Depression

Question 1

MDD has a prevalance of 5-25% (????)

Answer 1

(DSM-IV-TR, 2000)

Question 2

What is the criteria according the DSM-IV-TR 2000

Answer 2

The experiences of major depressive episodes that are define by at least of the 5 following symptoms for at least 2 weeks:

• Loss of interest
• Depressed mood
• Appetite or weight disturbance
• Thoughts of suicide/death
• Worthlessness/guilt
• Sleep disturbance
• Concentration difficulties

Depressed mood or loss of interest must be one of the symptoms with an inclusion compound.

Question 3

MDD is common and moderately heritable and serotonin is the main neurotransmitter that is implicated in depression. (????)

Answer 3

(Levinson, 2006)

Question 4

genetics have a small effect of risk and GxE factors are more likely necessary for the development of depression. (????)

Answer 4

(Lohoff, 2010)

Question 5

A longitudinal study, examined why stressful life events can lead to depression in some but not others.
- found that indv with one/two copies of the short allell 5HT T (serotinin transporter) exhibited suicidality, depressive symptoms and dep dianogsis
- compared to indv who are homozygous for long allele
indicates that indv response to stimuli is moderated by their genetic make-up
- evidence for GxE (????)

Answer 5

(Caspi et al., 2003)

Question 6

what are the 3 main aspects of beck’s cognitive triad?

Answer 6

Negative thoughts about the Self, The World and The Future

Question 7

Menke (2014) conducted a review and found

Answer 7

• some candidates of prototypes show epigenetic changes with anti-depressant treatment
• and so epigenetic mechanisms could be a new avenue for novel antidepressant drugs
• states that epigenetics could yield as biomarkers for diagnosis and treatment for Depression.

Question 8

Fournier and colleagues, (2010) found

Answer 8

anti-depressant medication is more beneficial for severe depressive symptoms but not for mild to moderate.

Question 9

patients who received MBCT had a reduced relapse risk (at 60 week follow up) compared to those who did not
- suggests that MBCT is efficacious for treatment and relapse prevention (????)

Answer 9

(Kukyen et al., 2016)

Question 10

BMJ, (2015) review found

Answer 10

that CBT and antidepressants are equally effective for acute dep, but evidence is limited.

Question 11

Piet et al., (2011) meta analysis for MBCT as an effective intervention

Answer 11

• they found two studies showed MBCT was as effective as antidepressants
• Also indicated MBCT is an effective intervention for relapse prevention in indv with recurrent MDD in remission.

Question 12

what system is involved in emotion regulation?

Answer 12

The Limbic System

Question 13

• Biased attention in dep (sad stimuli) is associated with decrease activity in DLPFC, VLPFC and ACC
• Biased awareness for -ve aspects of stimuli is associated with greater amygdala reactivity, accompanied with lDLPFC hyperactivity and rDLPFC reactivity
• Biased memory in dep is associated with amygdala hyperactivity which is correlates with the hippocmapus and the brain requires less effort to recall -ve events (????)

Answer 13

(Disner et al., 2011)

Question 14

what is the default mode network (DMN)?

Answer 14

it is a mechanism (a group of brain regions) known for day-dreaming, rumination, thinking without a goal. it has lower levels of activity when we are engaged in a task, like paying attention.

Question 15

during resting state subjects with MDD have hyperacivity within the DMN comapred to HC’s. (????)

Answer 15

(Grecius et al., 2007)

Question 16

Hamilton and colleagues (2015) conducted a meta-analysis and found

Answer 16

• that increased functional activity between the DMN and the sgPFC (subgenual) often predicts levels of depressive rumination.

Question 17

found that MDD is associated with reduced stability of the DMN in key regions relevant to the generation of ruminative cognition. (????)

Answer 17

(Wise et al., 2017)

Question 18

Posner and colleagues (2013) found

Answer 18

• that indvs who took antidepressants for MDD had a greater coherence of DMN compared to HCs.
• suggests a causal pathway which anti-depressants may reduce dep.

Question 19

Gotlid and Hamilton (2008) found

Answer 19

• amygdala and subgenal ACC is overactive in MDD and the DLPFC is under active
• also found amygdala volume decreases significantly with the increase of depressive episodes

Question 20

found elevated baseline amygdala activity is positively correlated with depression severity (????)

Answer 20

(Drevets et al., 2001)

Question 21

Skeline and colleagues (2001) found

Answer 21

that depressed indvs exhibit greater amygdala reactivity in response to emotion stimuli, especially to -ve, compared to contorls.

Question 22

recruitment of frontal regions such as OPF, DLPFC, DMPFC and VLPFC occurs when subjects engage in self-regulation and it is associated with the modulation of amygdala activity. (????)

Answer 22

(Urry et al., 2006)

Question 23

Nolen-Hoeksema and colleagues (2008) response styles theory suggests

Answer 23

depressed people are more likely to respond to the experience of negative affect with rumination. And ruminative response style has been show to exacerbate sad mood and r[predict future depressive episodes.

Question 24

Found that self campassion was superior to reappraisal and acceptance for negative affect reduction in MDD (????)

Answer 24

(Ehret et al., 2018)

Question 25

Found that higher levels of self compassion and self forgives ness has a relationship with lovely levels of self harm and suicide ideation (????)

Answer 25

(O’Connor et al., 2018)

Question 26

ketamine’s rapid antidepressant properties is having a major impact in psychiatry

If clinical studies continue to support ketamine for depression, a future of infusion therapies and other rapid response interventions will be increasingly available for patients.

Which can bridge the gap between pharmacology and psychotherapy and gives a wider bio-psycho-social perspective

Answer 26

Cusin, (2018) a review of ketamine