Depression Flashcards
Globally, what percentage of adults suffer from depression?
5%
What percentage of patients with depressive illness are eventually found to have a bipolar illness?
10%
Describe the 3 types of bipolar disorder.
Bipolar I - at least one manic episode
Bipolar II - at least one hypomanic episode
Bipolar III - hypomania only occurs when taking an antidepressant
Depression in elderly patients can mimic which disease?
Dementia
In depression, which 2 areas of the brain have decreased activity?
Prefrontal cortex
Hippocampus
In depression, which 2 areas of the brain have increased activity?
Amygdala
Hypothalamus
The monoamine hypothesis of depression states that there is a reduction in which 3 neurotransmitters?
Noradrenaline
Serotonin
Dopamine
What are the 2 main sites of production of noradrenaline?
Locus coeruleus
Lateral tegmental area
What is the main site of production of serotonin?
Raphe nuclei
Explain in what way the HPA axis is abnormal in depression, and what effects this has on the hippocampus and amygdala.
The hypothalamus is overactive, producing too much CRH and stimulating the anterior pituitary to release too much ACTH, and therefore causing elevated cortisol in the blood.
The elevated cortisol causes atrophy of the hippocampus and stimulates the amygdala.
Stimulation of the amygdala results in a positive feedback loop.
Which test can be used for suspected depression to check the function of the HPA axis?
With an abnormal HPA axis, what would the result be?
Dexamethasone suppression test
In a positive test, cortisol levels would remain high after taking dexamethasone
Which neurotrophic factor is decreased in depression?
Brain-derived neurotrophic factor
Which receptors bind brain-derived neurotrophic factor?
TrkB receptors
How are TrkB receptors changed in depression? Why is this?
Overproduction of TrkB receptors in an attempt to compensate for decreased levels of brain-derived neurotrophic factor (BDNF)
In what way are dendrites changed in depression?
Decreased dendritic arborisation (branching)
What are the 3 main negative thinking patterns that CBT would attempt to fix?
Catastrophizing
Over-generalizing
Categorial (all or nothing) thinking
What are 2 stimulation therapies used to treat depression?
Electroconvulsive therapy (ECT)
Transcranial Magnetic Stimulation (TMS)
What are 2 common side effects of electroconvulsive therapy?
Memory loss
Short term muscle aches
