Depression Flashcards
Dx criteria for MDD?
Sx for reference
1. Depressed/anxiety
2. Anhedonia (loss of interest)
3. Weight changes >BMI%
4. (Insomnia/Hypersomnia)
5. Agitation/restlessness
6. Fatigue/loss of energy
7. Increased guilt/worthlessness
8. Decreased Concentration
9. Recurrent morbid/suicidal thoughts
5 symptoms for a duration of at least two weeks
Dx criteria for persistent depressive disorder?
Sad most days for at least 2 years. (1 year kids)
At least 2 symptoms (almost all of the time)
- Hopeless
- Hypo/hypersomnia
- Low energy or fatigue
- Low self-esteem
- Poor appetite
- Poor concentration
What are the characteristics of Atypical subtype depression?
- Overeating
- Oversleeping
- Weight Gain
- Over-reactive mood
Nearly 40% of the risk for depression is dependent on what?
Genetic factors
Predisposition to depression is linked to genes related to _______ _____
Monoamine neurotransmitters
Which regions of the brain are hypoactive in depression?
Prefrontal Cortex
Hippocampus
What is significant anatomically about the hippocampus in depression
The total hippocampus volume gets LOWER after more DAYS of untreated depression
Genetic predisposition for depression have a negative affective bias, which leads to what?
Disorder of synaptic plasticity leading to a maladaptive emotional learning
Chronic, inescapable stress can lead to enduring and profound changes in synaptic plasticity which gradually modify what?
The shape and connectivity of neurons in key brain regions
Chronic stress leads to what hormone?
Cortisol
Genetic factors can lead to changes in which two hormones?
Serotonin and NE
If Serotonin and NE, along with extra cortisol, contribute to BDNF and other neuroptrophic factors, thus changing synaptic plasticity, what results?
Depression
5HT2C relates to which chemical
Serotonin
Which receptors relate to NE
A1, a2, b1, b2, b3
What does Brain-Derived Neurotrophic Factor (BDNF) do?
Cell health/growth
Cell apoptosis (death)
Learning and memory
______ regulate the synthesis and release of BDNF
Monoamines
HPA Axis is a feedback loop that enables the key endocrine response to stress.
- What are the main hormones that activate the HPA axis?
- What hormone is involved in the negative feedback loop?
- Corticotropin-Release Hormone (CRH) and Adrenocorticotropin Hormone(ACTH)
- CORTISOL
Chronically, cortisol, reduces what?
Cortisol chronically reduces serotonin, norepinephrine, and BDNF, resulting in synapties and dendritic remodeling.
Cortisol chronically reduces serotonin, norepinephrine, and BDNF, resulting in synaptic changes and dendritic remodeling.
Atrophy of cortex results from what
Excess cortisol which leads to BDNF suppression.
Dexamethasone is used in endocrine tests in depression how?
Dexamethasone typically suppresses ACTH and cortisol in normal individuals.
Not in depressed patients. (Due to tolerance to persistently high CRH secretion)
In the hippocampus and some part of the cortex: chronic stress causes a reduction of BDNF and dendritic arborization.
How can antidepressants work to alleviate this?
Antidepressant therapies reverse effects and enhance BDNF and dendritic growth
In the graph, what did we see in the treatment of depression time frame.
Acute (6-12 weeks)
Continuation (4-9 Months)
Maintenance (>1 year)
Acute (6-12 weeks): Response, Relapse, Remission
Continuation (4-9 Months): Relapse?
Maintenance (>1 year): Possible recurrence
The transport of serotonin by SERT is regulated by co-transport with _____
Sodium
