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Neuroscience > Neuroscience Week 8: Depressive Disorders > Flashcards

Neuroscience Week 8: Depressive Disorders Flashcards

1
Q

What is mood?

A
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2
Q

Depression prevalence

A

3rd most Common leading cause of woldwide disability

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3
Q

Depression treatment importance

A

Because it is treatable!!!!!

it is very dangerous if untreated (suicide)

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4
Q

Comorbidity of depression

4 listed

A
  • Anxiety
  • substance use
  • personality disorders
  • ADHD
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5
Q

Bipolar disorder treatment importance

A

Treatable

dangerous if untreated (suicide)

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6
Q

Bipolar disorder comorbidity

3 listed

A
  • anxiety
  • substance use
  • high IQ
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7
Q

Depression pathology components

4 listed

A
  • Cognitive thoughts
  • emotions and feelings
  • Vegetative or physiological symptoms
  • behavioral (impulsivity)
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8
Q

Kay Jamison

A
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9
Q

Depression diagnostic characteristics

A
  • 5 or more of the following symptoms for at least 2 weeks
  • 1 symptom must be depressed mood or decreased interest
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10
Q

Depression symptom mnemonic

A

SIG E CAPS

  • Sleep changes
  • Interest
  • guilt or worthlessness
  • Energy loss
  • concentration loss
  • appetite loss or weight loss
  • psychomotor agitation or retardation
  • Suicidal ideation
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11
Q

depression: changes in the brain

3 listed

A
  • decreased flow to the left frontal areas
  • atrophy in the hippocampus
  • antidepressants improve and neuroplasticity in the hippocampi
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12
Q

Manic Episode description

A
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13
Q

Hypomanic Episode description

A
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14
Q

Major Depressive Disorder: onset

A

25-35 years of age

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15
Q

Major Depressive Disorder: episodes

2 listed

A
  • depressive episodes that last 10-12 weeks
  • average number of episodes per lifetime is 4
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16
Q

Major Depressive Disorder: chronic

A

12% of patients have chronic unremitting course

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17
Q

Course of Major Depressive Disorder

A
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18
Q

Cycling disorders

3 listed

A

Bipolar I

Bipolar II

and

Cyclothymia

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19
Q

Onset of Bipolar I disorder

A

19-29 years of age

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20
Q

Bipolar I episodes

A
  • manic episodes last 5-10 weeks
  • Depressed episodes last 19 weeks
  • Average number of episodes in lifetime is 10
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21
Q

Bipolar I Manic episodes duration

A

last 5-10 weeks

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22
Q

Bipolar I depressed episode duration

A

19 weeks

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23
Q

Bipolar I average # of episodes per lifetime

A

10

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24
Q

Major depressive disorder Episode duration

A

10-12 weeks

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25
Q

Major depressive disorder average # of Episodes per lifetime

A

4

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26
Q

Bipolar I disorder cycle

A

euthymia to mania to depression to euthymia

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27
Q

Bipolar II disorder cycle

A

Euthymia to hypomania to depression to euthymia

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28
Q

Cyclothymia disorder cycle

A

euthymia to hypomania to dysthymia to hypomania to euthymia

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29
Q

Course of Bipolar I Disorder

A
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30
Q

Disruptive mood dysregulation disorder

A
  • only seen in children
  • patterns of tantrums and erratic irritable moods
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31
Q

Persistent Depressive Disorder AKA

A

Dysthymia

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32
Q

Persistent Depressive Disorder description and diagnostic criteria

A

2 years or more of:

  • appetite changes
  • sleep changes
  • low energy or fatigue
  • low self-esteem
  • poor concentration or indecisiveness
  • feelings of hopelessness
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33
Q

Cyclothymic disorder description

A

Dysthymic and hypomanic periods

34
Q

Premenstrual Dysphoric Disorder description

A

in the majority of menstrual cycles at least 5 symptoms starting the week before menses and ending after

35
Q

Adjustment disorder with depressed mood description

A
  • occurs within 3 months of a stressor
  • can be good things like getting married or buying a house or bad things such as losing job etc.
  • much higher rates of suicide attempts and suicide completion
36
Q

Uncomplicated Bereavement description

A
  • normally grieving doesn’t have feelings attached to themselves
  • if they indicate self involvement this might be more of a depression
37
Q

Specifiers of mood episodes

38
Q

with anxious distress

A

anxious presentation

39
Q

…with mixed features

A

Manic symptoms, includes mood elevations or depressions

40
Q

…with melancholic features

A
  • terminal insomnia
  • wake up feeling melancholic at a specific time such as 3 AM
  • biological depression
41
Q

terminal insomnia description

A

Wake up way to early

42
Q

…with atypical features

A
  • often women
  • eat too much
  • sleep to much
  • diurnal mood variation
  • limb paralysis (arms and legs feel heavy)
  • increased rejection sensitivity
  • typically res[pond to MAOIs
43
Q

initial insomnia description

A

having trouble falling asleep

44
Q

Middle insomnia description

A

waking up in the middle of the night

45
Q

…with mood-congruent psychotic features

A
  • only get psychotic when depressed
  • delusions of something (feelings, brain rotting, dying)
46
Q

…with mood in-congruent psychotic features

A

as mood congruent but incongruent

47
Q

… with catatonia

A

abnormality of movement and behavior arising from a disturbed mental state (typically schizophrenia). It may involve repetitive or purposeless overactivity, or catalepsy, resistance to passive movement, and negativism.

48
Q

With peripartum onset

A

peripartum depression

49
Q

…with seasonal pattern

A

these are described as major depressive episode with a seasonal pattern

50
Q

Prevalence of depression

51
Q

High-risk populations for depression

52
Q

Psychological risks

6 listed

A

Early traumas

53
Q

Genetics of depression

A

Twin studies

54
Q

Neurotransmitters of depression

A
  • Serotonin
  • Norepinephrine
  • Dopamine
55
Q

Monoamine Deficiency Hypothesis

A

Also stress/inflammation/neuroplasticity

56
Q

There is reversible loss of ___________ after early depressive episodes

A

hippocampal volume

57
Q

Antidepressant drugs increase levels of ______

A
  • BDNF
  • hippocampal neurogenesis
  • neuritic elongation
  • idendritic branching density of CA3 hippocampal pyramidal cells

These changes correlate with changes in learning and long-term potentiation

58
Q

Brain changes in depression

5 listed

59
Q

Abnormal sleep in depression

A

↓ REM Latency

60
Q

Geriatric depression features

A
  • late onset depression associated with cerebrovascular disease
  • enlarged ventricles
  • cognitive impairment (pseudodementia)
61
Q

5hIAA

A

metabolite of serotonin

62
Q

Homovanilic acid

A

metabolite of dopamine

63
Q

negative triad

A

the negativity of past present and future

was a failure

am a failure

will be a failure

64
Q

Neural model of biased reprocessing to negative information in Major Depressive Disorder

A

goes to dorsolateral prefrontal cortex

65
Q

Decreasing REM sleep can?

A

help depressed patients feel better

66
Q

Suicide genetics

A

runs in families

67
Q

Suicide is associated with

A
  • impulsivity
  • aggression
  • alcohol/drug use
  • anxiety
68
Q

Suicide threats?

A

take threats seriously

69
Q

Suicide and healthcare

A
  • 20-48% see a primary physician in the week prior to suicide
  • 40-70% within a month prior to suicide
70
Q

Suicide overview

71
Q

Assessing for suicide

72
Q

Treating depression

5 listed

73
Q

Psychotherapy for mood disorders

74
Q

Interpersonal Psychotherapy

A

resolving loss, disputes, deficits

75
Q

Cognitive-behavioral Psychotherapy

A

correcting negative thoughts

behavioral activation

76
Q

Psychodynamic Psychotherapy

A

identify maladaptive defenses and decrease their use

77
Q

Psychotherapy vs medication for acute depression

78
Q

Psychotherapy for chronic depression

A

minimally efficacious for chronic depression

79
Q

Treatment of Bipolar Disorders

A

practical and emotional support

social considerations

Available caregivers

health facilities

ambulatory/outpatient treatment

combinations of medication and psychotherapy and sleep hygiene is crucial

80
Q

Hospitalize Bipolar Disorders

A
  • for psychosis
  • suicidality
  • continued self-harm due to substances
  • inability to care for self
  • medical problems
  • legal problems
81
Q

Mood stabilizers for Bipolar disorder

A
  • lithium
  • carbamazepine
  • lamotrigine
  • Atypical antipsychotics
  • stop antidepressants
  • sleep hygiene/benzos
  • psychotherapy

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