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Endo Yr 2 > Mood Disorders > Flashcards

Mood Disorders Flashcards

(53 cards)

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1
Q

what is the DSM

A

criteria to diagnose mental disorder

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2
Q

What changed in 1980

A

DSM-III came in - any recurrent mood episodes before then were diagnosed as manic depressive illness (bipolar and unipolar depressive illness bunched together)

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3
Q

what is a mood disorder

A

change in affect or mood to depression or elation

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4
Q

What is a mood change usually accompanied by

A

change in overall level of activity

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5
Q

2 features of mood disorders

A

recurrent and often related to stressful events

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6
Q

prevalence of major depressive disorder

A

10-20%

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7
Q

Bipolar 1 gender distribution?

A

equal dsitribution

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8
Q

Bipolar 2 and MDD gender distribution?

A

more women suffer

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9
Q

4 features of low mood/ elation cycles

A

thoughts, feelings, behaviours, physiological symptoms

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10
Q

DSM-5 criteria of depressive episode

A

at least 2 weeks of depressive mood with 4/8 of symptoms

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11
Q

Symptoms in DSM-5 criteria for depression

A 
Sleep disturbance
Appetite alterations
Anhedonia
Low energy
Guilt
Suicidal thoughts
psychomotor changes - agitation or retardation
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12
Q

Major depressive disorder requires the lack of what?

A

no manic or hypomanic episodes in history

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13
Q

Subtypes of DSM-5 criteria

A

Atypical features - increased sleep/ appetite with heightened mood reactivity
Melancholic features - no mood reactivity + anhedonia + psychomotor retardation
Psychotic features - presence of delusions/ hallucinations

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14
Q

Core symptoms

A

low mood
anergia
anhedonia

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15
Q

Biological symptoms

A

libido
appetite
sleep

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16
Q

psychological symptoms

A

the world
oneself
the future

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17
Q

Criteria of mania/ bipolar

A

Euphoric or irritable mood with 3+/7 symptoms

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18
Q

Mania symptoms

A 
decreased need for sleep
distractibility
grandiose thoughts
racing thoughts
talkativeness
goal-directed activities
impulsive behaviour
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19
Q

Bipolar 1 requirement

A

Mania symptoms for min 1 wk with notable functional impairment

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20
Q

Hypomanic episode requirement

A

Mania symptoms for min 4 days with no functional impairment (if psychotic features are present/ patient is diagnosed = cannot be hypomania - is manic)

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21
Q

Type II bipolar requirement

A

Only hypomanic and not manic episodes with at least one major depressive episode

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22
Q

Manic symptoms occur for less than 4 days/ none of the thresholds met = what is the diagnosis?

Study These Flashcards
A

unspecified bipolar disorder

23
Q

What is no longer an exclusion factor for bipolar diagnosis

Study These Flashcards
A

antidepressant- related mania/ hypomania

24
Q

What is the difference between bipolar 1 and 2

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A

Bipolar 2 - manic episodes are not as strong but depressive episodes are

25
How prevalent is anxiety in bipolar patients
30-70% have anxiety
26
Bipolar vs unipolar
bipolar - earlier age of onset (19 vs 20s) - shorter depressive episodes - different drugs used to treat each - mania had a genetic component - not in relation to unipolar depression - more frequent episodes in bipolar disease
27
Differences in heritability in bipolar vs unipolar
Bipolar - much more heritable | MDD - almost half as heritable
28
Differences in insight in bipolar vs unipolar
Bipolar - insight impaired in mania (U-shaped curve in relation to severity - more normal in moderate) MDD - insight preserved
29
Why can antidepressants be bad for treating bipolar disease
- Ineffective for bipolar depression - Can cause manic episodes - Can worsen long-term course of bipolar illness (lead to more mood episodes in those with rapid-cycling)
30
What is attention bias
bias in maintaining/ shifting attention (difficult for depressed ppl to disengage from negative material)
31
Test to identify attention bias
functional MRI
32
What does fMRI show
detects changes in blood oxygenation and low in response to neural activity
33
What is memory bias
Preferential recall of negative compared to positive material
34
what is the facial expression recognition task?
people exposed to face images of different emotions to see if they have a different level of recognition of happy or sad faces (tips in balance of sad in depression)
35
What neural changes are seen in depression during the passive viewing of emotional facial expressions
Enhanced amygdala (temporal lobe region in perception + encoding stimuli )response to negative faces
36
Noradrenergic vs serotonergic antidepressant effects on facial expression recognition module? - acute single dose
Noradrenergic - better recognition of happy faces serotonergic - decreased recognition of fearful faces
37
what is the monoamine deficiency hypothesis
lack of serotonin as well as other monoamines (eg. noradrenaline)causes depressive symptoms
38
Evidence for monoamine deficiency hypothesis
- Medications that cause 5-HT depletion would have side effects of depressive symptoms - Useful anti-depressants all increase synaptic monoamines (some selectively 5-HT) - Post mortem = brains of suicide victims show depleted serotonin - Tryptophan depletion (important for 5-HT synthesis) triggers relapse in MDD
39
how to measure receptors/ transmitters in living brain
PET imaging - best method to measure brain pharmacology
40
How does it differ from fMRI
Selective (tracer binds to specific target), invasive, radioactive, expensive
41
PET tracer mechanism
once neurotransmitter release is triggered, it floods the synapse and competes with the radioactive tracer (difference in amount of tracer can be used as a marker of neurotransmitter)
42
what is a personality disorder
maladaptive patterns of behaviour, cognition and inner experience - deviate from those accepted by the individual's culture
43
Bipolar affective disorder vs borderline personality disorder
BPAD - heritable/ grandiosity/ mood states less affected by environment BPD - poor self image/ fear of abandonment/ emptiness Both have mood swings/ impulsive sexual behaviour/ suicidality
44
BPAD vs Schizophrenia
BPAD - episodic delusions/ hallucinations Schizophrenia - chronic delusions/ hallucinations Both have hallucinations/ cog. impairment/ depressive symptoms
45
BPAD vs attention deficit disorder
BPAD - heritable, recurrent depressive episodes amphetamines worsen mania Both have impaired conc/ abnormal working + short term memory
46
endocrine causes of depression?
hypothyroidism/ hypoglycaemia/ cushings + addisons/ hyper + hypoparathyroidism
47
infective causes of depression?
viral infections SLE HIV - cytokines manifested in systemic disease can cause depressive symptoms
48
Deficiencies that cause depression
Vitamin B12/Folic acid
49
Neurological cause of depression
MS/ Alzheimer's/ Parkinson's
50
Medications that cause depression
beta-blockers/ steroids/ anti-cholinergics/ some AB
51
What is vascular depression?
subtype of late-life depression characterised by a distinct clinical presentation and an association with cerebrovascular damage (increased white matter)
52
Hyperintensities on an MRI can affect depression how?
can make individual more vulnerable to stressors
53
poststroke depression
lesions in left frontal lobe/ basal ganglia can cause depression

Endo Yr 2 (2 decks)

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