Depression Flashcards
(52 cards)
What system in the brain is involved in depression?
Aversive system
-it promotes survival in event of stress
loss event- depression
threat event- anxiety
what mediates the aversive system?
serotonin
what system in the brian is involved in mania?
Appetitive system
-promotes seeking behaviours
what mediates the appetitive system?
dopamine
what structure in brain is reduced in depression?
hippocampal volume reduced
how is depression diagnosed?
Depressive episodes should last at least 2 weeks (with no hypomanic or manic symptoms)
At least 2 of the following must be present:
-Depressed mood (to a degree that is abnormal for the individual, present for most of day and almost every day, uninfluenced by circumstances, and for at least 2 weeks)
-Loss of interest or pleasure in activities that are normally pleasurable
-Decreased energy or increased fatigue
PLUS at least 4 of:
-loss of confidence or self esteem
-unreasonable guilt
-suicidal behaviours
-complaints of diminished ability to concentrate
-agitation or retardation
-sleep disturbance of any type
-change in appetite
classifications used for depression?
ICD10/11
DSM5
what can be used to assess severity of depression?
-HRSD
-MADRS
-PHQ 9
-
Subtypes of depression?
-psychotic depression
-Cotard’s syndrome
-Somatic syndrome
-Atypical depression
-Late onset depression
‘I cant eat because my bowels have turned to durst’
-what subtype
Cotard’s
-weight loss, lack of appetite
-depression worse in morning
-waking in morning 2 hours before usual time
-loss of libido
-loss of interest of pleasure in activities that normally enjoy
-lack of emotional reaction to things they would normally react to
what subtype?
Somatic syndrome
- Mood reactivity (that is, mood brightens in response to actual or potential positive events)
- Significant weight gain or increase in appetite
- Hypersomnia
- Leaden paralysis (heavy, leaden feelings in arms or legs)
- Long-standing pattern of interpersonal rejection sensitivity (not limited to episodes of mood disturbance) that results in significant social or occupational impairment
what subtype?
Atypical depression
Depression occuring for first time in later life
-what subtype?
late onset depression
Occasionally paranoid, typically ‘mood-congrent’ or hypochondiacal
what subtype?
Psychotic depression
what is considered mild depression?
key symptoms most of the time for atleast 2 weeks
5 symptoms of depression (<5 subthreshold depressive symptoms)
Key symptoms= low mood, fatigue + anhedonia
other:
-disturbed sleep
-reduced appetitie and/or weight
-fatigue or loss of energy
-agitation or slowing of movements
-poor concentration or indicisive
-feeling worthless, excessive guilt
-suicidal thoughts or acts
what is considered moderate depression?
key symptoms
5-7 symptoms
key symptoms= low mood, fatigue + anhedonia
other:
-disturbed sleep
-reduced appetitie and/or weight
-fatigue or loss of energy
-agitation or slowing of movements
-poor concentration or indicisive
-feeling worthless, excessive guilt
-suicidal thoughts or acts
what is considered severe depression?
3 key symptoms (fatigue, low mood + anhedonia)
>7 symptoms
can occur with or without psychotic symptoms
interfere with functioning
or PHQ >16
other:
-disturbed sleep
-reduced appetitie and/or weight
-fatigue or loss of energy
-agitation or slowing of movements
-poor concentration or indicisive
-feeling worthless, excessive guilt
-suicidal thoughts or acts
spontaneously resolving brief depressive episode following childbirth (50% of women)
-what subtype
post partum depression
recurrent depression in winter months
-what is this + what is treatment?
seasonal depression
-treat with bright light therapy
what is the monoamine hypothesis?
Depression is thought to be related to monoamine deficiency
-so medications which increase monoamine activity reduce depressive symptoms
what are examples of monoamines?
-Serotonin (5-HT)
-Dopamine
-Noradrenaline
what role does stress play in depression?
Stress releases cortisol
-Chronic stress can cause cortisol dysregulation
Excess cortisol may cause depression through:
-neuronal damage (low hippocampal volume)
-release of proinflammatory cytokines
what are the mofa of antidepressants?
Increase monoamine activity by two main mechanisms:
Reuptake inhibition- Keep monoamine in synaptic cleft
Monoamine oxidase inhibitors- Prevent removal of monoamine from presynaptic neuron
examples of tricyclic antidepressants?
-amitriptyline
-Imipramine
