Week 4.2: Cognition in mood disorders

Question 1

This refers to difficulties with mental abilities such as thinking, knowing, remembering, judging, and problem-solving.

Answer 1

Cognitive Impairment

Question 2

The complex network of neurons and their connections in the brain that work together to process information.

Answer 2

Brain Circuitry

Question 3

The process by which the information in a gene’s DNA is transferred to messenger RNA (mRNA) for protein production.

Answer 3

Gene Transcription

Question 3

What are the different cognitive domains?

Answer 3

Attention: The ability to focus on specific stimuli or tasks.

Learning and Memory: The processes involved in acquiring new information and recalling it.

Speed of Processing: How quickly one can understand and respond to information.

Question 4

The process of evaluating a person’s cognitive functions, such as memory, attention, and problem-solving skills.

Answer 4

Cognitive Assessment

Question 5

This involves self-reported measures where individuals rate their own cognitive abilities, often using rating scales or questionnaires.

Answer 5

Subjective Assessment

Question 6

This involves standardized tests administered by clinicians to measure cognitive abilities.

Answer 6

Objective Assessment

Question 7

Assessments made by healthcare professionals through interviews or observing a person’s behavior.

Answer 7

Clinician Ratings

Question 8

Quick assessments done by healthcare professionals to evaluate cognitive function. Two common tests are:

Mini Mental State Examination (MMSE): A brief 30-point questionnaire used to screen for cognitive impairment.
Montreal Cognitive Assessment (MoCA): A 30-point test designed to detect mild cognitive impairment.

Answer 8

Cognitive Function Bedside Tests

Question 8

Significant and noticeable cognitive deficits, often seen in conditions like dementia or neurodegenerative disorders.

Answer 8

Gross Cognitive Impairments

Question 9

Tools where individuals rate their own cognitive abilities by answering questions about their experiences.

These questionnaires are valuable because they capture the individual’s subjective experience of their cognitive abilities, providing insight into how they perceive their cognitive function.

Answer 9

Self-Rated Cognitive Questionnaires

Question 10

A cognitive test where individuals match symbols with corresponding digits as quickly as possible. It measures speed of processing. The score is the number of correct symbols matched within 90 seconds, with a maximum score of 93.

Answer 10

Digit Symbol Substitution Test (DSST)

Question 11

A test to assess immediate and delayed recall. The administrator reads a list of words, and the individual repeats back as many words as they can remember. There is also a delayed recall component where the individual is asked to recall the words after some time.

Answer 11

Rey Auditory Verbal Learning Test (RAVLT)

Question 12

Higher-order cognitive processes that include planning, decision-making, problem-solving, and task flexibility. Often impaired in mood disorders.

Answer 12

Executive Function

Question 13

A test to assess executive function. The individual connects circles in an ascending pattern, alternating between numbers and letters (e.g., 1-A, 2-B, 3-C). The time taken to complete the task is recorded, with higher times indicating greater impairment.

Answer 13

Trail-Making Test, Part B (TMT-B)

Question 13

Cognitive processes that are influenced by emotions and involve emotional processing. It includes how we respond to negative feedback and is important in mood disorders because it can affect antidepressant response and overall mood.

Answer 13

Hot Cognition

Question 14

Cognitive processes that are more logical and emotion-independent. It involves executive functions like attention, perception, and psychomotor functions (coordination of movement).

Answer 14

Cold Cognition

Question 15

A brain region associated with hot cognition and emotional processing. It has connections to the amygdala, which is involved in processing emotions.

Answer 15

Ventral Medial Prefrontal Cortex (vmPFC)

Question 15

A brain region associated with cold cognition and non-emotional cognitive functions. It is involved in logical thinking, sensory processing, and motor functions, and has connections to areas like the basal ganglia and parietal cortex.

Answer 15

Dorsal Lateral Prefrontal Cortex (dlPFC)

Question 16

Brain pathways involved in motivation and reward. Dysfunction in these pathways can lead to reduced decision-making capacity and loss of reward sensitivity.

Answer 16

Mesolimbic-Cortical Circuitry

Question 17

What is depression’s link to dysfunction in the brain’s motivational pathways?

Answer 17

People with depression may have trouble making decisions, especially under pressure, and may not respond to rewards as they typically would.

Question 18

Difficulties in functioning in social and work environments due to cognitive deficits.

Answer 18

Psychosocial Impairment

Question 19

Treatments involving medications that can help reduce or manage cognitive deficits.

Answer 19

Pharmacological Interventions

Question 20

Non-medication-based treatments, such as cognitive-behavioral therapy (CBT), that aim to improve cognitive function and coping strategies.

Answer 20

Behavioral Interventions

Question 20

Techniques that directly stimulate or modulate brain activity, such as transcranial magnetic stimulation (TMS) or electroconvulsive therapy (ECT).

Answer 20

Neuromodulatory Interventions

Question 21

Factors that might influence the results of a study, making it difficult to determine the true effect of the variable being studied. Examples include medication effects, previous head injuries, and other health conditions.

Answer 21

Confounding Variables

Question 22

Drugs that affect a person's mental state, often used to treat psychiatric disorders.

Answer 22

Psychotropic Medications

Question 23

Another term for major depressive disorder (MDD), characterized by persistent low mood and other symptoms.

Answer 23

Unipolar Depression

Question 24

A period during which the symptoms of depression are reduced or disappear.

Answer 24

Remission

Question 25

Symptoms that remain even after the major depressive episode has resolved.

Answer 25

Residual or Persisting Symptoms

Question 26

The return of symptoms after a period of improvement.

Answer 26

Relapse

Question 26

Waking up in the middle of the night and having difficulty falling back asleep.

Answer 26

Mild-Nocturnal Insomnia

Question 27

A mental health condition characterized by extreme mood swings, including manic (high) and depressive (low) episodes. Previously known as manic-depressive illness

Answer 27

Bipolar Disorder (BD)

Question 28

A severe mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self, and behavior. Previously known as dementia praecox.

Answer 28

Schizophrenia

Question 29

Is a normal, tranquil mental state or mood.

Answer 29

Euthymia

Question 30

Is there a difference in cognitive impairments of patients with schizophrenia from those with bipolar disorder?

Answer 30

Schizophrenia: Cognitive impairments are broad and linked to developmental issues, affecting multiple cognitive domains from an early stage. Bipolar Disorder: Cognitive impairments are more episodic, related to mood episodes, but can persist over time. There is significant variation in cognitive performance among individuals with bipolar disorder.

Question 31

It suggests cognitive deficits are present before the onset of the illness and are linked to abnormal brain development.

Answer 31

Neurodevelopmental Model of Cognitive Impairment

Question 32

A model of cognitive impairment that suggests cognitive deficits begin at the onset of the illness and worsen with each episode.

Answer 32

Neuroprogressive Model of Cognitive Impairmaint

Question 33

Studies that observe a population at a single point in time, providing a snapshot of the current state.

Answer 33

Cross-Sectional Studies

Question 34

Studies that follow the same individuals over a period of time, allowing researchers to observe changes and developments.

Answer 34

Longitudinal Studies

Question 35

What are the cognitive subgroups in bipolar disorder?

Answer 35

Intact: Individuals with no significant cognitive impairments. Selective Deficits: Individuals with impairments in specific cognitive areas. Global Deficits: Individuals with widespread cognitive impairments.

Question 36

What is the impact of mood episodes on cognition?

Answer 36

Mood episodes can affect cognition due to a combination of medication effects, environmental factors, and abnormal metabolic processes in the brain. These processes occur against a background of vulnerability to mental health conditions, influenced by genetics, childhood trauma, and stress.

Question 37

What are the possible causes of cognitive impairments for individuals with mood disorders?

Answer 37

Illness-Related Impairments: Cognitive impairments that are directly related to the mood disorder. Secondary Causes: Impairments that may be due to medication, comorbid conditions, unhealthy lifestyle, or organic brain illnesses like dementia.

Question 38

The presence of one or more additional conditions co-occurring with a primary condition.

Answer 38

Co-morbidity

Question 39

Physical disorders that affect brain function, such as dementia.

Answer 39

Organic Brain Illness

Question 40

A substance that blocks the action of hormones.

Answer 40

Hormonal Antagonist

Question 41

A drug that mimics the action of dopamine, a neurotransmitter.

Answer 41

Dopamine Agonist

Question 42

A class of antidepressants that increase the levels of serotonin and norepinephrine in the brain.

Answer 42

Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)

Question 43

A substance that improves cognitive function, particularly executive functions, memory, creativity, or motivation.

Answer 43

Cognitive Enhancer

Question 44

Improvement in patients receiving a placebo due to their belief in the treatment.

Answer 44

Placebo Response

Question 45

The ability of a substance to improve cognitive function.

Answer 45

Pro-Cognitive Effects

Question 46

The improvement in cognitive functions happens regardless of changes in mood.

Answer 46

Mood-Independent

Question 47

What is the impact of stress on prefrontal networks?

Answer 47

Stress weakens the networks in the prefrontal cortex, which is crucial for regulating thought, action, and emotion

Question 48

The part of the brain responsible for higher-order functions like decision-making, problem-solving, and regulating emotions.

Answer 48

Pre-frontal Cortex (PFC)

Question 49

A brain region involved in processing emotions, particularly fear and stress.

Answer 49

Amygdala

Question 50

A group of structures linked to controlling movement and habitual behaviors.

Answer 50

Basal Ganglia

Question 51

The part of the nervous system that controls involuntary actions like heart rate and digestion.

Answer 51

Autonomic Nervous System

Question 52

Behaviors where we automatically react without thinking things through.

Answer 52

Reflexive or Habitual Behaviors

Question 53

These are older parts of the brain that handle basic survival functions. Under stress, these circuits take over, leading to more instinctual and less rational responses.

Answer 53

Primitive Brain Circuits

Question 54

Type: Hormonal antagonist. Benefit: Used primarily for its effects on the hormonal system, with some evidence suggesting cognitive benefits in mood disorders.

Answer 54

Mifepristone

Question 55

Type: Antidepressant. Benefit: Shown to improve cognitive function in patients with major depressive disorder (MDD) by enhancing cognitive abilities such as memory and executive function

Answer 55

Vortioxetine

Question 56

Type: Dopamine agonist. Benefit: Used in Parkinson's disease, it has shown potential cognitive benefits due to its action on dopamine pathways

Answer 56

Pramipexole

Question 56

Type: Antidepressant (Serotonin-Norepinephrine Reuptake Inhibitor - SNRI). Benefit: While primarily used to treat depression and anxiety, it has some evidence suggesting cognitive benefits

Answer 56

Duloxetine

Question 57

Type: Antipsychotic. Benefit: Used in the treatment of bipolar disorder and schizophrenia, with some evidence of cognitive benefits

Answer 57

Lurasidone

Question 58

Type: Stimulates red blood cell formation. Benefit: Known for its use in treating anemia, it has also shown potential cognitive benefits in mood disorders

Answer 58

Erythropoietin

Question 58

Type: Cognitive enhancer. Benefit: Recognized for its ability to enhance cognitive function in healthy individuals and may have similar benefits in people with mood disorders

Answer 58

Modafinil

Question 59

A condition caused by high levels of cortisol (a stress hormone).

Answer 59

Cushing's Disorder

Question 60

A drug that blocks the effects of glucocorticoids, which are stress hormones.

Answer 60

Glucocorticoid Receptor Antagonist

Question 61

A drug that blocks the effects of progesterone, a hormone involved in pregnancy.

Answer 61

Progesterone Receptor Antagonist

Question 62

The ability to protect nerve cells from damage or degeneration.

Answer 62

Neuroprotective

Question 63

Refers to the support and growth of neurons (nerve cells) in the brain. Neurotrophic factors are proteins that help neurons survive, grow, and maintain their functions. They play a crucial role in the development, maintenance, and repair of the nervous system.

Answer 63

Neurotrophic

Question 64

A psychoeducative strategy aimed at improving everyday functioning in patients with mental health disorders. It combines education about cognitive dysfunctions with practical techniques to enhance daily life skills

Answer 64

Functional Remediation

Question 65

Thinking about thinking.

Answer 65

Metacognition

Question 66

Traditionally used for mood stabilization, it may also have neuroprotective and cognitive benefits.

Answer 66

Lithium

Question 67

Therapeutic approaches to enhance cognitive abilities and daily functioning.

Answer 67

Cognitive Remediation