Session 12: Mood Disorders Flashcards

1
Q

Core symptoms of depression

A

Low mood

Lack of energy

Lack of enjoyment and interest

These symptoms should be continous and persist for 2 weeks

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2
Q

Give other symptoms of depression.

A

Depressive thoughts

Somatic symptoms

Psychotic symptoms in severe cases

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3
Q

What is the difference between adjustment reaction and depression?

A
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4
Q

Features of mania

A

Elated mood

Increased energy

Pressure of speech and quick speech

Decreased need for sleep

Flight of ideas and jumping ideas

Normal social inhibitions are lost

Attention cannot be sustained

Self esteem is inflated and delusion of grandeur

May have psychotic symptoms

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5
Q

What is bipolar affective disorder?

A

Diagnosis is made following 2 episodes of a mood disorder at least on ofe which is mania or hypomania.

This means that you don’t have to have a diagnosis of depression to be given the diagnosis bipolar disorder

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6
Q

What is bipolar 1?

A

Discrete episodes of mania only or mania and depression.

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7
Q

What is bipolar 2?

A

Discrete episodes of hypomania or hypomania and depression.

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8
Q

Give examples of physical health differentials of depression.

A

Hormone disturbance such as thyroid dysfunction

Vitamin deficiencies such as vit B12

Chronic disease like renal, CVS and liver failure

Anaemias

Substance misuse such as alcohol, cannabis and stimulants

Hypoactive delirium.

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9
Q

Give examples of physical health differentials to mania.

A

Steroid induced

Hyperthyroidism

Delirium

Infection such as encephalitis, HIV and syphillis

Head injury

Intoxication with stimulants

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10
Q

Brain structures involved in mood disorders

A

Limbic system

Frontal lobe

Basal ganglia

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11
Q

Main hypothesis of mood.

A

Determined by functional circuits between the brain structures involved in mood.

Frontal lobe -> limbic system -> basal ganglia -> brainstem.

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12
Q

Main functions of the limbic system.

A

Emotion

Motivation

Memory

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13
Q

Limbic system changes in unipolar depression.

A

Decreased hippocampal volume

Decreased cerebral blood flow and metabolism in the amygdala

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14
Q

Limbic system changes in bipolar disorder.

A

Altered amygdala volume

Increased amygdala activation and volume in mania

Decreases in volume in anterior paralimbic cortices

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15
Q

Frontal lobe functions

A

Motor function

Language (Broca’s)

Executive functions (purposeful goal directed behaviours)

Attention

Memory

Mood

Social and moral reasoning

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16
Q

Function of the ventromedial prefrontal cortex

A

Generation of emotions

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17
Q

Function of the orbital prefrontal cortex

A

Emotional responses

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18
Q

Frontal lobe changes in unipolar depression

A

Decreased activity in dorsolateral PFC

Decreased volume of orbitofrontal PFC

19
Q

Frontal lobe changes in bipolar disorder.

A

Reduced dorsolateral PFC activation

20
Q

Malfunction of the basal ganglia are implicated in neurological illnesses such as:

A

Parkinson’s disease

Huntington’s disease

Wilson’s disease

21
Q

Psychological functions of the basal ganglia

A

Emotion

Cognition

Behaviour

22
Q

Basal ganglia changes in unipolar depression

A

Decreased basal ganglia volume

Reduced activation between striatum, amygdala and PFC

23
Q

Prefrontal cortex functions that are changed in depression.

A

There’s slowing of thought, executive dysfunction and altered emotional processing

24
Q

Amygdala functions that are altered in depression

A

Abnormal emotional processing

25
Q

Basal ganglia functions that are changed in depression

A

Impaired incentive behaviour

Psychomotor changes

26
Q

Two main neurotransmitters in depressive disorders.

A

Serotonin

Noradrenaline

27
Q

What is the monoamine hypothesis?

A

Depressive disorders are due to abnormality in the availability of monoamine neurotransmitters (serotonin and NA)

28
Q

Where is serotonin produced?

A

Raphe nuclei

Then transported to cortical areas and limbic system

29
Q

Roles of serotonin

A

Sleep

Impulse control

Appetite

Mood

30
Q

Serotonin levels in depression

A

Low

31
Q

Where is NA produced?

A

Locus coeruleus and projects to limbic system and cortex

32
Q

Functions of NA in the brain

A

Mood

Arousal and attention

Memory functions

33
Q

Levels of NA in depression

A

Thought to be low

34
Q

Biological treatment of depression

A

1st line - SSRIs

SNRIs, TCAs

In the case of life-threatening or treatment resistant depression ECT

35
Q

Psychological treatment of depression

A

CBT

36
Q

Social treatment of depression

A

Help with isolation, social stressors including housing and finances

37
Q

Biological treatment of mania

A

1st line is antipsychotics (D2 antagonists)

Mood stabilisers such as lithium and sodium valproate

38
Q

Psychological treatment of mania

A
39
Q

Social treatment of mania

A

Treat in a place of safety where the risks to self are minimal.

40
Q

Biological treatment of bipolar

A

Can use antidepressants but only with mood stabiliser cover.

ECT

Lithium

41
Q

Psychological treatment of bipolar

A

CBT

42
Q

Social treatment of bipolar.

A

Same as unipolar depression and mania

43
Q
A