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NEUROPSYCH & CLINICAL NEURO > Week 8: Mood disorders > Flashcards

Week 8: Mood disorders Flashcards

1
Q

What is a mood disorder?

A

A mental health problem that primarily affects a person’s emotional state. A person may experience long periods of extreme happiness, extreme sadness or both

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2
Q

How long do symptoms need to be present for a person to be diagnosed with depression?

A

2 weeks

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3
Q

How many symptoms from the DSM5 do you need to be diagnosed with depression?

A

5 or more

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4
Q

What 4 things have to be occurring to be diagnosed with depression?

A
  • Symptoms are causing clinically significant distress or impairment in social, occupational or other functioning
  • Episode not caused by physiological effects, substances or medical condition
  • Episode should not be explained by schizophrenia or psychotic disorders
  • No history of manic or hyper manic episodes
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5
Q

Mild depression?

A

Some difficulty in concentrating in ordinary work and social activities but will not cease to function completely

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6
Q

Severe depression?

A

Unlikely that they will be able to continue with social, work or domestic activities

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7
Q

Explain the adverse life events and depression cycle

A

People who have gone through adverse life events are more likely to develop depression.
Can lead to more stress and dysfunction and make the life events worse, worsening depression

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8
Q

Depression and physical health?

A

There are interrelationships between depression and physical health

E.g CVD can lead to depression

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9
Q

What preventions have been used in elderly for depression?

A

Exercise programs

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10
Q

Postpartum depression?

A

Occurs during pregnancy or after delivery

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11
Q

Persistent depressive disorder (dysthymia)?

A

Chronic form lasting for at least 2 years

May occasionally lessen and worsen in severity during this time

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12
Q

Seasonal affective disorder (SAD)?

A

Occurs during certain seasons of the year.

Typically late autumn early winter until spring or summer

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13
Q

Psychotic depression?

A

Severe.
Often combined with psychotic episodes such as hallucinations or delusions

Episodes may be upsetting, disturbing and often have a theme

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14
Q

Depression may also be related to….

A

A medical condition, medication or substance abuse

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15
Q

Recurrent depressive disorder?

A

Repeated depressive episodes

Depressed moods, loss of interest and enjoyment, reduced energy and lethargy for at least 2 weeks

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16
Q

Psychological treatments for depression?

A

CBT
Interpersonal Psychotherapy

Can be individualised or group form

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17
Q

What other treatments (other than psychological) are available for depression?

A

SSRIs - selective serotonin reuptake inhibitors
SNRIs - serotonin and noradrenaline reuptake inhibitors
TCAs - tricyclic antidepressants
MAOIs - monoamine oxidase inhibitors
ECT - electroconvulsvie therapy
Ketamine therapy

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18
Q

SSRI examples?

A

Prozac
Paxil
Celexa
Zoloft

19
Q

SSNI examples?

A

Cymbalta (duloxetine)
Effexor (venlafaxine)
Meridian (subutramine)

20
Q

What are tricyclic antidepressants?

A

They have 3 rings in their chemical structure hence the name

Mode of action is to block the reuptake of serotonin, noradrenaline, histamines and acetylcholine

21
Q

Tricyclic antidepressants are considered a dirty drug. What does this mean?

A

Less specific in what they target. This may lead to some side effects

22
Q

What are monoamine oxidise inhbitiors?

A

Mode of action: monoamine oxidizers are involved in the reuptake and breaking down of neurotransmitters
By inhibiting this there is less breakdown and more neurotransmitter available

Acts on noradrenaline and serotonin

23
Q

What is ECT?

A

Being put under anesthetic and having a current applied to the brain that induces a seizure
Rapidly relieves depressive symptoms

24
Q

What severity of depression is ECT recommended for?

A

Severe. Only when they are resistant to drug and psychotherapy

25
Q

What else is ECT effective in treating?

A

Mania and schizophrenia

26
Q

What is ketamine therapy?

A

Pain-relieving medication that can induce a seizure

Low doses relieve symptoms rapidly

27
Q

Is ketamine therapy permanent?

A

No. You need maintenance doses.

28
Q

How does ketamine therapy work?

A

Works on NMDA receptors - promotes more glutamate, more excitation and less depressive symptoms

29
Q

How many people worldwide are affected by depression?

A

264+ million

30
Q

What is bipolar disorder?

A

Defined by mood swings from periods of depression to periods of mania

31
Q

What are the 4 types of bipolar?

A

Bipolar I, II, Cyclothymia disorder and other or unspecified

32
Q

Bipolar I?

A

Most severe form with episodes lasting at least 7 days
may recquire hospitilisation

Depressive episodes last up to 2 weeks

Depression and mania can be present at the same time

33
Q

Bipolar II?

A

Cycles of depression, however, experience hypomania. These are less severe episodes of mania that aren’t as intense or disruptive

Can usually handle daily responsibilities and does not require hospitalisation

34
Q

Cyclothymia bipolar disorder?

A

Milder form

Continuous regular mood swings from mild to moderate highs and lows for extended periods of time

Changes in mood occur quickly and at any time

Can have short periods of normal mood

35
Q

How long do cyclothymia symptoms need to be experienced before diagnosis?

A

Adults: at least 2 years
Children: 1 year

36
Q

Other or unspecified bipolar?

A

The symptoms do not meet criteria for diagnosis but there are still significant, abnormal changes in mood

37
Q

What treatments are available for bipolar?

A

Lithium

Valpronic acid

38
Q

How does lithium work?

A

Dissolves in the bloodstream and interacts with GABA, dopamine and glutamate - GABA dampens activity, with less excitation from glutamate

39
Q

Down side to lithium treatment?

A

Can be toxic!

Need to be monitored and a balance found

40
Q

What is valpronic acid?

A

Typically used for epilepsy

Acts on glutamate to reduce and dampen activity

41
Q

What is bipolar affective disorder?

A

Type of depression that typically consists of both manic and depressive episodes separated by periods of normal mood.

Elevated or irritable mood, overactivity, pressure of speech, inflated sense of self and decreased need for sleep

42
Q

How many people in middle and low income countries receive no treatment for their disorder?

A

76-86%

43
Q

What are some barriers to receiving treatment?

A

Lack of resources
Lack of trained health care providers
Social stigma
Inaccurate assessment

NEUROPSYCH & CLINICAL NEURO (12 decks)

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