12.1.1 Mood Disorders

Question 1

What are the two classes of mood disorders?

Answer 1

Depressive disorders
Bipolar disorders

Question 2

What is another term for mood disorders?

Answer 2

Affective disorders

Question 3

How long must you have symptoms before diagnosing a depressive disorder?

Answer 3

At least 2 weeks

Question 4

What are the core symptoms of depressive disorders?

Answer 4

Low mood
Lack of energy
Lack of enjoyment and interest

Question 5

What type of depressive thoughts may a person with depressive disorder have?

Answer 5

Suicidal ideation

Question 6

What are some biological symptoms of depressive disorders?

Answer 6

Lack of appetite
Pain

Question 7

What may be experienced in severe cases of depressive disorders ?

Answer 7

Psychotic symptoms e.g. delusions

Question 8

What is the difference between depression and adjustment reaction?

Answer 8

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- Adjustment reaction typically occurs after a traumatic event, fewer somatic features
- Adjustment reactions do not last as long as depression and tend to have a fluctuating course

Question 9

What are the clinical features of mania?

Answer 9

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- Elevated mood and energy levels with racing thoughts
- Psychosis may be a feature

Manic people are quite easy to identify

Hypomania refers to symptoms that are still clearly manic but don’t necessarily reach full criteria for mania

Question 10

How can you diagnose bipolar affective disorders?

Answer 10

Can diagnose following two episodes of a mood disorder, one of which must be either mania or hypomania

Can be diagnosed with bipolar without ever having been diagnosed with depression
Bipolar disorder is essentially fluctuations in mood

Question 11

What are the two types of bipolar disorder?

Answer 11

Bipolar 1- episodes of mania or mania and depression
Bipolar 2-episodes of hypomania or hypomania and depression

Question 12

What physical differentials are there for depression?

Answer 12

Hypothyroidism
B12 deficiency
Chronic disease
Substance misuse
Hypoactive delirium

Question 13

What physical differentials are there for mania?

Answer 13

Hyperthyroidism
Delirium (hyperactive type)
Iatrogenic (e.g. steroids)
Infection (encephalitis or HIV)
Head injury
Intoxication (stimulants e.g. cocaine)

Question 14

What regions of the brain may have pathology in mood disorders?

Answer 14

Limbic system
Frontal lobe
Basal ganglia

All interact with each other

Question 15

What are the important functions of the limbic system?

Answer 15

Emotion
Memory
Motivation

Question 16

What is the main circuit in the limbic system?

Answer 16

Papez circuit

Question 17

Outline the Papez circuit

Answer 17

MAKE PICTURE LATER

1. Various cortical areas send input to the hippocampus
2. Hippocampus projects to the mamillary bodies via the fornix (white matter output pathway of the hippocampus)
3. Mamillary bodies project to the thalamus and hypothalamus
4. Thalamus projects back to the cortex and the hypothalamus projects to pituitary and autonomics mediating some of somatic effects

Amygdala is another part of the limbic system, can be grouped with hippocampus in terms of connections

Question 18

What part of the brain is also very important for the papez circuit?

Answer 18

Hypothalamus

Question 19

What is the Papez circuit also responsible for?

Answer 19

Memory consolidation where the hippocampus is able to induce long term potentiation in the cortex to lay down long term memory

Question 20

What happens structure size of the limbic system and hypothalamus in depression and bipolar disorders?

Answer 20

Change in size and activity

Question 21

What is the frontal lobe responsible for?

Answer 21

Higher cognition
Impulse control
Voluntary muscle control
Social and moral reasoning
Speech- Broca’s
Memory, mood and attention

HIV Serious Stuff, Might Mean AIDS

Question 22

Why is the frontal lobe involved in generation and expression of emotions?

Answer 22

Inferior portions of the anterior part of the frontal lobe are connected with the amygdala

Question 23

What is the role of the basal ganglia?

Answer 23

Motor and cognitive

Also has important roles in emotion, thought and behaviour ergo changes in basal ganglia volume and activity are seen in mood disorders

Question 24

What does deep brain stimulation do in OCD?

Answer 24

Subthalamic nucleus is stimulated, leads to increased excitation of globus pallidus internus and substantia nigra