Depression & affective disorders Fall 2009

Depression & affective disorders Fall 2009 - AFFECTIVE...

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Chronic, endogenous rather than transitory, exogenous. Major depression “persistent and severe feelings of sadness and worthlessness”; sleeplessness, agitation, loss of appetite & libido; social withdrawal. Guilt, delusions, suicidal thoughts. Dysthymia (“chronic mood disorder”) Bipolar disorder (“manic - depressive”) depression - normalcy - mania cycles Heritability: Very high for bipolar (> 70% concordance in MZs). Lower but substantial for major depression (> 40%). AFFECTIVE DISORDERS 1
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Affective Disorders and Suicide 4 General population: 20 per 100,000
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Reinforcement Decrement and Depression Model 6 Keep the diathesis principle in mind here
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Serotonin : A basic neurotransmitter/neuromodulator. Generated in the brain stem --important for many basic physiological functions (temperature, heart rate, sleep, sex, mood, aggression). Evidence of serotonin’s role in depression 1. Drugs that prolong serotonin activity in the synapse/receptors (SSRIs: “re-uptake inhibitors”) have anti-depressant effects (Prozac, others). They are relatively selective (fewer side effects). Serotonin and Depression 7
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BRAIN AND SEROTONIN 8
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New neurons can develop from stem cells in the human hippocampus (also in the olfactory bulb; maybe other regions too). Stress tends to suppress hippocampal neurogenesis: Stress glucocorticoids "neurotoxic" effect Depression is related to or accompanied by stress-induced loss of neurons or reduced neurogenesis in hippocampus. 9
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. Serotonin neurons : their firing rate tracks activity/movement levels (don’t fire during REM sleep). Also coordinated with responding to external stimuli. Hypothersis: Motor retardation and cognitive deficits of depression result from low levels of serotonin neuron activity. Serotonin level may also be related to repeated movement
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Depression & affective disorders Fall 2009 - AFFECTIVE...

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