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Depression Flashcards

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1
Q

What are the 2 major types of depression?

A
  1. Unipolar depression: Single or recurrent episodes of depression only.
  2. Bipolar depression: Episodes of depression with episodes of mania.
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2
Q

What is the occurrence of depression across different genders?

A
  1. Unipolar depression: More common in females (2:1 ratio compared to males)
  2. Bipolar depression: Equal gender distribution
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3
Q

What are the psychological symptoms of depression?

A
  1. Sad mood
  2. Worry
  3. Negative perception of self and life
  4. Concentration difficulties
  5. Suicidal thoughts
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4
Q

What are the biological symptoms of depression?

A
  1. Insomnia/excess sleep
  2. Weight gain/loss
  3. Loss of sex drive
  4. Motor changes (slow/fast movements)
  5. Lack of energy
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5
Q

What are the behavioural symptoms of depression?

A
  1. Anhedonia (inability to feel pleasure)
  2. Slow speech
  3. Excess crying
  4. Constant complaining
  5. Seeking help
  6. Hypochondria (anxiety about being ill)
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6
Q

What are the symptoms of mania?

A
  1. Heightened self-esteem
  2. Talkativeness
  3. Lack of concentration
  4. Increase in motivation
  5. Too little sleep
  6. More risk taking
  7. More ideas
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7
Q

What are the types of bipolar depression?

A
  1. Bipolar I: Episodes of mania >7 days
  2. Bipolar II (hypomania): Episodes of mania 3 - 7 days
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8
Q

What are possible causes for decreasing age of onset for depression?

A
  1. Loss of family support (e.g. due to university)
  2. Fewer/less stable marriages
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9
Q

What are the genetic aspects of depression?

A
  • Unipolar depression is slightly heritable (~30-50%)
  • Bipolar depression is highly heritable (~80%)
  • Several genes have been implicated as to having small effects
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10
Q

What is the psychoanalytic theory of depression?

A
  • Susceptibility to depression is caused by loss in early childhood, and is triggered later in life by similar loss.
  • Loss of parent before age of 11 is major risk factor for depression
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11
Q

What are the types of losses that can be exprienced according to the psychoanalytic theory of depression?

A
  1. Actual loss: Loss of loved one
  2. Symbolic loss: Loss of job, possession…
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12
Q

What is the ‘cognitive theory’ of depression?

A
  1. Negative self schema: Negative life event
  2. Cognitive bias: Greater bias for processing negative information
  3. Negative triad: Negative thinking
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13
Q

What is the negative triad?

A
  1. Self
  2. World
  3. Future
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14
Q

What is the evidence for negative cognitive bias?

A

Patients suffering from depression show:

  1. Enhanced ability to remember negative events.
  2. Slower reaction time towards positive stimuli compared to negative ones
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15
Q

What is the ‘absence of positive bias’ theory of depression?

A
  • Instead of having a bias towards negative thinking, depressed patients have a lack of positive bias displayed by non-depressed individuals.
  • Positive bias is the tendency to think that a negative event is less likely to happen to oneself despite prevalence suggesting probability is high.
  • Depressed individuals have a more realistic outlook on the world.
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16
Q

What are risk factors for depression?

A
  1. Negative life event: Experience of loss
  2. Challenging family dynamics: Lack of support
  3. Early childhood abuse
  4. Neuroendocrine factors
  5. Neurobiological factors
17
Q

How does early childhood abuse predispose to depression?

A
  1. Early childhood abuse leads to excess stress during childhood.
  2. Stress causes dysregulation of the HPA axis which causes increased cortisol release to later stressors.
  3. Increased release of cortisol predisposes to depression.
18
Q

What are the neuroendocrine factors predisposing to depression?

A

Elevated levels of stress hormone cortisol

19
Q

Which areas of the brain are involved in depression?

A
  1. Lower activity in prefrontal cortex of depressed patients compared to normal patients when shown positive words
  2. Higher activity in amygdala of depressed patients compared to normal patients when shown negative words
  3. Reduced activity in subgenual cingulate cortex (diminished in depressive episodes and elevated in manic episodes)
20
Q

What are the treatments for depression?

A
  1. Monoamin oxidase (MAO) inhibitors: Inhibits breakdown of 5-HT
  2. Selective serotonin reuptake inhibitors (SSRIs): Inhibits reuptake of sertonin
21
Q

What is the mechanism behind action of anti-depressants?

A

Upregulation of 5-HT activity in the brain

22
Q

What is the serotonin hypothesis of depression?

A

Depression is caused by low levels of serotonin activity in the brain

23
Q

What are the problems with the serotonin hypothesis of depression?

A
  1. Anti-depressants elevate 5-HT levels immediately, but their anti-depressive effects only take action after ~1 month.
  2. 5-HT based antidepressants don’t work on all patients with depression.
  3. Invalid to assume that just because anti-depressants work by increasing levels of serotonin, low levels of serotonin cause depression.
24
Q

What are non-pharmacological treatments for depression?

A
  1. Cognitive-based therapy (CBT): Psychiatrist discusses problems with patients and give them coping strategies.
  2. Self-remission: Depression goes away by itself.
  3. Electroconvulsive therapy: Small electric currents are passed through brain to trigger seizure.
  4. Surgery: E.g. deep brain stimulation, stimulating parts of the brain that are underactive in depression with electrode.
25
Q

What explanation is given for delayed effects of 5-HT based anti-depressants?

A
  • Anti-depressants don’t affect mood. Instead, they affect cognitive processing.
  • Anti-depressants promote positive bias in thinking.
  • Positive bias leads to more positive thoughts, thus alleviating symptoms of depression over period of time as these thoughts build up.
26
Q

What is the cognitive neuropsychological model of depression?

A
  1. Genetic changes in 5-HT transporters, reuptake and function.
  2. Compromised 5-HT function affects neural circuits involved in emotion control, causing negative bias.
  3. Higher executive function allows cognitive control over negative bias so that negative thoughts don’t ‘take-over’.
  4. Negative schema
  5. Loss of cognitive control of negative thoughts and therefore they take over, leading to symptoms of depression.

Psychology (12 decks)

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