Depression

  • Created by: oaschaaf
  • Created on: 21-04-18 12:28
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  • Depression
    • Diagnosing Depression
      • Increasingly common, around 1 in 8-10 people are diagnosed with depression in their lives.
      • For a diagnosis of major depression, at least five of the following symptoms must be present during the same two-week period.
        • Depressed mood, diminished interest, weight loss/gain, insomnia/hypersomnia, psychomotor agitation/retardation, fatigue, worthlessness/guilt, concentration, suicidal.
      • Subtypes
        • Unipolar: depression that alternates with normal emotional states. 10% of men and 20% of women suffer with it
        • Bipolar depression - fluctuation between depressive periods and episodes of euphoria, equal number of men and women. Less common.
    • Genes and Depression
      • Unipolar concordance - MZ = 60% and DZ = 20%
      • Bipolar concordance rates - MZ = 70% and DZ = 15%
      • Adoption studies show highe rates of depression in biological than adoptive parents.
        • No single gene for depression. Many genes contribute to susceptibility but environment triggers.
    • Treatment of Depression
      • MOIs (Monoamine Oxidase Inhibitors)
        • Inhibits enzymes which break down monoamines. Serotonin is usually broken down by monoamine oxidase therefore more serotonin left in the synaptic cleft.
        • Nasty side effects and only used in the most resistant cases.
        • 1950s: Iproniazid (MAOI). 1960s: Reserpine has opposite effect and causes severe depression. This led to the monoamine hypothesis of depression (Schildkraut & Kety)
      • Tricyclic Anti depressants - 1950s Trofanil - similar effect to MOAIs but different action. Inhibits reuptake of monoamine neurotransmitters, again leaving more to bind with receptors. Effective. SEs. Suicide risk.
      • SSRIs
        • Most modern drug treatment for depression: Prozac, sertraline, citalopram. More effective than MAOIs. Safe and few SEs
      • Fournier (2010) - taking placebo pill patients get better. If one is highly depressed medication does not work.
    • Neuroimaging of Depression
      • Increased activity in neural systems supporting emotion processing (e.g. amygdala)
      • Decreased activity in the neural systems supporting regulation of emotion e.g. dorsolateral prefrontal cortex
      • Kupfer et al., (2012)
    • Bipolar Disorder
      • Standard antidepressants have very little effect. 1940s: discovery of lithium. Without lithium the cycle would be every 14 months on average, with lithium on average it occurs every nine years.

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