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PSYC2111 > L4/L5 Major depressive disorder > Flashcards

L4/L5 Major depressive disorder Flashcards

1
Q

What is the difference between Incidence and Prevalence when we try to talk about the epidemiology of a disease?

A

Incidence: newly diagnosed cases of the disease
Prevalence: actual number of cases alive with the disease

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2
Q

What factor is a strong determinant of the likelihood of recovery for MDD?

A

Recency of onset

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3
Q

Many individuals who have been depressed only for several months can be expected to recover spontaneously, correct or not?

A

Corrct

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4
Q

Recovery likelihood is poor in the presence of late age of onset, true or false?

A

False; Recovery likelihood is poor in the presence of advanced age of onset

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5
Q

What are the diagnostic criteria now based on

A

Diagnostic and statistical manual of mental disorders 5th edition (DSM-5)

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6
Q

Five or more symptoms during the same 2-week period and at least one of the symptoms should be either of which two subtype?

A

(1) depressed mood
(2) loss of interest or pleasure

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7
Q

List the symptoms of the depressed mood subtype

A

(1) Depressed mood most of the day, nearly every day
(2) Significant weight loss when not dieting or decrease in appetite nearly every day (A change of more than 5% of body weight in a month)
(3) Hypersomnia nearly every day
(4) Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
(5) Fatigue or loss of energy nearly every day

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8
Q

List the symptoms of the loss of interest or pleasure subtype

A

(1) Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
(2) Significant weight gain when not dieting or increase in appetite nearly every day. (A change of more than 5% of body weight in a month)
(3) Insomnia nearly every day
(4) Feelings of worthlessness or excessive or inappropriate guilt nearly every day
(5) Diminished ability to think or concentrate, or indecisiveness, nearly every day
(6) Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

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9
Q

What are the purposes of subtyping?

A

(1) Differentiating large group of patients
(2) Predicting treatment effectiveness

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10
Q

From different perspectives, what subtype models can we generate?

A

(1) Symptom-based subtypes
(2) Aetiologically-based subtypes
(3) Time of onset-based subtypes
(4) Gender-based subtypes

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11
Q

Biotypes of MDD overlapped with which mental disorder but not with which mental disorder?

A

Overlap with general anxiety disorder (GAD) but not schizophrenia

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12
Q

The heritability of MDD is really high, true or false?

A

False
The heritability is moderate (0.3-0.5)

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13
Q

By using which technique can we get the conclusion that MDD is highly polygenic?

A

genome-wide association studies (GWAS)

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14
Q

What does the monoamine theory proposes?

A

Serotonin, norepinephrine and dopamine deficiencies are responsible for the occurrence of depressive symptoms

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15
Q

In MDD, serotonin level is higher or lower?

A

Lower

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16
Q

In MDD, serotonin receptor activity is higher or lower?

A

Lower

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17
Q

In MDD, serotonin transporter activity is higher or lower?

A

Higher
Here the transporter means reuptake transporter

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18
Q

Briefly introduce the neuroplasticity hypothesis of MDD.

A

Stress and other negative stimuli induce changes in neural plasticity plays a significant role in the onset and development of depression

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19
Q

The evidence of animal model studies demonstrating that depressive-like behaviors are associated with alterations in cortical glutamate support which hypothesis of MDD?

A

The neuroplasticity hypothesis of MDD

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20
Q

Psychological Factor for MDD

A

(1) Neuroticism
(2) Adverse childhood experience
(3) Stressful life event

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21
Q

Genetic Factor for MDD

A

(1) 30-50% heritability from twins & adoption study
(2) polygenic

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22
Q

Serotonin Hypothesis:
How does serotonin work as a neurotransmitter? Describe the steps.

A

(1) Tryptophan obtained from daily diet
(2) Tryptophan → Serotonin (=5HT)
(3) Serotonin Stored in the vesicle
(4) When pre-synaptic neuron reaches activation potential, serotonin is released to postsynaptic neuron

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23
Q

Serotonin Hypothesis:
Based on this mechanism, what are the evidence on MDD patients that support this theory?

A

(1) tryptophan depletion
(2) low serotonin & its metabolite 5-HIAA level
(3) lower activity receptor on post-synaptic neuron
(4) higher activity & gene (relate to stress) for reuptake transporter → so there is less successful synaptic communication

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24
Q

Predominantly limbic connectivity features are correlated with what MDD symptoms?

A

Anxiety and insomnia

25
Q

What are the two dimensions when subtyping patients to different clusters?

A

Anhedonia-related connectivity and Anxiety-related connectivity

26
Q

According to studies related to neuroplasticity hypothesis, what metabolites in the medial frontal cortex are linked with depression?

A

Glutamatergic metabolites

27
Q

According to neuroplasticity hypothesis, only single region and single pathway is involved or are there many of them?

A

Many of them are involved
Brain regions: hippocampus, prefrontal cortex, amygdala
Pathways: glutamate and glucocorticoid signaling pathways

28
Q

According to neuroplasticity hypothesis, disruption of hippocampal function (including its capacity for neuroplasticity) lead to what?

A

(1) Anhedonia (because hippocampus regulates nucleus accumbens and the ventral tegmental area)
(2) Deficits in concentration and memory
(3) Dysregulation of the HPA axis stress response

29
Q

Give a brief definition for schema

A

Internally stored representations of stimuli, ideas or experiences

30
Q

What are the 3 features of depressive schema characterized by negative self-referential beliefs?

A

Unlovability
Hopelessness
Worthlessness

31
Q

What is Beck’s cognitive traid for faulty information processing?

A

negative views about self, world and future

32
Q

According to cognitive model of depression, three process are biased, what are they?

A

Biased attention, biased processing and biased memory

33
Q

The biased memory is restricted to which kind of memory?

A

Explicit memory

34
Q

What is the test used for testing biased attention?

A

eye-tracking

35
Q

What is early attentional engagement?

A

latency/location/duration of inital fixation

36
Q

What is the feature for MDD patients in eye-tracking tasks compared with controlled group?

A

(1) no differences in early attentional engagement
(2) longer maintenance in negative stimuli
(3) moderate decrease on positive stimuli
(4) attentional disengagement

37
Q

For biased memory, is there any memory bias if the participants are asked to count letters in emotional words (encoding) and complete word stem/fragments (recall)?

A

no

38
Q

What is interpretation bias for MDD?

A

create more negative, fewer positive meaning to explain ambiguous information

39
Q

What is the test used for testing interpretation bias?

A

Scrambled sentence test (SST)

40
Q

What is the test used for testing self-referential processing bias?

A

Self-referential encoding task

41
Q

If a person stuck in rumination, is he/she going to take action?

A

No

42
Q

Which part of Anterior cingulate cortex (ACC) is cognitive and which part is affective?

A

Dorsal ACC = cognitive
Ventral ACC = affective

43
Q

What does valence identification mean?

A

Identification of positive/ neutral/ negative words

44
Q

Give examples of dorsal ACC’s cognitive functions

A

(1) Conflict-monitoring
(2) Response-selection and execution

45
Q

Give examples of ventral ACC’s affective functions

A

(1) Emotion assessment
(2) Emotion related learning
(3) Autonomic regulation (related to autonomical nervous system)

46
Q

Dorsal ACC relays which type of cognitive inputs, top-down or bottom-up?

A

Top-down

47
Q

Which part of ACC integrates emotional feedback from the limbic system (e.g. amygdala) and projects to higher-order cognitive structures (e.g. dlPFC)?

A

Subgenual ACC (sgACC)

48
Q

Resting state sgACC functional connectivity with which brain network was significantly greater in the depressed subjects compared to the control group?

A

Default-mode network (DMN)

49
Q

Dorsolateral prefrontal cortex (DLPFC) tends to be hypoactive or hyperactive in depression?

A

hypoactive

50
Q

Name a task that can assess executive-control/ working memory

A

Digit sorting task

51
Q

Depression is associated with increased or decreased amygdala activity in response to emotional information processing?

A

Increased

52
Q

Depression is associated with increased or decreased Dorsal Lateral prefrontal cortex (DLPFC) activity in response to cognitive tasks?

A

Decreased

53
Q

Depressed individuals display decreased or increased relationships between amygdala and DLPFC activity?

A

Decreased

54
Q

Hyperactive sgACC is associated with which mental disorder and anticorrelated with activity in which brain region?

A

Hyperactive sgACC is associated with MDD and anticorrelated with activity in dlPFC

55
Q

Give a brief definition of psychotherapy

A

Identify, evaluate, challenge and modify dysfunctional beliefs and alter maladaptive behaviors

56
Q

Give some examples of symptom-based subtypes of MDD

A

Melancholia, psychotic depression, atypical depression, anxious depression

57
Q

Give some examples of aetiologically-based subtypes of MDD

A

Adjustment disorders, early trauma depression, reproductive depression, perinatal depression, organic depression and drug-induced depression

58
Q

Give some examples of time of onset-based subtypes of MDD

A

early and late onset depression, seasonal affective disorder

PSYC2111 (8 decks)

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