Term
| What are the 5 types of mood disorders? |
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Definition
MDD - major depressive disorder
Bipolar disorder
Hypomania
Cyclothymia
Dysthymia |
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Term
| What is the gender preference in major depressive disorder? |
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Definition
| Twice more common in women |
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Term
| What is the gender preference in bipolar I disorder? |
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Definition
No gender preference
Manic episodes more common in men, depressive episodes in women |
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Term
| What is the mean age of onset for MDD and bipolar I? |
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Definition
MDD - 40 years
Bipolar I - 30 years |
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Term
| In which demographic groups is depression more common? |
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Definition
Single or seperated
Rural areas |
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Term
| Patients with mood disorders are at higher risk for which four Axis I disorders? |
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Definition
Alcohol abuse or dependence
Panic disorder
OCD
Social anxiety disorder |
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Term
| What 3 facts imply a role for norepinephrine in the pathophysiology of depression? |
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Definition
1. Correlation between downregulation or decreased sensitivity of β-adrenergic receptors and antidepressant responses
2. Role of presynaptic β2-receptors in the release of norepinephrine and serotonin
3. The effectiveness of noradrenergic drugs (e.g. Effexor) |
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Term
| What 3 facts support the role of serotonin in the pathophysiology of depression? |
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Definition
1. The effectiveness of SSRIs
2. Depletion of serotonin may precipitate depression
3. Some patients with suicidal impulses have low levels of serotonin in CSF |
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Term
| Other than the biogenic monoamines, what 4 other neurotransmitters are implicated in depression? |
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Definition
1. Acetylcholine
2. GABA
3+4. Glutamate glycine |
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Term
| What percentage of depressed patients show dysfunction of the HPA (hypothalamic-pituitary-adrenal) axis? |
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Definition
20-40% of outpatients
40-60% of inpatients |
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Term
| What percentage of patients with depression have thyroid dysfunction? |
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Definition
| 5-10% have previously undetected thyroid dysfunction: ↑TSH or ↑ response to TRH challenge |
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Term
| Do the hormonal imbalances in depression resolve with treatment? |
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Definition
| Results of the dexamethasone suppression test normalize with effective treatment, but the blunted TSH response to TRH challenge does not. |
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Term
| What are the 5 changes in sleep neurophysiology noted in depression? |
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Definition
1. Premature loss of deep (slow wave) sleep
2. Increase in nocturnal awakenings
3. Reduced total sleep time
4. Increased REM sleep
5. Increased core body T° |
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Term
| What percentage of patients with depression have the combination of reduced REM latency, increased REM density and decreased sleep maintenance? |
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Definition
| 40% of outpatients, 80% of inpatients |
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Term
| What is the estimated risk of mood disorder in the child of a parent with a mood disorder? |
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Definition
| 10-25% if one parent is affected, double that if both |
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Term
| What is the most common mood disorder in families of bipolar probands? |
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Definition
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Term
| What is the estimated "weight" of genetic factors in the etiology of mood disorders? |
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Definition
| 50-70%, based on twin data |
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Term
| What is the concordance of mood disorders among monozygotic and dizygotic twins? |
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Definition
| 70-90% in MZ twins, 16-35% in DZ |
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Term
| Which two chromosomes are most strongly linked with bipolar disorder? |
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Definition
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Term
| Do stressful life events usually precede episodes of mood disorder? |
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Definition
| Stressful life events more often precede first episodes of mood disorder, rather than subsequent episodes. |
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Term
| What life event is most often associated with development of depression? |
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Definition
| Losing a parent before age 11 |
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Term
| What environmental stressor is most commonly associated with the onset of an episode of depression? |
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Definition
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Term
| Who are the authors of the classic view of depression, and what are the 4 key points of this view? |
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Definition
Defined by Sigmund Freud and expanded by Karl Abraham.
1) Disturbance of mother-infant relationship in oral phase (10-18m)
2) Linked to real or imagined object loss
3) Introjection as a defense mechanism
4) Lost object regarded with mix of love & hate, leading to feelings of anger directed at the self |
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Term
| What was Edward Bibring's concept of depression? |
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Definition
| A phenomenon that sets in when a person becomes aware of the discrepancy between extraordinarily high ideas and the inability to meet these goals. |
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Term
| What is Edith Jacobson's idea of depression? |
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Definition
| A state similar to a powerless, helpless child victimized by a tormenting parent |
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Term
| What is Silvano Arieti's theory of depression? |
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Definition
| Many depressed people have lived their lives for a dominant other (which may be a person, ideal, principle, institution etc.). Depression sets in when the patient realizes the dominant other will never respond in a way that meets their expectation. |
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Term
| What is Heinz Kohut's conceptualization of depression? |
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Definition
| Depression results from loss of self-esteem due to parents and others not meeting the self's needs (required to achieve self-esteem and self-cohesion) |
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Term
| What is John Bowlby's theory of depression? |
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Definition
| Depression is the revivication of traumatic childhood experiences of loss (a history of damaged attachment and traumatic separations) |
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Term
| What is Aaron Beck's triad of depression? |
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Definition
A cognitive theory of depression.
1) Views about the self - negative self-precept
2) Environment - percieved as hostile and demanding
3) Future - expectation of suffering and failure |
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