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Frontiers In Neuroscience > Depression > Flashcards

Depression Flashcards

1
Q

How is depression diagnosed?

A

DSM-5

ICD-10

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2
Q

How is a mental disorder characterised?

A

Clinically significant disturbance in cognition, emotion regulation or behaviour

Reflecting dysfunction in the psychological, biological or developmental prep eases underlying mental functioning

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3
Q

Other depressive disorders

A
  • mood dysregulation disorder
    -major depressive disorder (MDD)
  • persistent depressive disorder (dysthymia)
  • premenstrual dysphoric disorder
  • substance/medication-induced depressive disorder
  • depressive disorder due to another medical condition
  • other specified depressive disorder, and unspecified depressive disorder
  • disruptive mood dysregulation disorder (for children up to 12 years)
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4
Q

DSM-V criteria for depression?

A
  • discrete episodes of at least 2 weeks’ duration
  • clear-cut changes in affect, cognition, and neurovegetative functions
  • inter-episode remissions
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5
Q

What fraction of adults have depression in the UK?

A

1 in 4

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6
Q

What fraction of children have depression in the uk?

A

1 in 10

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7
Q

Deaths per year due to suicide in the UK?

A

6,000

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8
Q

People diagnosed with depression worldwide?

A

300,000,000

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9
Q

Symptoms of depression?

A
  • Depressed mood
  • Diminished interest or pleasure in all, or almost all the activities
  • Change in weight and/or appetite
  • Insomnia or hypersomnia
  • Psychomotor agitation or retardation
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Diminished ability to think or concentrate, or indecisiveness
  • Suicidal thought/attempts
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10
Q

Risk factors for depression?

A
  • Temperamental: negative affectivity (neuroticism) is a risk factor for the onset of depression
  • Environmental: adverse childhood experiences, stressful life events
  • Genetic: ~40% heritability, 2-4 times higher in family members of depressed individuals
  • Physiological
  • Course modifiers: other disease that are commonly accompanied by depression – for example, substance use and anxiety; chronic debilitating medical conditions such as diabetes and cardiovascular disease
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11
Q

Original name for depression?

A

Melancholia

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12
Q

First theory of depression?

A

Hippocrates 400BC

Agony of soul expressed by fear, despondency, sadness and gloom

Humoral theory - black bile (melancholic)

Treatment - diet, exercise, purgatives and bleeding

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13
Q

Celsus’s theory?

A

25-50BC

Demonic possession

Treatment - exorcism, burning, beating, solitary confinement, restrain with chains and manacles

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14
Q

Theory of the 17th century?

A

René Descartes - Cartesian dualism (mind and body dualism)

Two collateral histories

  • what happens in and to the body
  • what happens in and to the mind

First history - physical world
Second history - mental world

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15
Q

Where did René Descartes say the soul was?

A

Pineal gland

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16
Q

Charles Darwin’s hypothesis

A

‘Grief muscles’

1872 - The expression of the Emotions in Man and Animals

17
Q

Key brain regions implicated in depression

A 
Amygdala
Prefrontal cortex
Insular cortex
Anterior cingulate cortex
Hippocampus 
Nucleus accumbens
18
Q

Tuberculosis treatment drug?

A

Iproniazid- 1952

Elevated mood

19
Q

Which three drugs prompted the monoaminergic theory?

A
  • Imipramine (increases noradrenaline release)
  • Iproniazid (inhibits monoamine oxidase - MAO)
  • Reserpine (inhibits VMAT)
20
Q

When was serotonin discovered?

A

1964

Vasoconstricting substance in serum

21
Q

What does imipramine do?

A

Increases noradrenaline and serotonin release

Enhanced mood

22
Q

What does iproniazid do?

A

Inhibits monoamine oxidase (MAO)

The enzyme that catalyses

Adrenaline and noradrenaline —> dihydroxymandelic acid

Serotonin —> 5-hydroxyindoleacetic acid

Enhanced mood

23
Q

What does reserpine do?

A

Inhibit vesicular monoamine transporter (VMAT)

Therefore - depletes serotonin

Low mood

24
Q

Different antidepressants?

A
  • MAOA inhibitors
  • Tricyclic antidepressants
  • Selective serotonin reuptake inhibitors (SSRIs)
25
Q

Side effects of antidepressants

A
  • Reduced libido
  • Appetite
  • Vomiting
  • Nausea
  • Irritability
  • Anxiety
  • Insomnia
  • Headaches
26
Q

Negatives of antidepressants

A
  • Side effects - vomiting etc
  • Delayed by ~4weeks onset of therapeutic effects
  • Acute depletion of tryptophan does not cause depression
  • Only 1 in 3 patients achieve remission
  • Only reduce frequency, duration and severity of symptoms
  • Reduce mortality by suicide
27
Q

Effects of reduced tryptophan

A
  • Environment and mental state
  • Different sensitivity of 5-HT receptors
  • Changes in other neurotransmitters - NO, BDNF, kynurenic acid
  • Cerebrovascular changes
  • Amino Avis inbalance
  • Protein synthesis

Frontiers In Neuroscience (8 decks)

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