©PREP4EXAMS@2024 [REAL EXAM DUMPS] Tuesday, July 23, 2024 10:52 AM
NR546 Psychopharmacology Week 5
Questions and Answers (Success)
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 - ✔️✔️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,
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,©PREP4EXAMS@2024 [REAL EXAM DUMPS] Tuesday, July 23, 2024 10:52 AM
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
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
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, ©PREP4EXAMS@2024 [REAL EXAM DUMPS] Tuesday, July 23, 2024 10:52 AM
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 - ✔️✔️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
What diagnostic symptoms in MDD present when the hypothalamus is involved - ✔️✔️Sleep
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