Mood Disorders

Question 1

Definition

Answer 1

Change in affect/mood to depression or elation

Usually accompanied with change in overall level of activity

Question 2

Depressive episode criteria

Answer 2

Ppt

Question 3

Major depressive disorder

Answer 3

No manic or hypo manic episodes in the past

Question 4

Subtypes of MDD

Answer 4

Atypical features - increased sleep and appetite
Melancholic - no mood reactivity, psychomotor retardation and anhedonia
Psychotic - delusions/hallucinations

Question 5

Depression triads

Answer 5

Core symptoms - low mood, anergia, anhedonia
Biological symptoms - sleep, libido, apppetite
Psychological - worlds, self, future

Question 6

Cycle of low mood

Answer 6

Ppt

Question 7

Cycle of high mood

Answer 7

Ppt

Question 8

Manic episode criteria

Answer 8

Ppt

Question 9

Types of bipolar disorder

Answer 9

Minimum 1 week with notable functional impairment - manic episode - type 1 - majority first case are depressive

Minimum 4 days without notable functional impairment - hypomanic - cannot diagnose if psychotic

Must be manic and not hypomanic if hospitalised
Only hypomanic and one MD episode - type 2

Question 10

Bipolar and unipolar

Answer 10

Bipolar early age of onset
Shorter depressive episodes 
Recurrent course 
Genetic specificity 
Differential treatment 

MDD commonly diagnosed in children
High rates of depressive episodes without mania in bipolar
Treatment now overlaps

Insight is preserved in depression, but absent in mania

Question 11

Attention bias

Answer 11

Depression is characterised bias in maintaining or shifting attention - difficulties for depressed people to disengage from negative material

Sustained amygdala response to negative stimuli
Prefrontal cortex - perigenual anterior cingulate cortex mediate negative attentional bias - increases lateral inferior frontal cortex associated with attention bias

Question 12

Amygdala

Answer 12

Perception and encoding stimuli relevant to affective goals

Exhibits bias towards detecting cues signalling potential threats

Question 13

Treatment attention bias

Answer 13

Noadrenergic antidepressants
Serotonergic antidepressants

Elevated baseline ACC activity in depressed patients

Question 14

Monoamine deficiency hypothesis

Answer 14

Depression arise from insufficient level of monoamine neurotransmitter serotonin, norepinephrine, or dopamine

Question 15

Indirect evidence for monoamine deficiency hypothesis

Answer 15

5HT depletion by antihypertensive drug can cause depression
Post mortem show reduced 5HT levels in brainstem
Monoamine oxidase A increased in MDD
Monoamine depletion correlates with decreased mood both in at risk and MDD remission

Question 16

Measuring receptor and transmitter in human brain

Answer 16

PET imaging injection of radioactive pharmaceutical in vein
Tracer bind to target (receptor)
Cause increased dopamine release through amphetamin challenge, cause dopamine to compete - same for serotonin

Measurable 5HT release in healthy, no measurable 5HT release in depression

Question 17

Psychedelic

Answer 17

Tryptamine psychedelics