Mood disorders Flashcards by Mia Cameron

what is the ICD 10 classification for all mood/affective disorders?

fundamental disturbance is a change in affect/mood to depression OR elation

usually accompanied by change of overall level of activity
tend to be recurrent and onset related to stressful events

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what is the typical cycle of low mood?

negative automatic thinking
negative feelings
psychological related symptoms (fatigue)
negative behaviours - due to thoughts, feelings

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what is negative automatic thinking?

negative thoughts towards onseself during everyday thoughts/reactions
whats the point
im a bad person

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what is CBT based on?

addressing cycles of low or high mood

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what are negative feelings?

irritability
low
flat feelings/apathy

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what are negative behaviours?

ruminating
laying in bed all day
social isolation

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what is the DSM-5 criteria for a depressive episode?

occurence of 2 weeks+
depressed mood AND 4/8 of:
sleep alterations
appetite alterations
anhedonia
decreased conc
low energy
guilt
psychomotor changes
suicidal thoughts

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what are the subtypes of major depressive disorders features?

atypical features
melancholic features
psychotic features

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what are atypical features of MDD?

mainly increased sleep and appetite, heightened mood reactivity

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what are melancholic features of MDD?

no mood reactivity
psychomotor retardation
anhedonia

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what are psychotic features of MDD?

prescence of delusions/hallucinations

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when can major depressive disorder be diagnosed?

in the absence of any manic/hypomanic episodes

and following a major depressive episode

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what is the typical cycle of elated/high mood?

positive automatic thinking
positive feelings
positive physiological symptoms
postive behaviours/erratic behaviours

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what are positive automatic thoughts?

positive view of oneself in response to daily life
im the best
i can do it all

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what are positive behaviours in mania?

impulsivity

increased activity/productivity

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what are positive physiological symptoms?

increased energy

race sensation

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what is a hypomanic episode?

symptoms of manic episode present for at least 4 dys but without functional impairment

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what is a manic episode?

at least 1 week of euphoric/irritable mood with 3/7 of:
decreased need of sleep
distractibility
grandiosity
flight of ideas
pressured speech, talkativeness
goal-directed activities/psychomotor agitation
impulsive behaviour

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what type of manic episode leads to a diagnosis of type 1 bipolar disorder?

present for at least a week with notable functional impairment

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what type of manic episode leads to a diagnosis of type II bipolar disorder?

no manic episodes but multiple hypomanic episodes along with at least one major depressive episode

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what type of manic episode leads to a diagnosis of unspecified bipolar disorder?

if manic symptoms last less than 4 days or other specific thresholds are unmet

what is cyclothymia?

mood swings without extent of mania or depression

when can hypomania not be diagnosed?

when psychotic symptoms are present

or if hospitalised

what diagnosis is made if manic episode is caused by antidepressants?

normal diagnosis of bipolar disorder depending on other characteristics

what is bipolar I disorder?

majority of cases first episode is depressive, then manic then more depressive almost half of the time with symptoms, half free experience full manic episodes

what is the difference between bipolar and unipolar mood disorder?

bipolar highly heritable | insight preserved in depression, impaired in mania

what are attention biases in depression?

difficulties for depressed people to disengage from negative material

how was attentional bias in depression studied?

depressed people had prolonged maintenance of attention to negative pictures, often negative emotional face pictures and reduced attention to positive stimuli

what brain abnormalities are observed by fMRI in depressed people?

sustained amygdala response to negative stimuli anterior cingulate cortex appears to mediate negative attentional biases increased activity in lateral inferior cortex associated with impaired ability to divert attention from task-irrelevant negative info

what are memory biases in depression?

preferential recall of negative compared to positive material

in what population do memory biases present?

depressed individuals and: individuals at risk of affective disorder - neuroticism recovered depressed individuals

what are perceptive biases in depression?

reduced recognition of all basic emotions except for sadness

what is the brains response to negative faces in depressed people?

enhanced amygdala response

what is the role of the amygdala in depression?

exhibits bias towards detecting cues signalling potential threats like expression of fear more active in depressed individuals

what is the amygdala?

region in medial temporal lobe involved in percepion and encoding of stimuli, reward, punishment sensitive to detecting and triggering responses to arousing stimuli

what is the effect of noradrenergic antidepressants on brain function studies?

better recognition of happy faces

what is the effect of serotonergic antidepressants in brain studies for depression?

decreased recognition of fearful faces | mixed results with citalopram

where do serotonergic neurones project from?

Raphe nuclei in midbrain

what is the role of serotonin?

regulation of mood | key role in monoamine deficiency hypothesis of depression

what is the monoamine hypothesis of depression?

depressive symptoms arise from insufficient levels of monoamine NTs (serotonin, noradrenaline, dopamine)

what is PET imaging used for in psychiatry?

investigating brain pharmacology

how does PET imaging work?

injection of radioactive pharmaceutical, binds to specific target can use to quantify receptors by looking at tracer density

how does PET scanning compare to fMRI?

more selective, more invasive radioactive expensive less optimal temporal and spatial resolution

what is the importance of distinguishing bipolar vs unipolar mood disorders?

antidepressants can be ineffective in acute bipolar depressive episodes can cause acute manic/hypomanic episodes worsen long term course of bipolar illness leads to more depressive states in bipolar illness over time

how to differentiate bipolar affective disorder from borderline personality disorder

BPAD - heritable, grandiosity, mood states less effected by environment BPD - poor self image, fear of abandonment and feelings of emptiness both have rapid mood swings, unstable interpersonal relationships, sexual behaviour and suicidality

how to differentiate bipolar affective disorder from schizophrenia

BPAD - episodic delusions/halluc schiz - chronic delusions/halluc both - cognitive impairment, depression/negative symptoms

what is schizoaffective disorder?

features of both bipolar affective disorder and schizophrenia

what is an important broad differential from bipolar affective disorder?

personality disorders

how to differentiate bipolar affective disorder from attention deficit disorder

BPAD - family history, recurrent deprssive episodes, amphetamines worsen mania both - impaired concentration, executive function, abnormal working and short term memory

what are personality disorders?

maladaptive patterns of behaviour, cognition, inner experience exhibited across many contexts, deviating from individuals normal culture

what is bipolar II disorder?

only experience depressive and hypomanic episodes | less common