening of the “day”
Vitamin D
What characterizes an anxiety disorder?
Overwhelming intensity
Irrational fear
Intense physiological reaction (e.g. dizziness, trembling)
Unpredictable
How can panic attacks be triggered in those with a history?
Exercise
Injection of lactic acid
How does the injection of lactic acid trigger attack in those who suffer from panic disorders?
Activate norepinephrine cells in locus coerulus
With respect to neuroanatomy, what abnormalities are observed in patients with panic disorders?
Smaller temporal lobe volume
Lesions, dilation of lateral ventricles
There is a (positive/negative) correlation between # of abnormalities and # of attacks/age of onset.
Positive
There is a (positive/negative) correlation between # of abnormalities and # of attacks/age of onset.
Positive
Which circuit are panic disorders likely to affect?
Fear (amygdala)
Using functional imaging, what was observed in patients with panic disorders?
Increased activity in parahippocampal area
Lower activity in anterior temporal lobes and amygdala
What do patients with panic disorders often self-medicate themselves with?
Alcohol, opiates, barbiturate
What is the most effective/most prescribed drug for panic disorders?
Benzodiazepines (Vallium)
How do benzodiazepines act?
Act at GABA(A) synapses, enhance GABA activity
What has been observed of 5HIAA levels in CSF of panic disorder patients?
Elevated levels
What type of agnostic can induce panic attacks?
Serotonin
What type of receptors are less numerous in panic attack patients?
5HT(1A) receptors
(Raphe, cingulate
What type of receptors are less numerous in panic attack patients?
5HT(1A) receptors
Raphe, cingulate
What agonists can reduce panic disorder symptoms?
SSRIs and some 5HT1A agonists
What characterizes obsessive compulsive disorder (OCD)?
Pathological orderliness
Compulsions - tasks repeated
Obsessions - recurrent thoughts
OCD often co-occurs with which mood disorder?
Depression
Like depression, OCD patients also show (increased/decreased) REM latency?
Decreased
PET scans of OCD patients reveal what?
High metabolic activity in orbitofrontal cortex, cingulate, caudate nucleus
What type of treatment is particularly effective against OCD and what does this suggest?
SSRI
Suggests serotonergic cause
