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Endo Yr 2 > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

what is the DSM

A

criteria to diagnose mental disorder

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2
Q

What changed in 1980

A

DSM-III came in - any recurrent mood episodes before then were diagnosed as manic depressive illness (bipolar and unipolar depressive illness bunched together)

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3
Q

what is a mood disorder

A

change in affect or mood to depression or elation

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4
Q

What is a mood change usually accompanied by

A

change in overall level of activity

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5
Q

2 features of mood disorders

A

recurrent and often related to stressful events

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6
Q

prevalence of major depressive disorder

A

10-20%

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7
Q

Bipolar 1 gender distribution?

A

equal dsitribution

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8
Q

Bipolar 2 and MDD gender distribution?

A

more women suffer

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9
Q

4 features of low mood/ elation cycles

A

thoughts, feelings, behaviours, physiological symptoms

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10
Q

DSM-5 criteria of depressive episode

A

at least 2 weeks of depressive mood with 4/8 of symptoms

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11
Q

Symptoms in DSM-5 criteria for depression

A 
Sleep disturbance
Appetite alterations
Anhedonia
Low energy
Guilt
Suicidal thoughts
psychomotor changes - agitation or retardation
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12
Q

Major depressive disorder requires the lack of what?

A

no manic or hypomanic episodes in history

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13
Q

Subtypes of DSM-5 criteria

A

Atypical features - increased sleep/ appetite with heightened mood reactivity
Melancholic features - no mood reactivity + anhedonia + psychomotor retardation
Psychotic features - presence of delusions/ hallucinations

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14
Q

Core symptoms

A

low mood
anergia
anhedonia

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15
Q

Biological symptoms

A

libido
appetite
sleep

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16
Q

psychological symptoms

A

the world
oneself
the future

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17
Q

Criteria of mania/ bipolar

A

Euphoric or irritable mood with 3+/7 symptoms

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18
Q

Mania symptoms

A 
decreased need for sleep
distractibility
grandiose thoughts
racing thoughts
talkativeness
goal-directed activities
impulsive behaviour
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19
Q

Bipolar 1 requirement

A

Mania symptoms for min 1 wk with notable functional impairment

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20
Q

Hypomanic episode requirement

A

Mania symptoms for min 4 days with no functional impairment (if psychotic features are present/ patient is diagnosed = cannot be hypomania - is manic)

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21
Q

Type II bipolar requirement

A

Only hypomanic and not manic episodes with at least one major depressive episode

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22
Q

Manic symptoms occur for less than 4 days/ none of the thresholds met = what is the diagnosis?

A

unspecified bipolar disorder

23
Q

What is no longer an exclusion factor for bipolar diagnosis

A

antidepressant- related mania/ hypomania

24
Q

What is the difference between bipolar 1 and 2

A

Bipolar 2 - manic episodes are not as strong but depressive episodes are

25
Q

How prevalent is anxiety in bipolar patients

A

30-70% have anxiety

26
Q

Bipolar vs unipolar

A

bipolar - earlier age of onset (19 vs 20s)

  • shorter depressive episodes
  • different drugs used to treat each
  • mania had a genetic component - not in relation to unipolar depression
  • more frequent episodes in bipolar disease
27
Q

Differences in heritability in bipolar vs unipolar

A

Bipolar - much more heritable

MDD - almost half as heritable

28
Q

Differences in insight in bipolar vs unipolar

A

Bipolar - insight impaired in mania (U-shaped curve in relation to severity - more normal in moderate)
MDD - insight preserved

29
Q

Why can antidepressants be bad for treating bipolar disease

A
  • Ineffective for bipolar depression
  • Can cause manic episodes
  • Can worsen long-term course of bipolar illness (lead to more mood episodes in those with rapid-cycling)
30
Q

What is attention bias

A

bias in maintaining/ shifting attention (difficult for depressed ppl to disengage from negative material)

31
Q

Test to identify attention bias

A

functional MRI

32
Q

What does fMRI show

A

detects changes in blood oxygenation and low in response to neural activity

33
Q

What is memory bias

A

Preferential recall of negative compared to positive material

34
Q

what is the facial expression recognition task?

A

people exposed to face images of different emotions to see if they have a different level of recognition of happy or sad faces (tips in balance of sad in depression)

35
Q

What neural changes are seen in depression during the passive viewing of emotional facial expressions

A

Enhanced amygdala (temporal lobe region in perception + encoding stimuli )response to negative faces

36
Q

Noradrenergic vs serotonergic antidepressant effects on facial expression recognition module? - acute single dose

A

Noradrenergic - better recognition of happy faces

serotonergic - decreased recognition of fearful faces

37
Q

what is the monoamine deficiency hypothesis

A

lack of serotonin as well as other monoamines (eg. noradrenaline)causes depressive symptoms

38
Q

Evidence for monoamine deficiency hypothesis

A
  • Medications that cause 5-HT depletion would have side effects of depressive symptoms
  • Useful anti-depressants all increase synaptic monoamines (some selectively 5-HT)
  • Post mortem = brains of suicide victims show depleted serotonin
  • Tryptophan depletion (important for 5-HT synthesis) triggers relapse in MDD
39
Q

how to measure receptors/ transmitters in living brain

A

PET imaging - best method to measure brain pharmacology

40
Q

How does it differ from fMRI

A

Selective (tracer binds to specific target), invasive, radioactive, expensive

41
Q

PET tracer mechanism

A

once neurotransmitter release is triggered, it floods the synapse and competes with the radioactive tracer (difference in amount of tracer can be used as a marker of neurotransmitter)

42
Q

what is a personality disorder

A

maladaptive patterns of behaviour, cognition and inner experience - deviate from those accepted by the individual’s culture

43
Q

Bipolar affective disorder vs borderline personality disorder

A

BPAD - heritable/ grandiosity/ mood states less affected by environment
BPD - poor self image/ fear of abandonment/ emptiness

Both have mood swings/ impulsive sexual behaviour/ suicidality

44
Q

BPAD vs Schizophrenia

A

BPAD - episodic delusions/ hallucinations
Schizophrenia - chronic delusions/ hallucinations

Both have hallucinations/ cog. impairment/ depressive symptoms

45
Q

BPAD vs attention deficit disorder

A

BPAD - heritable, recurrent depressive episodes
amphetamines worsen mania

Both have impaired conc/ abnormal working + short term memory

46
Q

endocrine causes of depression?

A

hypothyroidism/ hypoglycaemia/ cushings + addisons/ hyper + hypoparathyroidism

47
Q

infective causes of depression?

A

viral infections
SLE
HIV
- cytokines manifested in systemic disease can cause depressive symptoms

48
Q

Deficiencies that cause depression

A

Vitamin B12/Folic acid

49
Q

Neurological cause of depression

A

MS/ Alzheimer’s/ Parkinson’s

50
Q

Medications that cause depression

A

beta-blockers/ steroids/ anti-cholinergics/ some AB

51
Q

What is vascular depression?

A

subtype of late-life depression characterised by a distinct clinical presentation and an association with cerebrovascular damage (increased white matter)

52
Q

Hyperintensities on an MRI can affect depression how?

A

can make individual more vulnerable to stressors

53
Q

poststroke depression

A

lesions in left frontal lobe/ basal ganglia can cause depression

Endo Yr 2 (2 decks)

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