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.
- MOIs (Monoamine Oxidase Inhibitors)
- 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.
- Diagnosing Depression
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