Flashcards in Depression Deck (58)
How does depression mask itself in men?
as somatic complaints like migraines, back pain or IBS
What is the DSM 5 criteria for depression?
five or more symptoms must be present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) anhedonia
What are some common comorbid diagnoses with depression?
DM, heart disease, autoimmune disorders and pain
What are some risk factors associated with depression?
1. childhood emotional, physical and sexual abuse
2. prior episode of depression
3. family hx of DD
4. lack of social support
5. stressful life event
6. current substance abuse
7. economic difficulties
What is the etiology of depression?
multifactorial; dynamic, interplay amongst genetics, environment, life hx, development and biological changes. More focus now on the deficits in NT system.
_ may increase the risk for depression
What is thought to contribute to the dysregulation of serotonin? (NT)
The short allele slows down the synthesis of the serotonin transporter. this is thought to reduce the speed with which serotonin neurons can adapt to changes in their stimulation -> dysregulation
What plays an important role in birth, survival, and maturation of brain cells during development (as well as the synaptic changes that occur throughout a person's life)?
Brain Derived Neurotrophic Factor (BDNF)
What does BDNF do?
activates DNA binding factors that stimulate gene transcription of genes involved in serotonin function (serotonin transporter and tryptophan hydrolase, the serotonin synthesizing enzyme).
In a person with MDD what would you expect their levels of BDNF to look like?
What alleles in gene code for BDNF?
val and met, people with met allele increases vulnerability to depression
What structure contributes to memory impairments and feelings of hopelessness, guilt, doom and suicidality?
Where is the major source of Ach found in the brain?
[high] in the basal ganglia and motor cortex (derived from choline)
What effect and implication does Ach have for mental illness?
Can be excitatory or inhibitory, depending on the area of the brain. Underactivity implicated in Alzheimer disease.
Where is the major source of dopamine found in the brain?
Substantia nigra and ventral segmental area in the midbrain (derived from tyrosine)
What effect and implication does DA have for mental illness?
Usually, excitatory. Involved in motivation, thought and emotional regulation. Overactivity thought to be involved in schizophrenia and other psychotic disorders.
Where is the major brain source of NE and E found?
Locus cerleus in the brain stem
- Derived from dopamine
What effect and implication does NE and E have on mental illness?
Can be excitatory or inhibitory, depending on the area of the brain.
Noradrenergic pathways to cerebral cortex, limbic system, and brain stem.
Underactivity thought to be involved in some depressions.
Where is the major brain source of serotonin found?
Raphe nucleus in the brain stem
-Derived from tryptophan
What is the effect and implication does serotonin have on mental illness?
Involved in the regulation of attention and complex cognitive functions.
Underactivity thought to be involved in some depressions and OCD.
Where is the major source of y-Aminobutyric acid, (GABA). Glutamate, aspartate, and glycine in the brain?
no single major source
What effect and implication do y-Aminobutyric acid, (GABA). Glutamate, aspartate, and glycine have on mental illness?
GABA and glycine usually are inhibitory; glutamate is excitatory.
Implicated in anxiety disorders.
What are the 4 steps of neurotransmission?
1. The synthesis of a transmitter substance
2. The storage and release of the transmitter
3. Binding of the transmitter to receptors on the postsynaptic membrane
4. Removal of the transmitter from the synaptic cleft
Where are NTs stored and how are they released?
- NTs are typically stored in the vesicles in the presynaptic axonal terminal and released by the process of exocytosis.
What often results from the binding of an excitatory NT?
b. Binding of an excitatory NT often results in the opening of an ion channel, such as the Na+ channel.
What are the 3 ways NTs are removed from the postsynaptic neuron?
ii. Diffuse out of the synaptic cleft
iii. Broken down by enzymes into inactive substances or metabolites.
What is the underlying pathologic process in depression?
Decreased levels of serotonin and norepinephrine in the synaptic cleft is the underlying pathologic process in depression.
Why is depression higher in patients with Parkinson's disease?
Studies show that the frequency of depression is higher in patients with Parkinson’s disease which is caused by lower rates of dopamine production in the substantia nigra.
What functions does the prefrontal cortex carry out?
It contains the centres of elaboration of thought, voluntary motor and sensory functions, speech, and memory patterns and has extensive connections with deeper parts of the brain.