Depression Flashcards
4 Depressive Disorders
Major Depressive Disorder (Unipolar)
Bipolar Depressive Disorder
Dysthymic Disorder - chronic, not as severe
Depressive Disorder NOS
Notable Point about Depression After Medical Event
Increased mortality rate in post-MI and stroke pts
Who Depression Hits
Mainly women right in prime production years
Highest Depression Risk Factor
Recent childbirth
Chief Complaint of Depressed Patients
Usually physica symptoms
Criteria for MDD
> = 5 SIGECAPS, one MUST be depressed mood/loss of interest or pleasure
Risk Factors for Suicide
SADPERSONS Sex - F more likely to try, M more likely to succeed Age Depression Prior Attempt EtOH Abuse Rational Thinking Loss Social support loss Organized plan No spouse Sickness chronic
4 Biological Theories of MD Pathogenesis
Genetic predisposition
Neurochemical alterations
Neuroendocrine Alterations (HPA alteration)
Inflammation (pro inf cytokines)
3 Serendipitous Findings of Biogenic Amine Theory
Reserpine is anti-NE, suicide increased
Iproniazid is MAOI - mood improvement
Tryptophan depletion diet = recurrence of depression episodes (precursor to 5HT)
5HT and Depression 3 Connections
Low levels of 5HT metabolite found in CSF
Increased density of 5HT2 Rs found
SSRIs are highly effective antidepressants
NE and Depression 3 Connections
Low levels of NE metabolites found in urine/CSF
Increased density of BetaARs found on cortex
NE reuptake inhibitors are effecitve antidepressants
BDNF
End point of all antidepressants: increase BDNF for neuronal growth and maintenance. Years of depression shows brainn atrophy from lack of BDNF
Neuroendocrine Theory
HPA dysregulation yields higher CRF release from hypothal and you lose feedback from ACTH and cortisol and diurnal rhythm
Inflammation Theory of Depression
Endocrine dysregulation stimulates immune system to increase cytokines (like IFN alpha) which are messengers b/w it and CNS. These lead to “sickness behavior,” similar to depression
Best Marker for Depression
Increased IL-6
