Test: Mood Disorders - 1 - NEET PG MCQ

Depression is a common mental health condition that can affect anyone, but it is most frequently observed in specific age groups and genders. Here are the key points regarding the prevalence of depression:

• Middle aged men often experience depression due to various life stresses, including work and personal responsibilities.
• Middle aged women are also significantly affected, often due to hormonal changes, societal pressures, and family dynamics.
• While young girls can experience depression, it is less common compared to middle aged individuals.
• Children may show signs of depression, but it is often difficult to diagnose as they may not express their feelings clearly.

Overall, the highest rates of depression are seen in middle aged females, making them a key demographic for mental health support.

Neurotransmitters play a crucial role in regulating mood and emotions. Here are the key neurotransmitters associated with depression:

• Serotonin: Often referred to as the "feel-good" neurotransmitter, it helps to stabilise mood and feelings of happiness.
• Norepinephrine: This neurotransmitter is involved in arousal and alertness, and it also affects mood regulation.

Low levels of both serotonin and norepinephrine are commonly linked to symptoms of depression. Understanding their roles can help in developing effective treatment strategies.

The cognitive triad, developed by Aaron Beck, consists of three key components that contribute to negative thinking patterns. These components are:

• Hopelessness: A feeling that things will not improve.
• Worthlessness: A belief that one is not valuable or important.
• Helplessness: A sense of being unable to change or control situations.

However, guilt is not a part of Beck's cognitive triad. It is related to feelings of remorse or regret but does not fit within the core components that define the triad.

Aaron Beck's cognitive theory of depression emphasises the role of negative thoughts in shaping a person's mood. According to this theory, individuals suffering from depression often experience:

• Negative thoughts about the past: These thoughts can lead to feelings of regret or failure.
• Negative thoughts about the future: Individuals may feel hopeless and believe that things will never improve.
• Negative thoughts about the environment: This refers to a person's perception of their surroundings, which can seem bleak or threatening.
• Negative thoughts about themselves: These thoughts often involve low self-esteem and feelings of worthlessness.

In summary, Beck's theory highlights how these negative thought patterns contribute to depression, affecting a person's overall mental health.

Major depressive disorder is associated with several key features:

• Reduced activity in the prefrontal cortex, which affects mood regulation.
• Disturbances in the monoaminergic system, impacting neurotransmitters like serotonin and dopamine.
• A genetic predisposition, indicating that it can run in families.

However, lesions in the corticospinal tract are not directly linked to this disorder.

Depression is the most prevalent psychiatric disorder linked with both hypothyroidism and hyperthyroidism. Additionally, in adrenal conditions such as Cushing's syndrome and Addison's disease, depression is frequently associated.

In cases of hypopituitarism, depression is frequently observed.

Several commonly used medications that can lead to depression are:

• Antihypertensives such as reserpine, methyldopa, and beta blockers.
• Steroids including corticosteroids and oral contraceptive pills.
• Barbiturates.
• Benzodiazepines like clonazepam.

The feeling of guilt is a common symptom in various mental health conditions. However, it is most persistently seen in:

• Obsessive Compulsive Disorder (OCD): Individuals may experience intense guilt over their thoughts or actions.
• Depression: Guilt is a significant symptom, often related to feelings of worthlessness.

Among these, the most consistent experience of guilt is found in depression. This condition can lead to overwhelming feelings of regret and self-blame.

The DSM IV states that the duration criterion for diagnosing depression is a minimum of:

• Two weeks of persistent symptoms.
• Symptoms must include a depressed mood or loss of interest.
• Other symptoms may include changes in appetite, sleep disturbances, fatigue, and feelings of worthlessness.

It's important for the symptoms to cause significant distress or impairment in daily functioning.

As per DSM-IV and DSM-5, a diagnosis of depression requires the presence of at least one of the following two symptoms:

• depressed mood
• loss of interest or pleasure

Individuals with depression often experience specific sleep disturbances, including:

• Insomnia in the early hours of the morning
• Decreased latency to REM sleep

Psychotic symptoms are observed more frequently in both endogenous and melancholic depression (depression during the involutional stage). They can also occur in double depression, although this is less prevalent (double depression refers to the condition where depression is layered on top of dysthymia).

The occurrence of psychotic symptoms indicates that a depression is severe; as such, these symptoms are typically associated only with severe depression.

Psychotic symptoms may be classified as either mood congruent or mood incongruent.

Intense nihilism, somatization, and agitation in older adults often indicate a specific type of depression. The symptoms include:

• Nihilism: A feeling that life is meaningless.
• Somatization: Physical symptoms that arise from emotional distress.
• Agitation: Increased restlessness or anxiety.

These characteristics are commonly associated with:

• Involutional melancholia: A severe form of depression typically occurring in later life, marked by profound sadness and significant changes in sleep and appetite.

Understanding these symptoms can help in identifying and addressing the mental health needs of older individuals effectively.

The recovery process is frequently partial for individuals suffering from depression.

Dysthymia is a form of chronic mild depression. It is characterised by a persistent low mood that lasts for a long time, often for years. People with dysthymia may experience:

• Feelings of sadness or hopelessness
• Fatigue and low energy
• Difficulty concentrating
• Changes in sleep patterns
• Changes in appetite

This condition can affect daily life and overall well-being, but it is less severe than major depression. Treatment options include therapy and medication, which can help manage symptoms and improve quality of life.

The most frequent form of postpuerperal psychosis is depression.

The patient exhibits notable somatic symptoms, including:

• aches and pains
• generalised weakness

In numerous cases, depression predominantly manifests through somatic issues, with patients often denying psychological symptoms like a low mood. Additionally, this patient experiences:

• sleep disturbances
• appetite changes
• a loss of interest

These factors confirm the diagnosis of depression.

This individual is experiencing depression accompanied by psychotic symptoms. The patient's conviction that he has sinned in his life, along with his persistent belief despite his wife's reassurances, indicates the presence of a delusion. Therefore, it is recommended that this patient receives treatment with both antidepressants and antipsychotics.