T3 L6: Affective Disorders: Neurobiology and Treatment (AC)

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Questions and Answers

Which neurotransmitters are implicated in the pathophysiology of depression?

  • GABA and glutamate
  • Serotonin and noradrenaline (correct)
  • Serotonin and dopamine
  • Dopamine and noradrenaline

What is the estimated heritability of major depression?

  • 60%
  • 50%
  • 85%
  • 37% (correct)

Which neurotransmitter system is dysfunctional in depression?

  • Serotonin and noradrenaline (correct)
  • Dopamine and noradrenaline
  • GABA and glutamate
  • Serotonin and dopamine

What is the primary pharmacological target for traditional antidepressants?

<p>Serotonin transporters (C)</p> Signup and view all the answers

Which type of antidepressant is known to have rapid and striking antidepressant effects?

<p>NMDAR blockers (C)</p> Signup and view all the answers

What is the concordance rate of bipolar disorder in monozygotic twins?

<p>60% (A)</p> Signup and view all the answers

What is the estimated heritability of bipolar disorder?

<p>85% (C)</p> Signup and view all the answers

Which gene has been associated with bipolar disorder in genome-wide association studies?

<p>CACNA1C (D)</p> Signup and view all the answers

What is the overlap between risk alleles identified in genome-wide association studies for bipolar disorder and schizophrenia?

<p>Partial overlap (A)</p> Signup and view all the answers

What is the primary pharmacological target for traditional antipsychotics?

<p>Dopamine receptors (C)</p> Signup and view all the answers

Which neurotransmitter abnormality is associated with depression?

<p>Excessive serotonin (D)</p> Signup and view all the answers

What is the main purpose of short-term treatment for Bipolar Disorder?

<p>To reduce the severity and shorten the duration of the acute episode (D)</p> Signup and view all the answers

Which drug category is used for the prevention of depression in Bipolar Disorder?

<p>Anticonvulsants (D)</p> Signup and view all the answers

What is a potential adverse effect of Lithium treatment?

<p>Kidney dysfunction (A)</p> Signup and view all the answers

Which drug category has a risk of inducing mania in Bipolar Disorder?

<p>Antidepressants (B)</p> Signup and view all the answers

What is a disadvantage of stopping Lithium abruptly in Bipolar Disorder treatment?

<p>Exacerbation of manic relapses (D)</p> Signup and view all the answers

What is a potential adverse effect of Valproate treatment in Bipolar Disorder?

<p>Liver damage (D)</p> Signup and view all the answers

What is a potential adverse effect of 2nd generation antipsychotics in Bipolar Disorder treatment?

<p>Weight gain and metabolic syndrome (A)</p> Signup and view all the answers

What is a potential disadvantage of pharmacological treatments for Bipolar Disorder?

<p>Poor adherence and long-term compliance (C)</p> Signup and view all the answers

What is a cause of neurodevelopmental defects in pregnancy related to Bipolar Disorder treatment?

<p>Valproate (B)</p> Signup and view all the answers

Which of the following is NOT a learning outcome for the module?

<p>Describing the historical classification of mood disorders (A)</p> Signup and view all the answers

What is the current classification system for mood disorders?

<p>None of the above (D)</p> Signup and view all the answers

According to the text, what are the factors involved in the etiology of depression?

<p>All of the above (D)</p> Signup and view all the answers

What is the role of Dr. Alessandro Colasanti in relation to the module?

<p>Consultant Psychiatrist at OpCourage TILS Veterans service (B)</p> Signup and view all the answers

What is the main focus of the module?

<p>Neurobiology of affective disorders (C)</p> Signup and view all the answers

What is the historical classification of mood disorders mentioned in the text?

<p>Endogenous vs. reactive depression (A)</p> Signup and view all the answers

What is the role of OpCourage TILS Veterans service in relation to the module?

<p>None of the above (D)</p> Signup and view all the answers

What is the focus of the Immunopsychiatry Research clinic?

<p>Psychiatric research (C)</p> Signup and view all the answers

Which classification systems do not rely on the classification between reactive and endogenous depression?

<p>The DSM and the ICD (D)</p> Signup and view all the answers

What is the main focus of the module?

<p>The clinical aspects of depression (C)</p> Signup and view all the answers

What is the concordance rate of bipolar disorder in monozygotic twins?

<p>40-70% (B)</p> Signup and view all the answers

What is a potential adverse effect of Valproate treatment in Bipolar Disorder?

<p>Hepatotoxicity (D)</p> Signup and view all the answers

Which approach to understanding psychiatric syndromes was discussed in the previous lecture?

<p>Phenomenology (B)</p> Signup and view all the answers

What is the main focus of today's lecture on affective disorders?

<p>Objective data on causes and treatment (D)</p> Signup and view all the answers

How were the treatments for psychiatric disorders historically chosen?

<p>Through serendipity (B)</p> Signup and view all the answers

What is the emphasis when selecting medications for mood disorders?

<p>Drug tolerability (A)</p> Signup and view all the answers

Which factor is NOT considered a genetic cause of depression?

<p>Mood disorders (D)</p> Signup and view all the answers

What is the main reason why no convincing loci have been identified in genetic studies of depression?

<p>Heterogeneity in underlying genetic causes (B)</p> Signup and view all the answers

What is the interaction demonstrated by Caspi in the study mentioned in the text?

<p>Interaction between genetic and environmental factors (B)</p> Signup and view all the answers

What is the function of the serotonin transporter gene polymorphism mentioned in the text?

<p>Determining the reuptake rate of serotonin (A)</p> Signup and view all the answers

What is the primary hormone involved in the negative feedback regulation of cortisol release?

<p>Cortisol (D)</p> Signup and view all the answers

What is the state of cortisol primarily observed in people with depression?

<p>High cortisol (C)</p> Signup and view all the answers

What is the condition characterized by an increase in cortisol levels?

<p>Cushing's disease (A)</p> Signup and view all the answers

What structural changes are observed in the brain of individuals with depression?

<p>Decrease in hippocampus size and increase in ventricle size (B)</p> Signup and view all the answers

Which brain regions are important in emotional reward processing?

<p>The amygdala and the nucleus accumbens (D)</p> Signup and view all the answers

What is the main role of the dorsolateral prefrontal cortex and the ventral lateral frontal cortex?

<p>Integration of top-down voluntary control with autonomic control of emotions (B)</p> Signup and view all the answers

What is the main function of the anterior cingulate cortex and the medial prefrontal cortex?

<p>Integration of top-down voluntary control with autonomic control of emotions (D)</p> Signup and view all the answers

What is the rationale for focusing on serotonin in the treatment of depression?

<p>Historical evidence (A)</p> Signup and view all the answers

Which imaging technique has molecular specificity and can be used to measure the density of the five H2 transporter in the brain?

<p>Positron emission tomography (PET) (A)</p> Signup and view all the answers

What is the potential relationship between the reduction in 5G transport and depression?

<p>Reduction in 5G transport and depression have a reciprocal relationship (B)</p> Signup and view all the answers

What is the purpose of administering dexamethasone in the evening before going to bed?

<p>To activate the feedback of the glucocorticoid receptor (A)</p> Signup and view all the answers

What did the pet study using a particular ligand binding to the five H2 receptor demonstrate in people with depression?

<p>Alteration in the release of serotonin (A)</p> Signup and view all the answers

Which treatment has a potentially drastic reduction of serious depressive symptoms in a matter of two days?

<p>Ketamine infusion (D)</p> Signup and view all the answers

What is a concern when giving ketamine many times to a person with recurrent depression?

<p>Clinical concern (D)</p> Signup and view all the answers

What is ketamine potentially replacing or being an alternative of?

<p>Electroconvulsive treatment (A)</p> Signup and view all the answers

What is a potential disadvantage of ketamine treatment?

<p>Tolerability issues (B)</p> Signup and view all the answers

What is the primary pharmacological target for traditional antidepressants?

<p>Serotonin (B)</p> Signup and view all the answers

What is the estimated heritability of major depression?

<p>90% (B)</p> Signup and view all the answers

Flashcards

Neurotransmitters in depression

Serotonin and noradrenaline are the primary neurotransmitters implicated in the pathophysiology of depression.

Heritability of depression

The estimated heritability of major depression is 37%, which means that genetic factors play a significant role in its development.

Neurotransmitter dysfunction in depression

The serotonin and noradrenaline systems are dysfunctional in depression, leading to imbalances in these neurotransmitters.

Pharmacological target of antidepressants

Traditional antidepressants primarily target serotonin transporters, blocking the reuptake of serotonin in the synapse.

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Rapid-acting antidepressants

NMDAR blockers are a type of antidepressant that can have rapid and striking antidepressant effects, but they also have potential side effects.

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Concordance rate of bipolar disorder

The concordance rate of bipolar disorder in monozygotic twins is 60%, indicating a very strong genetic influence.

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Heritability of bipolar disorder

The estimated heritability of bipolar disorder is 85%, suggesting a major role of genes in its development.

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Gene associated with bipolar disorder

The CACNA1C gene has been consistently associated with bipolar disorder through genome-wide association studies.

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Genetic overlap between bipolar disorder and schizophrenia

There's a partial overlap between the risk alleles identified in genome-wide association studies for bipolar disorder and schizophrenia, suggesting shared genetic risks.

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Pharmacological target of antipsychotics

Traditional antipsychotics primarily target dopamine receptors, blocking the action of dopamine in the brain.

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Neurotransmitter abnormality in depression

Depression is associated with an excessive amount of serotonin in the brain, although this is not the only neurotransmitter involved.

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Short-term treatment goal for Bipolar Disorder

The main purpose of short-term treatment for Bipolar Disorder is to reduce the severity and shorten the duration of the acute episode.

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Drug category for depression prevention in Bipolar Disorder

Anticonvulsants, like valproic acid, are used in the prevention of depression in Bipolar Disorder patients.

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Potential side effect of Lithium

Lithium, a mood stabilizer, can cause kidney dysfunction as a potential adverse effect.

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Drug category that can trigger mania

Antidepressants can have a risk of inducing mania in Bipolar Disorder patients, leading to a worsening of symptoms.

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Disadvantage of abrupt Lithium discontinuation

Stopping Lithium abruptly in Bipolar Disorder treatment can exacerbate manic relapses and worsen the overall course of the disorder.

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Potential side effect of Valproate

Valproate, an anticonvulsant used in Bipolar Disorder treatment, can cause liver damage as a potential adverse effect.

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Potential side effect of 2nd generation antipsychotics

Second-generation antipsychotics, used in Bipolar Disorder treatment, can lead to weight gain and metabolic syndrome.

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Disadvantage of Bipolar Disorder medication

One disadvantage of pharmacological treatments for Bipolar Disorder is poor adherence and long-term compliance, making it challenging to manage the condition effectively.

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Neurodevelopmental defects in pregnancy

Valproate, an anticonvulsant, can lead to neurodevelopmental defects in pregnancy, posing risks to the developing fetus.

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Genetic causes of depression

Genetic factors are important contributors to the development of depression, but they are not the only factors.

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Challenges in genetic studies of depression

Heterogeneity in underlying genetic causes makes it challenging to identify conclusive loci associated with depression.

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Interaction between genetic and environmental factors

Caspi's study demonstrated the interaction between genetic and environmental factors in depression.

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Serotonin transporter gene polymorphism

The serotonin transporter gene polymorphism determines the reuptake rate of serotonin, potentially influencing vulnerability to depression.

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Cortisol regulation

Cortisol is the primary hormone involved in the negative feedback regulation of cortisol release, ensuring balance in the stress response.

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Cortisol levels in depression

People with depression often exhibit high cortisol levels, suggesting an imbalance in the stress response.

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Cushing's disease

Cushing's disease is characterized by an increase in cortisol levels, potentially leading to related symptoms.

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Brain changes in depression

Individuals with depression show structural changes in the brain, including a decrease in hippocampus size and an increase in ventricle size.

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Brain regions for reward processing

The amygdala and the nucleus accumbens are brain regions crucial for emotional reward processing, potentially dysregulated in depression.

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Brain regions for emotional regulation

The dorsolateral prefrontal cortex and the ventral lateral frontal cortex are involved in the integration of voluntary and autonomic control of emotions, crucial for emotional regulation.

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Brain regions for emotional integration

The anterior cingulate cortex and the medial prefrontal cortex play a role in integrating voluntary and autonomic control of emotions, essential for emotional regulation and response.

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Rationale for focusing on serotonin in depression

Focusing on serotonin in depression treatment is based on historical evidence suggesting its potential role in mood regulation, but more research is needed.

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Imaging technique for serotonin transporter

PET (Positron Emission Tomography) is an imaging technique with molecular specificity that can be used to measure the density of the serotonin transporter in the brain.

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Serotonin transport and depression

The reduction in serotonin transporter density and depression appear to have a reciprocal relationship, but more research is needed to fully understand their connection.

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