Mood disorders

Question 1

What is the current definition for mood disorders according to ICD-10?

Answer 1

Fundamental disturbance is a change in affect/mood from to depression or elation
Usually accompanied by change in overall activity
Usually recurrent, with individual episodes related to stressful events

Question 2

What are the DSM-5 criteria for a depressive episode? (8)

Answer 2

2 week or more of depressed mood
+
4/8 of the following:
- sleep alterations
- appetite changes
- anhedonia
- decreased concentration
- anergia
- guilt
- psychomotor changes
- suicidal thoughts

Question 3

What are the DSM-5 criteria for a manic episode? (7)

Answer 3

Euphoric or irritable mood
+
3/7 of the following:
- decreased need for sleep, increased energy
- distractibility
- grandiosity
- flight of ideas
- increased talkativeness/pressured speech
- psychomotor agitation
- impulsive behaviour

Lasts at least 1 week

Question 4

DSM-5 diagnosis for bipolar type I

Answer 4

Manic episode lasting at least 1 week
With notable functional impairment

Question 5

DSM-5 diagnosis for hypomanic episode
What are the exclusion criteria?

Answer 5

Symptoms lasting 4 days
Without notable functional impairment

If patient is hospitalised or has any psychotic symptoms (delusions/hallucinations), diagnosis automatically is manic, not hypomanic

Question 6

DSM-5 diagnosis for bipolar type II

Answer 6

Only hypomanic episodes present along with at least 1 major depressive episode

Question 7

If manic symptoms last for less than 4 days, what is the DSM-5 diagnosis?

Answer 7

Unspecific bipolar disorder

Question 8

What is the difference in insight between patients with depression and mania?

Answer 8

Insight preserved in depression, impaired in mania

Question 9

What attention biases are present in MDD?

Answer 9

Prolonges attention on negative stimuli
Reduced attention on positive stimuli

Question 10

What fMRI changes can be seen in MDD?

Answer 10

Enhanced amygdala response to negative stimuli
Increased activity in lateral inferior frontal cortex (impaired ability to divert attention from irrelevant negative information)
Anterior cingulate cortex mediates negative attentional biases

Question 11

What memory biases are present in MDD?

Answer 11

Preferential recall of negative compared to positive material

Question 12

What perceptual biases are present in MDD?

Answer 12

Increased recognition of negative faces
Decreased recognition of happy faces

Question 13

What is the function of the amygdala?

Answer 13

Emotional response centre, especially in response to fear

Question 14

How can serotonin be measured?

Answer 14

1. Indirectly, by measuring monoamine oxidase A - deaminates serotonin
   Therefore, high MOA = low serotonin
2. PET scan with 5HT agonist tracer