Depression Flashcards
subsets of MDD:
post partum and SAD
MDD criteria:
persistent over 2 weeks
core symptoms of MDD:
low mood
anhedonia
depression age of onset:
19
median age of depression age of onset:
31
the second peak of depression onset:
50-59 year olds
Higher rates of depression in those:
living with a disability, and unemployed
out of all mental disorders, has the largest effect on:
disability-adjusted life years
depression treatments
medication
CBT
life changes
creative therapies
electroconvulsive therapy
magnetic stimulation
ant-depressants are used…
short or long term
electroconvulsive therapy is used for what type of depression?
major depression
acute phase
relapse occurs before remission
continuation phase
relapse occurs after remision
recovery definition
maintenance phase, 1 year after episode
recurrence refers to symptoms arising during what phase?
maintenance
% of heritability for MDD?
30-50%
effect of genetic variants:
lower stress threshold for depression to develop
TB drugs used in depression
Iproniazid and isonaizid
Iproniazid and isonaizid mechanism of action:
monoamine oxidase A and B inhibitors
catecholamines
dopamine
noradrenaline
adrenaline
what are catecholamines derived from?
tyrosine
what are indolamines derived from?
tryptophan
histidine is the precursor of what group of monoamines?
imidazoleamines
he majority of antidepressants prescribed today target monoamines but many ….
do not respond, even if biochemical changes occur
limitations of the monoamine hypothesis:
- non-responders
- therapeutic lag
3.monoamine depletion experiments - no associated biomarkers
why do synaptic monoamine levels not remain high?
long-term firing rate causes receptor desensitisation
what is Reserpine?
prevents monoamine packing into vesicles
Reserpine was found to induce what effects?
depressant AND anti-depressant
issues with MAO-A activity in depressed patients?
can overlap with healthy participants
HAM-D
Hamilton Depression Rating Scale
which individuals show a larger response to anti-depressants?
those with lower monoamine breakdown rate
What processes does cortisol affect?
cognition (memory) and mood
cortisol is released via what axis?
HPA
Name 2 disorders that are symptomatic of depression and linked to HPA axis:
insomnia/ hypersomnia
when does cortisol peak in depressive episodes?
later in the day
describe the effect of antidepressants on cortisol peak?
resembles that of healthy individuals
explain the relationship between depression and neurogenesis and plasticity.
cortisol reduces neurogenesis
BDNF reduced in depressed patients
plasticity may explain the therapeutic lag in patients with depression
Why may depressed patients exhibit a larger negative bias?
emotional processing changes due to altered brain circuits
alternate explanations of depression
inflammation
glutamate
gut microbiome
