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NR546 Psychopharmacology Week 5 Questions and Correct Answers the Latest Update and Recommended Version
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Major Depressive Disorder (MDD) common symptoms depressed mood, loss of interest or pleasure in daily activities, irritability, withdrawal, and problems with sleep eating, energy, concentration, or self worth. Clients with severe depression may experience thoughts of suicide or psychotic symp...

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NR546 Psychopharmacology Week 5
Questions and Correct Answers the
Latest Update and Recommended
Version
Major Depressive Disorder (MDD) common symptoms

✓ depressed mood, loss of interest or pleasure in daily activities, irritability, withdrawal, and
problems with sleep eating, energy, concentration, or self worth. Clients with severe
depression may experience thoughts of suicide or psychotic symptoms.


Bipolar Disorder

✓ chronic condition characterized by extreme fluctuations in mood, energy, and ability to
function. May experience recurrent episodes and remissions. Moods may be manic,
hypomanic, or depressed. May be a mixed mood or psychotic features. Most bipolar
depression clients experience depression symptoms and may have only one manic episode
in their lifetime. Diagnosed when a client has one or more episodes of mania or
hypomania with a history of one or more major depressive episodes. Associated with
significant morbidity and mortality. High risk for suicide. Correct and early diagnosis is
essential to prevent complications and maximize treatment response.


Bipolar I

✓ Requires at least one episode of mania for at least one week (or any duration if
hospitalized due to symptoms is required).


Mania

✓ characterized by a persistently elevated, expansive, or irritable mood. Related symptoms
may include inflated self esteem, increased goal directed activity or energy, including
grandiosity, decreased need for sleep, excessive talkativeness, racing thoughts, flight of
ideas, distractibility, psychomotor agitation, and a propensity to be involved in high risk
activities. Leads to significant functional impairment and may include psychotic features or
necessitate hospitalization.


Bipolar II

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✓ Diagnosis requires a current or past hypomanic episode and a current or past major
depressive episode. Symptoms last for at least 4 days but fewer than 7. Hypomanic
symptoms are not sufficient duration or severity to cause significant functional impairment,
psychosis, or hospitalization. Anger ad irritability are common. Clients often enjoy the
elevation of mood and are reluctant to report these symptoms, making Bipolar more
difficult to diagnose if the client presents in the depression phase.


Cyclothymia

✓ involves the chronic presentation of hypomanic and depressive symptoms that do not meet
the diagnostic criteria for a major depressive or main/hypomanic episode.


Mood Related Symptoms

✓ may be characterized as having too little positive affect, or too much negative affect.


Positive affect

✓ Dopamine (DA) Norepinephrine (NE) dysfunction


Negative Affect

✓ 5-Hydroxytrpytamine (5HT) Norepinephrine (NE) Dysfunction


Decreased positive Affect: DA, NE Dysfunction

✓ Depressed mood
✓ loss of joy
✓ lack of interest
✓ loss of energy
✓ decreased alertness
✓ decreased self confidence
✓ appetite changes




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Increased Negative Affect: 5HT, NE Dysfunction

✓ depressed mood
✓ guilt
✓ fear/anxiety
✓ hostility
✓ irritability
✓ loneliness
✓ appetite changes


Neurobiological Basis: Genetics

✓ MDD and BD are heritable disorders. Genetic factors contribute 31-42% of the disease
risk in MDD and 59-85% in BD. Causes of mood disorders are complex and likely
involve interaction between genetic/epigenetic, biological, psychological, and social
factors including:
✓ dysfunctions in brain
✓ imbalance of neurotransmitters
✓ life events
✓ abuse or trauma
✓ substance use or medication
✓ menstruation
✓ season changes


Neurobiological Basis: Neuroanatomy

✓ Inefficient information processing by one or more brain circuits may result in mood
disorder symptoms


Neurobiological Basis: Neural Networks




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✓ Classic Monoamine hypothesis or depression posits that depression occurs as a result of a
deficiency of one or all three monoamine transmitters (serotonin, norepinephrine, and
dopamine), while mania may result from an excess. Stahl acknowledged that depression is
more complex than this but it is helpful in understanding the physiological functioning of
these NTs. Emphasis is now shifted to from the monoamine receptors and other
downstream events such as regulation of gene expression, growth factors, environmental
factors, and epigenetic changes.


Neurobiological Basis: Neural Signaling

✓ Three principial NTs (NE, DA, and 5HT) have implications for the pathophysiology and
treatment of mood disorders. These NTs are monoamines. Monoamines work in concert
and comprise the monoamine NT system. Many of the symptoms of odd disorders are
hypothesized to involve dysfunction of various combinations of monoamine NTs. All know
pharmacologic treatments for mood disorders act upon one or more of these three NTs.


What diagnostic symptoms in MDD present when prefrontal cortex is involved

✓ Concentration
✓ Mental Fatigue
✓ Mood


What diagnostic symptoms in MDD present when PFC and Amygdala are involved

✓ Guilt
✓ Suicidality
✓ Worthlessness


What diagnostic symptoms in MDD present when the striatum is involved

✓ Physical Fatigue


What diagnostic symptoms in MDD present when the nucleus accumbens is involved

✓ Pleasure interests



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