Neuro22 - Mood Disorders

Question 1

6 features of depression

Core Symptoms x3
Other Symptoms x3
Brain Circuits Affected x3
Neurotransmitters Involved x2
Treatment (biopsycosocial)
Differential Diagnoses x8

Answer 1

1. ) Core Symptoms - continuous (>2weeks), develop gradually, and need at least 2 of:
   - low mood, lack of energy, lack of enjoyment/interest
2. ) Other Symptoms - depressive thoughts
   - somatic symptoms e.g. lack of appetite, insomnia
   - in severe cases, psychotic symptoms
3. ) Brain Circuits Affected
   - prefrontal cortex: slowing of thought, executive function, and altered emotional processing
   - amygdala: abnormal emotional processing
   - basal ganglia: impaired incentive behavior
4. ) Neurotransmitters Involved - low amounts of:
   - serotonin and noradrenaline
5. ) Treatment
   - biological: SSRIs, SNRIs (serotonin+NA), TCA, ECT
   - psycho: CBT
   - social: ↓isolation, reduce social stressors
6. ) Differential Diagnoses
   - hypothyroidism, anaemias, vitB12 deficiency
   - renal, CVS, liver failure, hypoactive delirium
   - substance misuse: alcohol, cannabis, stimulants

Question 2

3 features of mania

Symptoms x6
Treatment (biopsychosocial)
Differential Diagnoses x6

Answer 2

1. ) Symptoms - elated mood, ↑energy, ↓need for sleep
   - lose social inhibitions, inflated self sesteem
   - in severe cases, psychotic symptoms
2. ) Treatment
   - biological: antipsychotics (dopamine antagonists), mood stabilisers (e.g. lithium)
   - psycho: only useful longer term
   - social: treat in place of safety, consider implications
3. ) Differential Diagnoses
   - hyperthyroidism, iatrogenic (e.g. steroid induced)
   - delirium, head injury, stimulant intoxication
   - infection: encephalitis, HIV, syphyllis

Question 3

3 features of bipolar disorders

Diagnosis x2
Treatment of Bipolar Depression (biopsychosocial)
Maintaining Stability (biopsychosocial)

Answer 3

1. ) Diagnosis - bipolar 1 or bipolar 2
   - 1: episodes of mania only or mania + depression
   - 2: episodes of hypomania or hypomania + depression
2. ) Treatment of Bipolar Depression
   - biological: antidepressant + mood stabiliser cover
   - psycho: CBT, social: same as unipolar
3. ) Maintaining Stability
   - biological: mood stabilisers (e.g. lithium, sodium valproate), antipsychotic e.g. quetiapine
   - psycho: psychoeducation, CBT (prevents relapse)
   - social: consider implication on work, family etc.

Question 4

3 brain structures involved in mood disorders and how they change w/ depression and bipolar disorder

Limbic System
Frontal Lobe
Basal Ganglia

Answer 4

1. ) Limbic System - emotion, motivation, memory
   - depression: ↓hippocampal volume, ↓cerebral blood flow and metabolism in the amygdala
   - bipolar: ↑amygdala volume and activation mania, ↓volume in paralimbic cortices (e.g. prefrontal coretex)
2. ) Frontal Lobe
   - depression: ↓activity/blood flow in prefrontal cortex
   - bipolar: ↓prefrontal cortex activation
3. ) Basal Ganglia - motor and psychological functions
   - depression: ↓volume, ↓activation between striatum, amygdala and prefrontal cortex
   - bipolar: functional changes in the striatum