CSB601 Week 3: Mental Health - Anxiety, Sleep Disorders, Major Depressive Disorder, and Bipolar Disorder

Comprehensive vocabulary flashcards covering major definitions, clinical features, pathophysiology, and treatment principles for Anxiety Disorders, Sleep Disorders, Major Depressive Disorder (MDD), and Bipolar Disorder.

Anxiety

A normal adaptive response to perceived threat that becomes a disorder when it is excessive, persistent, disproportionate to the situation, associated with clinically significant distress, or causes functional impairment.

Generalised Anxiety Disorder (GAD)

An anxiety disorder characterized by excessive worry lasting for greater than 6 months.

Panic Disorder

An anxiety disorder characterized by recurrent unexpected panic attacks.

Social Anxiety Disorder

An anxiety disorder characterized by fear of social scrutiny.

Obsessive–Compulsive Disorder (OCD)

A condition characterized by intrusive thoughts combined with compulsions.

Post-Traumatic Stress Disorder (PTSD)

A trauma-related condition characterized by trauma-related hyperarousal and re-experiencing.

Specific Phobias

An anxiety disorder characterized by object- or situation-specific fear.

Cognitive Behavioural Therapy (CBT)

A non-pharmacological psychosocial intervention involving cognitive restructuring, exposure therapy, or behavioural activation; it is the first-line treatment for all anxiety disorders, insomnia, and depression.

Benzodiazepines

Medications that enhance GABA-A receptor activity to increase central nervous system inhibition, producing anxiolytic, sedative, hypnotic, and muscle relaxant effects.

Clomipramine

A tricyclic antidepressant that is effective in the treatment of Obsessive–Compulsive Disorder.

Prazosin

A medication that may help reduce nightmares in patients with Post-Traumatic Stress Disorder.

Insomnia

A common sleep disorder characterized by difficulty initiating or maintaining sleep.

Cognitive Behavioural Therapy for Insomnia (CBT-I)

The most effective non-pharmacological first-line management for insomnia, incorporating sleep hygiene, stimulus control, and regular sleep schedules with long-term persistent benefits.

Z-drugs

Short-term hypnotic medications such as zolpidem and zopiclone used for insomnia, which are not proven to be safer alternatives to benzodiazepines.

Melatonin

A hormone used therapeutically to regulate circadian rhythms, with the best evidence for use in adults over 55 years, sleep onset insomnia, and jet lag.

Restless Legs Syndrome (RLS)

A sleep disorder characterized by an urge to move the legs at rest, associated with reduced dopamine transmission, and treated with dopamine agonists or iron correction if deficient.

Narcolepsy

A sleep disorder characterized by sudden sleep attacks, associated with orexin deficiency, and treated with stimulants such as dexamphetamine to promote dopamine and noradrenaline.

Major Depressive Disorder (MDD)

A high-prevalence psychiatric condition characterized by persistent low mood or loss of interest or pleasure in activities (anhedonia) for at least 2 weeks, requiring at least 5 depressive symptoms causing significant functional impairment.

Anhedonia

The loss of interest or pleasure in activities, which serves as a core clinical feature of Major Depressive Disorder.

Brain-Derived Neurotrophic Factor (BDNF)

A neurotrophic factor essential for neuroplasticity; reduced BDNF signalling and synaptic loss in the hippocampus are implicated in the pathophysiology of Major Depressive Disorder.

Selective Serotonin Reuptake Inhibitors (SSRIs)

First-line antidepressant agents that selectively inhibit the presynaptic reuptake of serotonin (5-HT), offering a favourable risk-benefit profile.

Serotonin–Noradrenaline Reuptake Inhibitors (SNRIs)

Antidepressants (e.g., venlafaxine, desvenlafaxine, duloxetine) that block presynaptic reuptake of both serotonin (5-HT) and noradrenaline (NA); they are useful when pain coexists with depression and are not associated with weight gain.

Tricyclic Antidepressants (TCAs)

Antidepressants that inhibit reuptake of 5-HT and NA while blocking muscarinic, histamine H1, and alpha-1 adrenergic receptors; they are not first-line due to high toxicity and fatality in overdose.

Serotonin Toxicity

A potentially fatal condition caused by excessive serotonergic activity, characterized by increased temperature, agitation, tremor, palpitations, sweating, diarrhoea, and mania.

Monoamine Oxidase Inhibitors (MAOIs)

Non-selective, irreversible inhibitors (e.g., phenelzine, tranylcypromine) of MAO-A and MAO-B that prevent the breakdown of 5-HT, NA, DA, and adrenaline; reserved as third-line or last-line therapy for treatment-resistant depression.

Tyramine Reaction

A severe adverse reaction occurring when non-selective MAOIs interact with tyramine-containing aged or fermented foods (e.g., mature cheese, salami, Vegemite), precipitating a hypertensive crisis.

Hypertensive Crisis

A medical emergency resulting from a tyramine reaction or sympathomimetic interaction with MAOIs, presenting with severe occipital headache and marked elevation in blood pressure.

Bipolar I Disorder

A mood disorder characterized by the occurrence of at least one manic episode, with or without depression.

Bipolar II Disorder

A mood disorder characterized by the occurrence of hypomania combined with depression.

Mania

A state characterized by elevated or irritable mood, decreased need for sleep, increased goal-directed activity, grandiosity, and risk-taking behavior.

Lithium

The gold standard mood stabilizer for relapse prevention in bipolar disorder, characterized by a narrow therapeutic index, renal clearance, and multiple drug interactions.

MESS Acronym

A drug interaction screening framework standing for Mechanism (PK or PD), Evidence, Severity, and Symptoms/Monitoring.

St John's Wort

An over-the-counter herbal supplement with serotonergic properties that can interact with prescribed antidepressants to precipitate serotonin toxicity.

Nortriptyline

A tricyclic antidepressant preferred in elderly patients due to its lower incidence of anticholinergic and hypotensive adverse effects compared to other TCAs.