Mood Disorders Flashcards by Alfie Saunders

Criteria for depressive episode?

DSM-5 criteria

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DSM-5 criteria for depressive episode?

2 weeks or more of depressed mood + 4/8 DSM-5 symptoms

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DSM-5 symptoms? Depression

-sleep alterations (insomnia or hypersomnia)
-appetite alterations
-anhedonia
-decreased concentration
-decreased energy
-guilt
-psychomotor changes (agitation or retardation)
-suicidal thoughts

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Major depressive disorder diagnosis?

If no manic or hypomanic episodes in the past

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Depression triads?

Core
Biological
Psychological

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Depression core symptoms?

Low mood
Anergia
Anhedonia

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Depression biological symptoms?

Sleep
Libido
Appetite

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Depression psychological symptoms?

The world
Oneself
The future

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Manic episode?

Euphoric or irritable mood with 3 or more of the 7 manic criteria

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7 manic criteria?

-decreased need for sleep with increased energy
-distractibility
-grandiosity or inflated self esteem
-flight of ideas or racing thoughts
-increased talkativeness or pressures speech
-increased goal-directed activities or psychomotor agitation
-impulsive behaviour (sexual impulsivity, spending sprees)

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Manic episode vs hypomanic episode?

Manic episode - over 1 week, can’t function

Hypomanic episode - over 4 days, can function

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Type II bipolar?

Not a single manic episode has ever occurred but only hypomanic episodes
Along with at least one major depressive episode

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Unspecified bipolar disorder?

If manic symptoms occur for less than 4 days

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Bipolar 1 vs bipolar 2?

Bipolar 1 has more severe amplitudes
More mania
Bipolar two hypomanic

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More than 4 cycles per year?

Rapid cycling

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Cyclothymia?

Smaller amplitude compared to bipolar 1 or 2

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Bipolar vs unipolar?

Bipolar:
-lower age of onset
-shorter episodes
-more frequent episodes
-genetic specificity
-differential treatments

compared to unipolar depression

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Differential treatment for bipolar vs unipolar?

Unipolar - antidepressants
Bipolar - neuroleptics and lithium for mania

Insight in depression vs mania?

Depression - insight is preserved
Mania - insight is impaired

Attention bias in depression?

Difficulty disengaging attention from negative material
more typical of anxiety

Memory biases in depression?

Preferential recall of negative compared to positive material

Perceptual biases in depression?

Recognised negative faces more than positive faces

Amygdala dysfunction in depression?

A bias towards detecting cues signalling potential threats, like expressions of fear

Monoamine deficiency hypothesis?

Insufficient levels of monoamine neurotransmitters can cause depressive symptoms

Monoamine neurotransmitters?

-serotonin (5-hydroxytryptamine/5-HT) -norepinephrine -dopamine

How to measure monoamine receptors and transmitters levels?

PET imaging and radiotracer

Monoamine scan method?

Measure levels of tracer left in brain (using PET scan) before and after challenge *challenge (e.g. amphetamine) - will cause spike in serotonin which will replace tracer. Higher serotonin = less tracer left*

Tryptamine psychedelics

-psilocin -DMT -LSD *serotonin receptor agonist - psychedelics are chemically similar to serotonin*

Psychedelic risks and benefits?

Benefits - non addictive, low physiological and brain toxicity, good therapeutic index Risks - dysphoria, anxiety, nausea, headache

Depression cognition?

Can cause pseudodementia

Bipolar antidepressants effect?

Could flip into manic episode

Differential personality disorders? (DSM-5)

Cluster A - paranoid, schizoid, schizotypal Cluster B - antisocial, borderline, histrionic, narcissistic Cluster C - avoidant, dependent, obsessive-compulsive personality disorder

Bipolar affective disorder symptoms? BPAD

Episodic Runs in family Grandiosity Mood states typically less affected by environment

Borderline personality disorder symptoms? BPD

-mood changes over course of hours/days (rather than days/weeks in BPAD) -poor self image -fear of abandonment -feelings of emptiness -Hx of self-harm -Hx of trauma/disrupted attachment

BPAD and BPD shared symptoms?

-rapid mood changes -unstable interpersonal relationships -impulsive sexual behaviour -suicidality

BPAD and schizophrenia shared symptoms?

Both can present with psychosis and mood symptoms (depression and mania) *typically schizophrenia is more prominent disorganisation of thought, paranoid delusional beliefs and auditory hallucinations*

BPAD and ADHD shared symptoms?

-hyperactivity -impulsivity -impaired concentration -impairment of executive function -abnormal working and short term memory

Possible organic causes of mood disorder?

Endocrine Systemic Deficiencies Neurological Medications

Other organic causes of mood disorders?

Vascular depression (associated with white matter hyperintensities) Poststroke depression (lesions in left frontal lobe or basal ganglia)

Medications that can cause mood disorders?

Beta-blockers Steroids Anti-Parkinson’s Some ABx (ciprofloxacin) Statins Oestrogen Opiates Acne medications

Cluster A personality disorders?

Paranoid, schizoid, schizotypal

Cluster B personality disorders?

Antisocial, borderline, histrionic, narcissistic

Cluster C personality disorders?

Avoidant, dependent, obsessive-compulsive personality disorder