PSY 241 Lecture 22

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ralejo
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219883
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PSY 241 Lecture 22
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2013-05-16 01:39:21
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arturo zavala psychobiology mood disorders
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arturo zavala psychobiology mood disorders
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  1. Depression
    • sadness
    • loss of interest in things
    • slowed movement
  2. Mania
    • wild excitement
    • racing thoughts
    • exaggerated feeling of well-bring
  3. Unipolar Depression
    • Depression only and normal emotional states
    • Dysthymia: less severe form of unipolar depression
  4. Bipolar Disorder
    • Depression and Mania
    • Clyclothymia: less severe form of bipolar disorder
  5. Genetics
    • likelihood of developing disorder increases if related to someone who has a mood disorder
    • rate of being diagnosed is higher if related to someone with bipolar disorder
    • not a single gene has been implicated - multiple
    • Genes may increase sensitivity to environmental stressors
  6. Environmental factors - Seasonal Affective Disorder (SAD)
    • depression and lethargy during winter months
    • Light therapy needed
  7. Sleep characteristic changes in affective disorders
    Difficulty falling asleep & inability to maintain sleep

    • EEG studies:striking reduction of stage 3 and increase in stages 1 & 2
    • Patients enter REM sleep very quickly, with an increase of REM sleep in the first half of the night
    • The length of time before REM sleep begins correlates with the severity of depression
  8. Brain changes with Depression
    • ↑ blood flow to frontal cortex + amygdala
    • ↓ blood flow to parietal + posterior temporal cortex + anterior cingulate
    • Cortex of right hemisphere is thinned
    • Increased activity in right prefrontal cortex and decreased in left
  9. Endocrine Dysfuntions
    • ~45-60% depressed patients have neuroendocrine abnormalities
    • Hyposecretion of Corticotropin Releasing Factor (CRF) + Cortisol (stress hormones)
    • *Disruption of Hypothalamic-Pituitary-Adrenal Axis (HPA-axis)
  10. Disruption in HPA Axis: ____________ levels of Cortisol in depressed patients compared to other psychiatric controls or normal controls
    Higher levels of Cortisol in depressed patients compared to other psychiatric controls or normal controls
  11. Dexamethasone
    Synthetic glucocorticoid
  12. Monoamine hypothesis of depression
    Idea that depression is caused by decreased activity at noradrenergic and serotonergic synapses

    • 5-HIAA (a serotonin metabolite) is lower in people with major depression
    • Low levels of CSF 5-HIAA associated with suicide
    • Norepinephrine metbolite (MHPG) lower in people with major depression
    • As norepinephrine metabolites increase, subjects with bipolar disorder become manic
  13. Low monoamine levels
    increase depression
  14. high monoamine levels
    reduce depression
  15. Actions of Antidepressants
    • MAOIs blocks enzyme MAO
    • prevent from breaking transmitters into inactive metabolites
    • Tricyclic drugs and SSRIs block reuptake
  16. Type of MAO-I
    Iproniazid (Ipronid)
  17. Type of Classic tricyclics - block serotonin and norepinephrine reuptake
    Imipramine (Tofranil)
  18. Type of Atypical antidepressants - selective norepinephrine reuptake inhibitors - SNRI
    Duloxetin (Cymbalta)
  19. Type of Norepinephrine reuptake inhibitor; Dopamine reuptake inhibitor
    Bupropion (Wellbutrin)
  20. Learned helplessnes
    Decrease in serotonin function
  21. Lithium Carbonate
    Metallic ion - has been shown to be clinically effective in treating bipolar disorder
  22. Ketamine (glutamate antagonist)
    relief occurs 2 hours of administration
  23. Deepr brain stimulation (DBS)
    • through a surgically implanted electrode directed at cingulate cortex
    • no control or placebo studies
    • low Ns
  24. Cognitive behavioral therapy (CBT)
    • 20 sessions
    • effective as SSRIs
  25. Sleep deprivation
    • Increase in Norepinephrine levels 
    • LC shuts down
  26. Exercise
    Increase adult hippocampal neurogenesis
  27. Electric Convulsive Therapy
    • Used for drug-resistant depression
    • Mechanism of action is not clear

    • Disadvantages
    • High relapse rate
    • Memory deficits

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