Mood disorders Flashcards

(37 cards)

1
Q

Symptoms of depression (4)

A

Low mood, Lack of motivation, Anxiety, Disturbed sleep

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2
Q

Prevalence stat for depression

A

Nearly a fifth of UK adults Predicted leading cause of burden of disease in the world by 2030 by WHO

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3
Q

Risk factors (7)

A

Stressful life events Adverse childhood experience Genetics Infection Personality Diet Gender

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4
Q

First gen antidepressant

A

iproniazid

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5
Q

4 types of AntiDEPs

A

Monoamine oxidase inhibitors Tricyclic SSRIs SNRIS

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6
Q

Name a MOI

A

iproniazid

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7
Q

Name a tricyclic

A

amitriptyline

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8
Q

SSRI

A

Fluoxetine

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9
Q

SNRI

A

Duloxetine

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10
Q

Where are the neurophysiological abnormalities?

A

Multiple areas of the PFC, amygdala, related parts of the striatum and thalamus. Some of these such as orbital and medial PFC persist following symptom remission

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11
Q

Drevets (1992)

A

PET to measure differences in cerebral blood flow. Amygdala hyperactivation in depression, correlating with symptom severity.

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12
Q

Kennedy (2005)

A

Subgenual cingulate region metabolically overactive in TR depression. Chronic DBS of WMTs adjacent to SCA associated with sustained remission in 4/6 patients.

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13
Q

Berlim (2014)

A

Meta-analysis of DBS- 12month response rate of 39.9%.

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14
Q

Critique of DBS (2)

A

Can’t do sham operations as risk of intracerebral haemorrage is 2%. Most studies still small scale and may not illustrate adverse effects.

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15
Q

Delgado (1999)

A

Rapid depletion of plasma TRP transiently reverses the antidepressant response in many patients on fluoxetine

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16
Q

Ruhe (2007)

A

Meta-analysis of TRP depletion studies. No simple direct correlation 5HT or NR levels in brain or mood. Depletion affects mood in unmedicated patients or healthy patients with family history. Monoamine systems therefore probs important in vulnerability to become depressed

17
Q

Caspi (2003)

A

Prospective longitudinal study showed functional polymorphism in the promoter region of the serotonin transporter was found to modulate the influence of stressful life events on depression.

18
Q

Malberg (2000)

A

BrdU (thymidine analog) used as a marker for dividing cells. Chronic antidepressant treatment increases the number of BrdU-labelled cells in the dentate gyrus of hippocampus.

19
Q

Huang (2008)

A

Chronic fluoxetine treatment did not increase hippocampal neurogenesis in mice

20
Q

Pringle (2011) theory

A

Cognitive neuropsychological model of antidepressant action- repeated treatment promotes synaptic plasticity and neurogenesis, reversing cellular changes of depressive state. Beck - gradual increase in salience of + info, decrease -.

21
Q

Holmes and Rahe

A

Seminal linkage of stressful life events and illness.

22
Q

Bargawagar (2005)

A

elevates post-wakening surge in salivary cortisol in depressed, non-medicated patients. Cushings and therapeutic corticoids also induce depressive phenotype in some.

23
Q

Qin (2016)

A

Female rhesus macaques - sig correlations found between stress, cortisol and depressive behaviour. Controlled environment, avoiding confounding effects that hinder studies in humans.

24
Q

Cortisol and hippocampus?

A

Cortisol is toxic to hippocampus and bilateral reduced vol. associated with depression- may contribute to memory impairment.

25
Gold (2005)
Major depression associated with significant diurnal elevations in plasma interleukin 6 levels (people)
26
Inflammatory cytokines and depression
Studies in lab animals demonstrate that inflammatory cytokines induce sickness syndrome of behaviour - anhedonia and impaired sleep. Associated with changes to 5HT stressors.
27
Bradley (1995)
Measure mean number of words recalles in different catagories by depressed, anxious and control subjects. Depressed people much better at remembering depression-related words.
28
Heritability of depression
37%. More heritable in women than in men.
29
Equifinality
In open systems a given end state can be reached by many potential means.
30
Epigenetics
Potentially heritable but environmentally modifiable, regulation of genetic function and expression that is mediated through non-DNA encoded mechanisms.
31
Melas (2013)
DNA methylation analyses of the glucocorticoid receptor gene using saliva samples from depressed and control subgroups. Early parental death associated with hypermethylation of the gene.
32
Covington (2011)
Repeated cocaine exposure prior to subchronic social defeat stress potentiated depressive-like behaviours in mice through decreased levels of histone H3 dimethylatiion in NAc.
33
Krishnan (2007)
BDNF levels are increased in NAC after chronic social defeat in mice susceptible to anhedonia but not resilient counterparts. Inbred mice used therefore genetically identical, phenotypic variation from genetic similarity through epigenetics.
34
Lopez (2008)
8 weeks of citalopram tratment in treatment-naive depressed patients. Responders increased BDNF mRNA levels with significant correlation between change in depression severity and in BDNF expression.
35
HDAC
Histone deacetylase, chromatin remodelling molecule.
36
Schmauss (2015)
Reducing HDAC activity in fluoxetine treated mice leads to robust antidepressant and anxiolytic effects. In the treated mice, BDNF transcription was increased.
37
What is the capsi diagram?