Disorders 3 Flashcards
What are mood disorders?
Depressive DIsorders:
- unipolar depression
Bipolar Disorders:
- Bipolar depression
- manic depression
What is major depressive disorder and how is it diagnosed?
You need at least 5 of these effects lasting > 2 weeks:
Core:
- depressed mood most of the time
- dramatically reduced interest or enjoyment in most activities most of the time
Somatic (effecting the body):
- Significant challenges regulating appetite and weight
- significant challenge regulating sleep
- Physically agitation or lethargy
Cognitive (affecting mind):
- Feeling worthless or feeling unwarranted guilt
- Problems in thinking concentration or decisions
- thinking repetively of death and suicide
What is the life time prevelance of Major depressive Disorder?
Lifetime prevalence: 16.9%
- high recurrent rate
- high rates of comorbidity (present with other disorders)
Females>males
Underdiagnosed in minority populations
What are the biological Causes of depression?
Biological Cause:
- Moderate heritability: 45%
Different ALLELES - 5 HTTLPR Transport Gene: Everyone has different alleles (transport genes in this case) that repackage serotonin (neurotransmitter) with varying degrees of effectiveness (some super effective, some not so much)
Alleles length:
- Long-long combo = low change of depression (fickle to environmental change)
- Long-short combo = more susceptible to environmental change, so more likely to develop depression
- Short-short combo = MOST likely/susceptible to environmental change
- Not enough serotonin (in the synapse)
- Too few serotonin-receptors
- receptors are not sensitive to it, etc.
How do Neurons and NEUROTRANSMITTERS work?
Neurotransmitters:
- The top neuron is called the AXON and the bottom one is called the DENDRITE. The gap in-between is called the SYNAPSE.
- Electrical charges stimulate the VESICLES (think balls filled with NEUROTRANSMITTERS) in the AXON, allowing them to move to the end of the AXON and release the NEUROTRANSMITTERS into the synapse. Here, they bind to little black things called GATES
- After binding, the GATES open up and release positively charged sodium ions, which then start flowing into the DENDRITE. When enough NA+ flows into the DENDRITE, the ELECTRICAL CHARGE from the AXON is allowed to flow through the DENDRITE!
(This is how our neurons communicate - this electro-chemical signal!)
- After the electrical charge is successfully delivered, the LEFTOVER NEUROTRANSMITTERS floating around are sucked back up (REUPTAKE), float away, or just hang around.
What are the two broad classes of NEUROTRANSMITTERS?
Excitatory: Make you excited
- Norepinephrine
- Dopamine
- Glutamate
- Substance P
Inhibitory: Calm you down
- Serotonin
- GABA
- Endorphins
Which neurotransmitter do we want to increase when we’re depressed? Why?
We want to increase serotonin (inhibitory) when we’re depressed.
Why? One of the biggest symptoms of depression if OVERTHINKING about how worthless you are, useless, etc.
We’re trying to get rid of these bad thoughts.
What are the cognitive causes of Depression?
Diathesis - our thoughts, interpretations, self-evaluations, expectations, etc.
These make someone more/less inclined to develop depressive disorders (think about internal/external locus)
Cognitive Biases
- Depression schemas (loss, failure, worthlessness, inadequacy)
- Tend to think of things in negative ways, about self/world
- focuses specifically on information that fits these schemas
Hopelessness Theory
Rumination
What is the lifetime prevalence of Major depressive Disorder?
Life time prevelence: 16.9%
- high recurrent rate
- high rates of comorbidity (present with other disorders)
Females>males
Underdiagnosed in minority populations
What is bipolar disorder and how is it diagnosed?
- Extremely positive or irritable mood AND increased energy/goal-directed behaviors
- lasting 1> week (less if hospitalization is required)
Accompanied by 3 of the following (4 if mood is irritable only)
- inflated self-esteem or grandiosity
- decreased need for sleep
- extremely talkative
- racing thoughts
- distractibility
- goal directed activity (socially) or psychomotor agitation
- excessive engagement in risky but pleasure-seeking activities
If you have 1 manic episode, you CAN be diagnosed with bipolar disorder
What is the life-time prevalence of bipolar disorder?
lifetime prevalence: 1-2.4%
Often comorbid with anxiety (70%) / substance abuse (50%) / Physical health issues (64%)
men=women
Misdiagnosis of minority populations
Age of onset< 25
High suicide rates
25-50% attempts
8-19% confirmed kills
What are the causes of Bipolar disorder?
- Strong heritability (70%)
- Polygenetic (different parts of the brain are involved)
- Pleiotropic effects (same gene involved in multiple disorder)
- Norepinephrine - too much
(Dopamine and serotonin hypotheses)
What is schizophrenia?
It is NOT multiple personality disorder
- defined by experience of psychosis (split from reality) = hallucinations and delusions
How do you diagnose schizophrenia?
At least two of the following for >1 month
- Delusions
- hallucinations
- disorganized speech
- disorganized behavior
- Inability to feel pleasure
- Flat affect
emotional expressions don’t show
- social withdrawal
> 6 months residual symptoms
AND
impaired functioning (in life)
What is the lifetime prevalence of schizophrenia?
Prevalence: 1%
15-20 years less life expectancy than general population
Higher rates of physical commodities (health conditions present at the same time)
Lifestyle risk, Ex/ 70% smoke Tabacco
Lower prevalence in developing countries
Prognosis (predicting likelihood or up/downs of symptoms) is also better in developing countries
