Symptoms and Circuits in Mood Disorders

These flashcards cover the neurobiological basis of mood disorders, diagnostic strategies for bipolar vs. unipolar depression, and the relationship between specific symptoms, brain regions, and neurotransmitters.

Major hypothesis in psychiatry

The idea that psychiatric symptoms in DSM-5 are linked to inefficient information processing in specific brain circuits, with different circuits mediating different symptoms.

"Who's your daddy?"

A question proposed by Stahl to solidify a bipolar diagnosis by looking at family history for mood disorders, psychiatric hospitalizations, completed suicides, or use of lithium, antipsychotics, and ECT.

"Where's your mama?"

A question proposed by Stahl to emphasize getting collateral information from someone who knows the patient well, especially since patients in manic episodes often lack insight and underreport symptoms.

Bipolarity Index

A scale created by experts at Massachusetts General Hospital used to help clinicians identify the likelihood of bipolar disorder versus non-bipolar disorder based on weighted characteristics.

Major Depressive Episode (Core Criteria)

A minimum of a two-week period featuring either depressed mood or a lack of interest (anhedonia), plus at least four of seven other DSM-5 symptoms.

Anhedonia

A core symptom of a major depressive episode defined as a lack of interest in things the patient typically enjoys.

Manic Episode (Duration Criteria)

A period of mood and energy disturbance lasting at least seven days, or any duration if the symptoms are severe enough to require hospitalization.

Major Monoamines

The three primary neurotransmitters involved in mood disorder circuitry: dopamine ($DA$), norepinephrine ($NE$), and serotonin ($5HT$).

Residual Symptoms

Lingering symptoms that do not completely resolve after treatment, such as insomnia, fatigue, somatic pain, impaired concentration, and lack of interest.

Hypothalamus

The brain region primarily associated with symptoms of insomnia or sleep disturbances in mood disorders.

Prefrontal Cortex

The brain region primarily associated with symptoms of mental fatigue and trouble with concentration.

Reduced Positive Affect

A symptom domain in depression driven primarily by dysfunction in dopamine ($DA$) and norepinephrine ($NE$) neurotransmission.

Increased Negative Affect

A symptom domain in depression related primarily to serotonin ($5HT$) and norepinephrine ($NE$) dysfunction.

Mixed State

A condition in mood disorders where an individual experiences symptoms of both mania and depression at the exact same time.

Chaotic Neuronal Transmission

A conceptualization of mood disorders as brain circuits being "out of tune" or disorganized rather than simply being too high or too low in neurotransmission.

Symptom-based Treatment Approach

A rational methodology where clinicians identify the most bothersome specific symptoms and select medications that target the neurotransmitters and brain circuits mediating those symptoms.