Mood disorders Flashcards
Most common psychiatric illness
anxiety disorders
Which is more heritable, bipolar disorder or unipolar depression?
bipolar disorder (risk increased 10 fold over gen population if one parent affected)
Neurons in paraventricular nucleus of hypothalamus secrete what
corticotropin releasing factor
CRF release from hypothalamus does what?
activates synthesis/relesase of adrenocorticotropin (ACTH) from anterior pituitary
Synthesis and release of ACTH leads to
activation of adrenal cortex to release glucocorticoids
sustained glucocorticoid elevation leads to what?
damage hippocampal neurons. May involve reduction in dendritic branching and loss of dendritic spines, where neurons receive their glutamatergic synaptic inputs
Diminished inhibitory control of hippocapmus on HPA axons does what?
leads to further increase in circulating glucocorticoid levels –> ultimately may see atrophy of hippocampus in some patients
Depression diagnosis
5+ symptoms persisting for 2 + weeks, are a change from previous function, patient experiences sad mood or anhedonia
SIGECAPS
sleep, interest, guilt, energy, concentration, anhedonia, psychomotor changes, suicidal ideation
Subtypes of depression
atypical, psychotic depression, melancholic, seasonal affective
Atypical depression
mood reactivity, leaden paralysis, reverse neurovegetative symptoms (increased appetite, weight gain, hypersomnia)
Psychotic depression
often with auditory halucinations, nihilistic delusions
melancholic depression
mood worse in morning, early morening awakening, anorexia, weight loss, guilt, psychomotor retardation
seasonal affective
mood typically worsens in fall/winter, improves in spring/summer
Lifetime risk of depression recurrence
50% after 1 episode, 60-70% after 2 episodes, 90% after 3+
