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NEUR1202 > Class 10: Depression > Flashcards

Class 10: Depression Flashcards

1
Q

Define Mood Disorder

A

A disorder in which a person’s general emotional state or mood is distorted or inconsistent with circumstances and interferes with your ability to function

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2
Q

Define Major Depressive Disorder

A

Persistent feeling of sadness and hopelessness and loss of interest in activities once enjoyed.

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3
Q

What is the most common mood disorder?

A

Major Depressive Disorder

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4
Q

Does Major Depressive Disorder have physical symptoms? If so what are some examples

A

Chronic pain or digestive issues

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5
Q

How common is depression?

A

1 in 6 people are diagnosed with depression

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6
Q

What are the 8 diagnostic criteria for depression in the DSM-5?

A
  1. Persistent feelings of sadness
  2. Diminished ability to think or concentrate, or indecisiveness
  3. Loss of interests in activities
  4. Appetite or weight changes (more than 5% in. month)
  5. Fatigue or decreased energy
  6. Feeling of worthlessness or excessive inappropriate guilt
  7. Slowing down of thoughts and physical movement
  8. Recurrent thoughts of death or suicide
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7
Q

What are the 3 criteria to be diagnosed with major depressive disorder and for how long?

A
  1. Must show 5+ symptoms for a period of 2 weeks and one must be depressed mood or loss of interest or pleasure.
    2 . Must NOT be due to direct physiological effects of a substance or medical condition
  2. Must NOT be better explained by other psychiatric disorders
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8
Q

In which gender is depression more often diagnosed?

A

Female

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9
Q

Does depression increase or decrease with age (in adults)?

A

Decrease

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10
Q

How are the symptoms of MDD between men and women different?

A

Males have higher rates of irritability, anger and often feel more discouraged.

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11
Q

What are 3 different risk factors for MDD?

A
  1. Genetics
  2. Major life changes, trauma, or stress
  3. Certain physical illnesses or medications
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12
Q

What can cause increased rate of MDD in women?

A

Hormonal fluctuations: menstrual cycle, pregnancy, postpartum, miscarriage, pre & post menopause

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13
Q

What is the concordance rate between twins (identical and fraternal) in MDD?

A

Identical: 45.6%
Fraternal: 20.2%

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14
Q

What can the gene BDNF increase the chance of?

A

MDD

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15
Q

What chemical is this?

A

Dopamine

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16
Q

What chemical is this?

A

Norepinephrine

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17
Q

What chemical is this?

A

Serotonin(5-HT)

18
Q

What was depression traditionally strictly thought to be?

A

A deficit in monoamine signaling

19
Q

Define Monoamine

A

A NT that contains one amino group connected to an aromatic ring by a two-carbon chain (such as -CH2-CH2)

20
Q

Define 4 examples of ‘deficit in signaling’

A
  • Limited release of NTs,
  • deficit in ability to clear NTs in synapse,
  • limited receptors to bind to,
  • low affinity,
  • etc
21
Q

What are three monoamines?

A

Dopamine, Norepinphrine, Serotonin

22
Q

What is the monoamine hypothesis?

A

Depression is caused by alterations in the synaptic activity of 5-HT

23
Q

What are two pieces of evidence of the monoamine hypothesis states?

A
  1. Monoamine oxidase inhibitors are effective antidepressants (in some individuals)
  2. Selective serotonin reuptake inhibitors (SSRIs) are effective antidepressants (in some individuals)
24
Q

How do SSRI drugs help treat depression?

A

Blocking the serotonin reuptake transporters while allows more Serotonin to activate post-synaptic transporters

25
Q

Do NTs work in isolation?

A

NO!

26
Q

Does SSRI’s efficacy prove that the low NTs are responsible for depression?

A

No. Since lowering NTs in a non depressed person does not lead to depression and while the NTs recover in days, symptoms do not recover as quickly (could be months)

27
Q

What 4 factors could be at play in MDD?

A
  1. NT imbalance
  2. Abnormal connections between important neuronal circuits (between PFC, hippocampus, etc)
  3. Dysfunctional neuroplasticity
  4. Stress/Glucocorticoid
28
Q

Define the Glucocorticoid Hypothesis

A

Dysfunctional regulation of the HPA axis stress response contributes to depression

29
Q

Define Hypercortisolemia

A

Elevated levels of cortisol in blood, even during non-stressful times.

30
Q

What can cause hypercortisolemia?

A

Chronic stress during childhood can lead to oversecretion of cortisol, associated with depression in adulthood (45% of (over 2 year) depressed patients experience abuse or loss in childhood)

31
Q

What is the effect of continued exposure to high levels of cortisol?

A

Further damages to hippocampus (meaning the longer you have depression the worse it gets)

32
Q

What is the visual difference of cell density between a healthy hippocampus and depressed hippocampus?

A

Healthy hippocampus have a higher cell density.

33
Q

What is the general relationship between total hippocampus volume by days of untreated depression?

A

Hippocampus volume decreases the longer depression is untreated.

34
Q

How do antidepressants reverse damage to hippocampus?

A

Antidepressants can increase the rate of neurogenesis in the hippocampus

35
Q

What is neurogenesis blocked by?

A

By cortisol and certain cytokines (IL-1)

36
Q

What are the 5 facets of the Multi-faceted disease, depression?

A
  1. NTs
  2. Structural Correlates
  3. Neuroinflammation
  4. HPA Axis Dysfunction
  5. Neurogenesis and Neuroplasticity
37
Q

Which mental illness could Ketamine potentially help?

A

Depression

38
Q

What type of drug is Ketamine?

A

Dissociative Anesthetic

39
Q

What are the effects of ketamine at low doses?

A

subject feels detached from their body, sensation of floating, dreamlike and euphoric state

40
Q

What are the effects of ketamine at high doses?

A

Subjects lose all mental contact with their environment, despite eyes open

41
Q

What does ketamine do for depression?

A

Inhibits GABA (which inhibits neurons) therefore strengthening of synaptic plasticity

NEUR1202 (15 decks)

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