Neuroscience Week 8: Depressive Disorders Flashcards
(81 cards)
1
Q
What is mood?
A
2
Q
Depression prevalence
A
3rd most Common leading cause of woldwide disability
3
Q
Depression treatment importance
A
Because it is treatable!!!!!
it is very dangerous if untreated (suicide)
4
Q
Comorbidity of depression
4 listed
A
- Anxiety
- substance use
- personality disorders
- ADHD
5
Q
Bipolar disorder treatment importance
A
Treatable
dangerous if untreated (suicide)
6
Q
Bipolar disorder comorbidity
3 listed
A
- anxiety
- substance use
- high IQ
7
Q
Depression pathology components
4 listed
A
- Cognitive thoughts
- emotions and feelings
- Vegetative or physiological symptoms
- behavioral (impulsivity)
8
Q
Kay Jamison
A
9
Q
Depression diagnostic characteristics
A
- 5 or more of the following symptoms for at least 2 weeks
- 1 symptom must be depressed mood or decreased interest
10
Q
Depression symptom mnemonic
A
SIG E CAPS
- Sleep changes
- Interest
- guilt or worthlessness
- Energy loss
- concentration loss
- appetite loss or weight loss
- psychomotor agitation or retardation
- Suicidal ideation
11
Q
depression: changes in the brain
3 listed
A
- decreased flow to the left frontal areas
- atrophy in the hippocampus
- antidepressants improve and neuroplasticity in the hippocampi
12
Q
Manic Episode description
A
13
Q
Hypomanic Episode description
A
14
Q
Major Depressive Disorder: onset
A
25-35 years of age
15
Q
Major Depressive Disorder: episodes
2 listed
A
- depressive episodes that last 10-12 weeks
- average number of episodes per lifetime is 4
16
Q
Major Depressive Disorder: chronic
A
12% of patients have chronic unremitting course
17
Q
Course of Major Depressive Disorder
A
18
Q
Cycling disorders
3 listed
A
Bipolar I
Bipolar II
and
Cyclothymia
19
Q
Onset of Bipolar I disorder
A
19-29 years of age
20
Q
Bipolar I episodes
A
- manic episodes last 5-10 weeks
- Depressed episodes last 19 weeks
- Average number of episodes in lifetime is 10
21
Q
Bipolar I Manic episodes duration
A
last 5-10 weeks
22
Q
Bipolar I depressed episode duration
A
19 weeks
23
Q
Bipolar I average # of episodes per lifetime
A
10
24
Q
Major depressive disorder Episode duration
A
10-12 weeks
25
Major depressive disorder average # of Episodes per lifetime
4
26
Bipolar I disorder cycle
euthymia to mania to depression to euthymia
27
Bipolar II disorder cycle
Euthymia to hypomania to depression to euthymia
28
Cyclothymia disorder cycle
euthymia to hypomania to dysthymia to hypomania to euthymia
29
Course of Bipolar I Disorder
30
Disruptive mood dysregulation disorder
* only seen in children
* patterns of tantrums and erratic irritable moods
31
Persistent Depressive Disorder AKA
Dysthymia
32
Persistent Depressive Disorder description and diagnostic criteria
2 years or more of:
* appetite changes
* sleep changes
* low energy or fatigue
* low self-esteem
* poor concentration or indecisiveness
* feelings of hopelessness
33
Cyclothymic disorder description
Dysthymic and hypomanic periods
34
Premenstrual Dysphoric Disorder description
in the majority of menstrual cycles at least 5 symptoms starting the week before menses and ending after
35
Adjustment disorder with depressed mood description
* occurs within 3 months of a stressor
* can be good things like getting married or buying a house or bad things such as losing job etc.
* much higher rates of suicide attempts and suicide completion
36
Uncomplicated Bereavement description
* normally grieving doesn't have feelings attached to themselves
* if they indicate self involvement this might be more of a depression
37
Specifiers of mood episodes
38
with anxious distress
anxious presentation
39
...with mixed features
Manic symptoms, includes mood elevations or depressions
40
...with melancholic features
* terminal insomnia
* wake up feeling melancholic at a specific time such as 3 AM
* biological depression
41
terminal insomnia description
Wake up way to early
42
...with atypical features
* often women
* eat too much
* sleep to much
* diurnal mood variation
* limb paralysis (arms and legs feel heavy)
* increased rejection sensitivity
* typically res[pond to MAOIs
43
initial insomnia description
having trouble falling asleep
44
Middle insomnia description
waking up in the middle of the night
45
...with mood-congruent psychotic features
* only get psychotic when depressed
* delusions of something (feelings, brain rotting, dying)
46
...with mood in-congruent psychotic features
as mood congruent but incongruent
47
... with catatonia
abnormality of movement and behavior arising from a disturbed mental state (typically schizophrenia). It may involve repetitive or purposeless overactivity, or catalepsy, resistance to passive movement, and negativism.
48
With peripartum onset
peripartum depression
49
...with seasonal pattern
these are described as major depressive episode with a seasonal pattern
50
Prevalence of depression
51
High-risk populations for depression
52
Psychological risks
6 listed
Early traumas
53
Genetics of depression
Twin studies
54
Neurotransmitters of depression
* Serotonin
* Norepinephrine
* Dopamine
55
Monoamine Deficiency Hypothesis
Also stress/inflammation/neuroplasticity
56
There is reversible loss of ___________ after early depressive episodes
hippocampal volume
57
Antidepressant drugs increase levels of \_\_\_\_\_\_
* BDNF
* hippocampal neurogenesis
* neuritic elongation
* idendritic branching density of CA3 hippocampal pyramidal cells
## Footnote
**These changes correlate with changes in learning and long-term potentiation**
58
Brain changes in depression
5 listed
59
Abnormal sleep in depression
↓ REM Latency
60
Geriatric depression features
* late onset depression associated with cerebrovascular disease
* enlarged ventricles
* cognitive impairment (pseudodementia)
61
5hIAA
metabolite of serotonin
62
Homovanilic acid
metabolite of dopamine
63
negative triad
the negativity of past present and future
was a failure
am a failure
will be a failure
64
Neural model of biased reprocessing to negative information in Major Depressive Disorder
goes to dorsolateral prefrontal cortex
65
Decreasing REM sleep can?
help depressed patients feel better
66
Suicide genetics
runs in families
67
Suicide is associated with
* impulsivity
* aggression
* alcohol/drug use
* anxiety
68
Suicide threats?
take threats seriously
69
Suicide and healthcare
* 20-48% see a primary physician in the week prior to suicide
* 40-70% within a month prior to suicide
70
Suicide overview
71
Assessing for suicide
72
Treating depression
5 listed
73
Psychotherapy for mood disorders
74
Interpersonal Psychotherapy
resolving loss, disputes, deficits
75
Cognitive-behavioral Psychotherapy
correcting negative thoughts
behavioral activation
76
Psychodynamic Psychotherapy
identify maladaptive defenses and decrease their use
77
Psychotherapy vs medication for acute depression
78
Psychotherapy for chronic depression
minimally efficacious for chronic depression
79
Treatment of Bipolar Disorders
practical and emotional support
social considerations
Available caregivers
health facilities
ambulatory/outpatient treatment
combinations of medication and psychotherapy and sleep hygiene is crucial
80
Hospitalize Bipolar Disorders
* for psychosis
* suicidality
* continued self-harm due to substances
* inability to care for self
* medical problems
* legal problems
81
Mood stabilizers for Bipolar disorder
* lithium
* carbamazepine
* lamotrigine
* Atypical antipsychotics
* stop antidepressants
* sleep hygiene/benzos
* psychotherapy
