Depression Flashcards
Major symptoms of depression?
Psychomotor retardation
Fatigue or loss of energy
Diminished ability to concentrate
Diminished interest in social activity
Psychomotor agitation
Depressed mood
Feelings of guilt and worthlessness
Suicidal ideation
Insomnia
Weight loss and decreased appetite
Lack of interest and anhedonia (reduced ability to experience pleasure)
What are the three typical core symptomsof depression? [3]
Thethree typical core symptomsof depression include:
- Low mood
- Anhedonia: low interest or pleasure in most activities of the day
- Lack of energy (anergia)
What is important to consider about the symptoms of depression? [1]
symptoms may present differently in people with different ethnic backgrounds raising the issue of how best to assess depression cross-culturally for research purposes
Name a scale used to rate depression [1]
Hamilton Rating Scale for Depression
Describe the genetic link of depression [2]
strong genetic component of depression [1]
genetic overlap with bipolar disorder too [1]
Name 6 genes of which there is evidence of a link to depression
More than 100 genetic variants have been associated with depression risk
- HTR2A
- GRIK4
- CRHR1 (corticotropin releasing hormone receptor 1)
- SLC6A4 (serotonin transporter)
- HTR1a
- MAOA
Neurotransmitter systems associated with mood disorders
Which NT systems are implicated with depression? [2]
monoaminergic pathways: noradrenergic and serotonergic
(but not the only players)
Which are the brain regions associated with depression? [6]
Amygdala
Ventrolateral prefrontal cortex
Dorsolateral prefrontal cortex
Medial prefrontal cortex
Striatal regions (ventral striatum)
Hippocampus
What happens to the hippocampus during stress in depression? [1]
Shrinks
Where is the subgenual anterior cingulate cortex ? [1]
How is the subgenual anterior cingulate cortex effected during depression? [1]
What structural implications does this have? [1]
Decreased metabolism: significant reduction in glucose consumption
The mean gray matter volume of the subgenual anterior cingulate cortex is reduced
Describe a relationship between genetics and environments that causes depression:
What occurs at a higher risk of major depression after significant life events? [1]
5-HT transporter polymorphism (impact on 5-HT signalling) is associated with a higher risk of major depression after significant life events
The different alleles may lead to different levels of transcription of the transporter
Therefore, the genetic variation modulates the response to stressful events
Describe a structural change to the brain that occurs in depression [2]
Decreased cortical thickness
Hippocampus white matter decreases (in first major epidsode)
Overview of changes to brain during depression [3]
- Decreased cortical thickness
- Decreased mean grey matter in ACC due to decreased glucose metabolism
- Volumes of hippocampal white matter decrease in patients with a first episode of depression
What is the default mode network (DMD)? [1]
What type of thoughts is the DMD involved with? [1]
DMD: a network of brain regions active when the brain is at wakeful rest
The DMN is involved in self-reference thoughts and negative recurrent thoughts
What is the DMD like in patients with depression? [2]
In which particular areas? [2]
Major depression have an increased functional connectivity within DMN
increased connectivity between DMN and fronto-parietal networks: especially left subgenual cingulate area
involved in self-reference thoughts and negative recurrent thoughts = worse :(
Describe interactions between key structures that involved in depression that cause an increase in depressive ruminations:
Which areas of the brain become hyperactive? [4]
Which areas of the brain become hypoactive
Hyperactive:
* amygdala
* hippocampus
* subgenual cingulate cortex
* medial prefrontal cortex
Hypoactive:
* Dorsolateral prefrontal cortex
* ventrolateral prefrontal cortex
