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Flashcards in Mood Disorders: Depression Deck (24)
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1
Q

How does having a mood disorder contrast with variations in temperament?

A

A mood disorder is a significant negative change from the patient’s baseline behavior, as opposed to an inborn pattern of experience and behavior.

2
Q

Do other animals get depression?

A

No. They can get some similar signs/symptoms when exposed chronically to noxious stimuli, but it’s not really depression (says he).

3
Q

What is mood? How does it relate to affect?

A

Mood is the underlying state of mind. It can bias the way stimuli are interpreted. Affect is the external expression of mood (facial expression, posture, speech quality, etc.).

4
Q

5 features of “sadness” as opposed to “depression”?

A
  • transient or shorter-lived
  • has definite, understandable cause
  • does not cause significant impairment
  • not associated with a syndrome
  • should be relieved by activities / distraction from thoughts
5
Q

6 steps on the spectrum of sadness -> depression?

A

Normal sadness
Adjustment disorder with depressed mood
Grief
Major Depressive Episode (mild-moderate)
Major Depressive Episode with melancholic symptoms
Major Depressive Episode with Psychotic symptoms

6
Q

What are the diagnostic criteria for a “major depressive episode”?

A
  • sad, low mood most days for at least 2 wks
    OR
  • anhedonia (loss of interest / pleasure in activities)
    PLUS at least 4 additional signs and symptoms.
7
Q

What are the additional signs and symptoms of which you must have 4 in order to be diagnosed with a major depressive episode? (7 were listed)

A
Fatigue or low energy
Insomnia or hypersomnia
Loss or increase of appetite -> weight loss/gain
Psychomotor retardation/agitation
Poor concentration
Suicidal ideation
Pathological guilt
8
Q

What are 7 clinically important subforms of Major Depressive Disorder (MDD)?

A
Neurotic (discredited?)
Melancholic
Atypical
Seasonal
Psychotic
Chronic
Post-Partum
9
Q

What’s neurotic MDD?

A

“Anger turned inward” - in Freudian days, this was thought to be the main depression caused by trauma / stressful life events. (not a term really used now. Why is it here?)

10
Q

What’s melancholia?

A

Classical “endogenous depression.” People without hard lives have major depression out of the blue in mid to late life.

11
Q

What’s atypical depression?

A

(a stupid term) Overeating, oversleeping, with mild depression. More often seen in young women. Often chronic. Now considered to be more associated with bipolar disorder.

12
Q

What’s seasonal depression?

A

Intermittent depression with regular fall-winter onset. Responds to treatment with bright light. (also more linked to bipolar disorder)

13
Q

What’s psychotic depression?

A

Most severe form of MDD, characterized by delusions and hallucinations.

14
Q

What’s chronic depression?

A

Depression lasts for at least 2 consecutive years OR

MDE on top of dysthymia.

15
Q

Time frame to be considered “Post-Partum” depression?

A

“within weeks”

16
Q

What’s a common thought for why women have higher rates of depression than men?

A

Women have more internalizing disorders in response to stressors.
Men have more externalizing disorders (e.g. alcoholism) in response to stressors.

17
Q

What’s the “kindling” concept for depression?

A

Stressful life events initiate depression, but then the depression becomes self-sustaining independent of life events.

18
Q

What’s one well-defined genetic risk factor for depression? What is required to reveal this effect?

A

5-HTT (serotonin transporter) short allele polymorphism is associated with increased risk of depression for people with at least one stressful life event.

19
Q

What has the nucleus accumbens and anterior cingulate cortex have to do with MDD?

A

Less active, less reward generated from performing activities.

20
Q

How do the amygdala and prefrontal cortex relate to MDD?

A
Overactive amygdala in MDD can produce aberrant arousal / fear.
Prefrontal cortex (esp ventrolateral) not functioning normally may impair ability to interpret info from amygdala, plan, make decisions.
21
Q

How might the insular cortex relate to MDD?

A

Affective component of sensory info might be altered.

22
Q

Might chronic stress activate many changes seen in the imaging studies of brains of patients with MDD?

A

Yup, it might. Cortisol, CRF, all that.

23
Q

How does the hippocampus tend to change in MDD?

A

Reduced volume without cell death. (loss of white matter)

24
Q

Other than neurotransmitters, what molecules are newly beginning to be thought to play a role in depression?

A

Neurotrophic factors, especially BDNF. Antidepressants such as SSRIs may actually work partly by increasing neurotrophic factors (still a hypothesis).