Mood Disorders Flashcards
What are common depressive signs and symptoms?
Sad mood, anhedonia, loss of appetite and weight, sleep disturbance, psychomotor retardation, agitation, and suicidal ideation
What are common manic signs?
Elevated or expansive mood, inflated self-esteem or grandiosity, decreased need for sleep, increased verbal output or pressured speech, flight of ideas or racing thoughts, distractibility, increase in goal directed activity, and excessive involvement in pleasurable activities that have a high potential for negative consequences
What are general neuroantatomical changes that are associated with mood disorders?
Disturbance of the limbic system and neurochemical changes
What do functional neuroimaging studies in patients with depression show?
Increased activity in ventral limbic regions (cingulate, amygdala, and ventral striatum) that affect the emotional and autonomic symptoms of mood disorders
What are neurobiological substrates of mania and bipolar disorder?
Reductions in brain volume and blood flow in dorsal medial and dorsal lateral prefrontal cortices
Reductions in size of hippocampus
Reductions in caudate/putamen only found in unipolar depression
What are two major theories regarding depression and serotonin?
A deficit of serotonin activity may directly cause depression
A serotonin deficit serves as a major risk factor for depression but is not a direct cause
Describe the relationship between NE and depression.
People w/ depression may have a NE system that does not handle the effects of stress efficiently
People w/ multiple depressive episodes have fewer NE neurons
People w/ low levels of serotonin trigger a drop in NE levels which leads to depression
Describe the relationship between DA and depression.
Low DA levels may explain why those with dep don’t get the same sense of pleasure our of activities
Decreased ligand binding to the DA transporter and increased DA binding potential in caudate and putamen- suggest functional deficiency of synaptic DA
Describe the relationship between GLU and epression
Multiple lines of evidence suggests that GLU and its receptors have an impact on depression and antidepressant activity
Are women or men more like to have mood disorders?
Women are 50% more likely than men
- women are 70% more likely than men to be depressed
- As women age, the transition into menopause can increase the risk for depression
Bipolar disorder is more common in woman than men with a ratio of 3:2
What are some epidemiological stats regarding major depressive disorder (MDD)?
- One of the most common disorders in the US
- Lifetime prevalence- 16.5%
- 30% of cases are severe
- Average age of onset is 32
at are some epidemiological stats regarding bipolar disorder?
- Lifetime prevalence: 3.9%
- Men have earlier age of onset
- Average age of onset is 25
Do more women or men attempt suicide?
More women attempt suicide but more men die from suicide
What are common presentations of depression in men?
- feeling tired, irritable, lost interest in activities, and sleep disturbance
- more likely to abuse alcohol or substances
- frustrated, discouraged, irritiable, and angry
Is depression a normal part of the aging process?
No. most elderly report being satisfied with their lives.
What are depressive signs and symptoms in the elderly?
Physical manifestations are more common
-Older adults often have medical conditions that result in depressive sx (low testosterone, vitamin deficiencies, thyroid problems, dementia, etc.)
Medication side effects can also contribute to depression
Who has the highest suicide rate in the US?
Elderly patients with depression, especially males
Describe the presentation of depression in children.
- Children will often continue to have episodes throughout adulthood and are mote likely to have severe medical/psychiatric illnesses in adulthood
- Young children will report physical illness, avoid school, become attached to parents
- Older children will sulk, develop behavioral problems, become negative/irritable
- Depression co-occurs with anxiety, eating disorders, substance abuse, and increased risk of suicide
What is a “mixed” state in bipiolar disorder?
A mood episode that includes symptoms of both depression and mania.
Do psychotic symptoms occur in bipolar disorder?
They can develop in the context of severe BD.
Describe the difference between Bipolar I, Bipolar II, Bipolar disorder NOS, and Cylclothymic disorder.
Bipolar 1: Manic or mixed episodes that last at least 7 days, depressive episodes of at least 2 weeks (typically)
Bipolar 2: Depressive episodes shifting back and forth with hypomanic episodes
Bipolar disorder, NOS: Person has symptoms but does not meet criteria for bipolar 1 or 2
Cyclothymic: Milder form where person shifts back and froth between hypomania and mild depression for 2 years
What is rapid cycling bipolar disorder?
Person has 4 or more episodes of major depression, mania, hypomania, or mixed symptoms w/in a 1 year period
