Week 1.3: Emerging Focuses in Affective Disorders Flashcards
These devices are revolutionizing data collection in affective disorders research.
Smartphones and Smartwatches
Uses accelerometers to track physical activity and assess sleep quality, amount, and timing.
Activity Monitoring (Actigraphy/Actimetry)
Gathers data on application usage, call and text information, and activity levels. This can help detect relapses in bipolar disorder by monitoring changes in activity and sleep patterns
Passive Data Collection
Analyzes speech and text for diagnostic accuracy, though privacy concerns limit its use
Speech/Text Data
Involves prompting participants several times a day to provide real-time data on their moods and behaviors
Ecological Momentary Assessment (EMA)
Are being developed to tailor data collection to specific research needs, improving the accuracy and relevance of the data collected
Smartphone Applications
Refers to the collection of detailed, high-quality, and high-integrity data that provides rich, actionable insights.
Deep Data
Is a type of artificial intelligence that uses algorithms to analyze data and make predictions.
Machine Learning
Occurs when a model is trained too closely to the training data, making it perform well on that data but poorly on new, unseen data
Overfitting
How is ML used in Affective Disorders?
1) Diagnostic Differentiation
2) Predicting Treatment Outcomes
3) Relapse Detection
Excessive or compulsive use of smartphones, which can lead to negative mental health outcomes
Problematic Smartphone Use
What is the link between Social Media and Depression?
Research indicates a correlation between time spent on social media and increased symptoms of depression, especially among young people.
Excessive social media use can lead to feelings of isolation, poor self-esteem, and disrupted sleep, all of which contribute to depression
Refers to a state of mental calmness, composure, and evenness of temper, especially in difficult situations.
It involves maintaining a balanced and stable mindset, regardless of external circumstances or emotional challenges.
Equanimity
Providing consistent, fair, and unbiased care to individuals from diverse cultural backgrounds, ensuring that everyone receives the same quality of treatment and support.
Equanimity of Care
An innovative mental health intervention developed in Zimbabwe to bridge the mental health treatment gap.
It uses a CBT-based approach, specifically problem-solving therapy, delivered by trained lay health workers
The Friendship Bench
Community volunteers, often referred to as “grandmothers,” who are trained to counsel patients
Lay Health Workers
The inability to feel pleasure, a common symptom in depression.
Anhedonia
Encourages looking at common features across different disorders to identify homogeneous sub-type
Transdiagnostic Approach
Helps disentangle the heterogeneity of affective disorders and improve mechanistic understanding using advanced technologies
Computational Models
Refers to the diversity and variability within affective disorders. This makes it difficult to achieve consistent research results.
Heterogeneity
Traditional VS Modern Approaches in Affective Disorders
Traditional Approach: Relied on singular experiments based on previous theories, often resulting in reductionist models that missed complex interactions.
Modern Approach: Uses sophisticated computational models to reproduce brain processes mathematically, providing a more nuanced understanding.
Mathematically explain relationships between neurobiology, environment, and symptoms.
Computational Psychiatry
Include serotonin, dopamine, and norepinephrine, which play key roles in mood regulation and cognitive functions.
Monoamine Neuotransmitters
Transdiagnostic VS Disorder-Specific Approaches to Affective Disorders
Transdiagnostic Approach: Focuses on common features across different disorders to identify homogeneous sub-types.
Example: Shared decision-making alterations in disorders like major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and schizophrenia.
Disorder-Specific Approach: Targets unique features specific to each disorder.
Example: Specific connectome fingerprints that predict responses to antidepressants in depression.
The brain’s ability to adapt and change.
Neuroplasticity
Hormonal associations with affective disorders, particularly the stress hormone cortisol.
Neuroendocrine Theories
Involves studying gut microbiota influencing mental health, with certain bacteria being more prevalent in people with affective disorders
Microbiomics
Involves studying small molecules in the body, which can provide insights into metabolic changes associated with affective disorders
Metabolomics
Modern neurobiological research aims to translate findings from the lab to clinical applications (bedside) to improve patient care
Translational Neurobiology
This field involves sequencing individuals’ genomes to predict their response to specific medications based on genetic data
Pharmacogenetics
Are groups of researchers and institutions that work together on large-scale studies to pool resources, data, and expertise.
Collaborative Consortia
Involve standardizing measurement tools and protocols across different studies to ensure consistency and comparability of data.
Harmonized Assessments
Is a type of anesthetic that can cause dissociation (a feeling of being detached from reality). It works by blocking NMDA receptors in the brain, which are involved in mood regulation.
Ketamine
Can reduce depressive symptoms very quickly, often within hours.
Ketamine
It is particularly effective for patients experiencing suicidal thoughts.
Ketamine
It shows high effectiveness in reducing symptoms of both bipolar and unipolar depression.
A single dose can reduce symptoms for up to two weeks, but the effect tends to diminish after that.
Ketamine
Are hallucinogenic compounds that alter states of consciousness, affecting psychological, visual, and auditory experiences.
They are being explored as treatments for unipolar depression due to their rapid-acting effects and unique mechanisms
Psychedelics
Why is Psilocybin better than Ketamine?
Longer-lasting Effects
Lower Risk of Dependence
Is a hallucinogenic compound with anecdotal evidence suggesting mood-lifting effects for centuries.
Psilocybin
Are substances that cause profound changes in perception, mood, and thought
Hallucinogens
Involves stimulating the brain to alter its activity and improve symptoms of mental health conditions.
Neuromodulation
One of the most well-evidenced neuromodulatory interventions.
Repetitive Transcranial Magnetic Stimulation (TMS)
Uses electromagnetic pulses to stimulate specific brain regions, inducing electrical currents in brain tissues.
It does not require surgery or anesthesia, making it easier and more acceptable to patients12.
Transcranial Magnetic Stimulation (TMS)
Involves applying a low-amplitude electrical current through electrodes placed on the scalp.
This targets brain activity near the surface to help alleviate symptoms of depression.
Transcranial Direct Current Stimulation (TDCS)
Involves implanting electrodes in specific brain areas to deliver electrical impulses, similar to a pacemaker for the brain
Deep Brain Stimulation (DBS)
Involves implanting a device that sends electrical impulses to the vagus nerve, which influences brain activity
Vagus Nerve Stimulation (VNS)
Is considered one of the most effective treatments for mood disorders, with response rates up to 80%.
Despite its effectiveness, ECT has negative connotations and must be administered carefully due to potential side effects
Electroconvulsive Therapy (ECT)
These medications are being trialed to treat mood symptoms by addressing biological abnormalities associated with mood disorders.
Uniquely, these treatments have been effective for both depression and mania, unlike most treatments which typically target one pole more effectively.
Anti-Inflammatory Medications
Known for its mood-stabilizing properties and effectiveness in reducing suicidal thoughts
Lithium
A psychological approach designed to stabilize circadian rhythms and improve overall mood. It is particularly beneficial for people with bipolar disorders, where disruptions in circadian rhythms are linked to both depressive and manic episodes
Interpersonal and Social Rythm Therapy (ISRT)
These are strategies aimed at preventing the onset of affective disorders (like depression or bipolar disorder) before they occur.
The idea is that preventing illness can reduce the overall burden of disability.
Preventative Interventions
Programs designed to prevent suicide, often targeting those at risk.
Online Anti-Suicide Interventions
The return of symptoms after a period of improvement.
Relapse
Early signs that may indicate a potential relapse.
Prelapse
An early symptom indicating the onset of a disease or disorder.
Prodrome
These are non-medical approaches to prevent the onset of affective disorders. They often involve therapy and counseling.
Psychological Interventions
These interventions involve the family in the treatment process, aiming to create a supportive environment for the individual.
Family-Focused Interventions
How does a general non-responding population of people with affective disorders impact treatment response?
Evidence shows that high inflammation predicts poor response to psychological therapy and responds less well to antidepressants.
High cortisol levels are found in patients who don’t respond to antidepressants and respond less well to psychotherapies.
These studies look back at existing data to see if the predictive model works. This step is crucial but has been a challenge in the field.
Retrospective Studies
These studies test the predictive model in real-time as new data is collected. This involves setting predictive markers beforehand and testing them during treatment.
Prospective Studies
These are studies conducted in real-world settings where patients receive usual care, and the predictive markers are tested as part of their treatment.
Naturalistic Studies
These are more structured studies where researchers control various factors to ensure that any observed benefits are due to the predictive model and not other variables.
Controlled Trials
This approach involves assessing an individual’s unique characteristics and tailoring an intervention strategy specifically for them.
Personalized Medicine
A more feasible alternative to fully personalised medicine. It involves categorizing people into groups based on certain characteristics (e.g., high or low levels of cortisol or inflammation) and then targeting treatments accordingly.
Stratified Medicine
