Mood Disorders and Mood Stabilizers

Question 1

Depression and mania

Answer 1

Opposite ends (poles) of the mood spectrum.

Question 2

Mixed mood state

Answer 2

Depression and mania occurring simultaneously. May have depressed mood but trouble sleeping or changes in appetite, etc.

Question 3

Euthymia

Answer 3

Normal mood

Question 4

Dysthymia

Answer 4

Depression (depressed mood) less severe than major depression but long-lasting (over 2 years).

Question 5

Double depression

Answer 5

Alternating between major depression and dysthymia, but not remitting. A form of recurrent major depressive disorder/episodes with poor inter-episode recovery.

Question 6

Bipolar Disorder

Answer 6

Generally characterized by four types of illness episodes: manic, major depressive, hypomanic, and mixed. Patients may have any combination of these episodes over course of illness.

Question 7

Rapid cycling

Answer 7

Mania in bipolar disorder occurring at least four times per year. Many patients experience mood switches more frequently than this and can include depressive episodes or shifts between euthymia and mania.

Question 8

Bipolar II (Bipolar depression)

Answer 8

At least one hypomanic/manic episode following a depressive episode.

Question 9

Cyclothymic disorder

Answer 9

Mood swings not as severe as full mania and full depression but switches that sit above and below boundaries of normal mood and may interfere with function.

Question 10

Schizoaffective disorder

Answer 10

Debatable diagnosis for patients with psychotic symptoms and mood cycling.

Question 11

Tyrosine

Answer 11

Precursor amino acid to norepinephrine (NE), acted on by TOH which converts the amino acid into DOPA. Decarboxylase (DDC) converts DOPA into dopamine (DA). Dopamine beta-hydroxylase (DBH) converts DA into NE via NE neurons.

Question 12

Norepinephrine functions

Answer 12

Ascending projections from locus coeruleus of brainstem to PFC, basal forebrain, striatum, nucleus accumbens, thalamus, hypothalamus, amygdala, hippocampus, brainstem neurotransmitters, and cerebellum: regulate mood, arousal, cognition. Descending projections down spinal cord regulate pain pathways.

Question 13

Monoamine hypothesis of depression

Answer 13

Dysfunction in all three monoamines NE, 5HT, and DA in various brain circuits, with different neurotransmitters contribute to depressive symptom profile of different patients.

Question 14

Monoamine signaling and brain-derived neurotrophic factor (BDNF) release

Answer 14

Depression may be caused by reduced synthesis of proteins involved in neurogenesis and synaptic plasticity.

Question 15

Monoamine receptor hypothesis of depression

Answer 15

Deficient activity of monoamine neurotransmitters causes upregulation of postsynaptic monoamine neurotransmitter receptors which leads to depression.

Question 16

Brain-derived neurotrophic factor (BDNF)

Answer 16

Promotes growth and development of immature neurons, including monoaminergic neurons, enhances survival and function of adult neurons, and helps maintain synaptic connections. Important for neuronal survival, decreased levels may contribute to cell atrophy and low levels may even cause cell loss. Low monoamine levels may correspond to this level being low.

Question 17

Prefrontal Cortex (PFC)

Answer 17

Brain area associated with concentration interest/pleasure, psychomotor fatigue (mental), guilt, worthlessless/suicidality, and mood in depression.

Question 18

Amygdala

Answer 18

Brain area associated with guilt, suicidality, worthlessness, and most strongly with mood in depression.

Question 19

Nucleus accubens

Answer 19

Brain region, along with PFC, most associated with pleasure, interests, fatigue and energy in depression.

Question 20

Striatum and spinal cord (neurotransmitters)

Answer 20

Brain regions associated with psychomotor fatigue (physical) in depression.

Question 21

Hypothalamus

Answer 21

Brain region associated with sleep and appetite in depression.

Question 22

Symptom cluster for dopamine with norepinephrine dysfunction

Answer 22

Reduced positive affect - depressed mood, loss of joy, loss of interest or pleasure, loss of energy/enthusiasm, decreased alertness, and decreased self-confidence.

Question 23

Symptom cluster for serotonin with norepinephrine dysfunction

Answer 23

Increased negative affect - depressed mood, guilt/disgust, fear/anxiety, hostility, irritability and loneliness.

Question 24

PFC

Answer 24

Brain region associated with racing thoughts, grandiosity, distractibility, talkative/pressured speech, mood and risk-taking behavior in mania.

Question 25

Basal forebrain

Answer 25

Brain region associated with decreased sleep/arousal in mania.

Question 26

Nucleus accubens

Answer 26

Brain region associated with racing thoughts, goal-directed actions and grandiosity in mania.

Question 27

Striatum

Answer 27

Brain region associated with motor agitation in mania.

Question 28

Hypothalamus and thalamus

Answer 28

Brain regions associated with decreased need for sleep/arousal and appetite changes in mania.