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Part II ISQ Club - Depression

29 posts in this topic

Part II ISQs on two topics will be posted twice a week. You are encouraged to post a reply in the thread, stating whether you think an ISQ is true or false and why (eg. a short explanation, with reference to the textbook you used). Please only deal with one ISQ in each post and include the question as the first line of your post. All ISQs are taken from previous posts by Forum members.

In a few days this ISQ Club thread will be moved to the Question Bank board. If you submit an answer, your status will be changed to 'Question Bank member' and you will be able to see the Question Bank board. Please allow up to 48 hours for this change to happen.

JUST 6 WEEKS LEFT UNTIL THE EXAM! OVER 300 POSTS IN THE QUESTION BANK BOARD!

1. Leukoariosis in old age is seen in anxiety and depression

2. Growth hormone blunting is seen in depression

3. Tryptophan-induced prolactin suppression is seen in depression

4. ACTH is raised in depression

5. Dexamethasone non-suppression can be diagnostic of depression

6. Tricyclic antidepressants can be used as maintenance treatment in older people

7. SSRIs cause their effect on sleep by acting on 5HT2A receptors

8. Sleep walking is seen in depression

9. The differences in scores between BDI and HAM-D are due to the way they are conducted

10. Depression is more prevalent in male homosexuals compared with male heterosexuals

11. Depression is more common in female homosexuals compared to female heterosexuals

12. The Impact of Life Events (Revised) scale has a measurement for increased arousal

13. Life events affect people of a lower social class than middle class

14. According to the National Co-morbidity Survey, 1% of the population admit to suicidal ideation in a week

15. Weight loss is seen in uncomplicated bereavenment

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1) False

Leukoariosis in old age is seen in vascular, degenerative dementia ,and also in non demented subjects. (ref Puri and hall )

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5) False

dexamethasone non suppression is not diagnostic of depression. also occurs in chronic schizo, mania and dementia.

indicates poorer response to treatment and high risk of relapse

Ref oxford text p298

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Q2. Growth hormone is seen in depression.

Answer is True

Malhi book page 226.

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6. Tricyclic antidepressants can be used as maintenance treatment in older people

True - 'can be'

but heart disease is relative contraindication and also the elderly are particularly prone to antimuscarinic effects which may result in acute brain syndromes, urinary retention and glaucoma (Puri and Hall, p.399)

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depression is more prevalent in male homosexuals compared to male heterosexuals-T and dep is more common in female homosexual compared to female hetrosexuals -T (COMPANION)- large scale study- found incidence of loneliness,lower self acceptance and depression,suicidal ideas in their male and female homosexuals than in heterosexual controls

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the difference in scores between BDI and HAM-D adre due to the way they are conducted-T

companion- BDI is by clinician and HAM-D is self rated

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tryptophan induced prolactin supression is seen in depression-T

core psych- prolactin response to L-tryptophan (5HT precursor) is blunted in depression

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12. The Impact of Life (!) Events Scale (Revised) has a

measurement for increased arousal.

TRUE IES-R (Weiss and Marmar, 1997)

' IES-R is similar to IES in that it is designed to

measure current subjective distress for any specific

life event. IES-R has 22 items, 7 items having been

added to the original 15 item IES.The 7 items

comprise 6 that tap hyperarousal systems such as

anger irritability heightened startle response

difficulty concentrating hypervigilance.

The hyperarousal subscale and new intrusion item

along with existing intrusion and avoidance

subscales parallel DSM IV criteria for PTSD. '

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14 According to the National Comorbidity Study, 1% of the population admit to suicidal ideation in a week.

True

Jenkins, BJPsych, 1998

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to question 9. I don't know the unswer but HamD is not self rating. it is observer rating- Examination notes in psychiatry P 7.

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1. True - Leukoariosis was used by Hachinski to describe CT scan appearances of reduced density of white matter. It differs from infarcts in that it affects only white matter, is patchy and diffuse and does not result in the enlargement of cerebral sulci or ventricles.

Puri&Hall (p.410)

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2. False - major depressive disorder has been associated with hypercortisolaemia for more than 50 years. 1/4 depressed patients can be considered to be hypercortisolaemic. CRH overdrive may have a central role.

Psychiatry (continually updated textbook, p.51)

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3. False - tryptophan depletion in a treated patient may lead to recurrence of depressive symptoms.

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4. False - The blunted ACTH response to CRH and the smaller pituitary glands in people with depression could be explained by homeostatic down-regulation as a result of chronically elevated CRH secretion.

Psychiatry (p.51)

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5. False - dexamethasone non-suppression is not diagnostic of depression, merely raising possibilty of this condition. Non-suppression is also present in other conditions, including Cushing's disease.

Psychiatry (p.52)

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6. True - TCAs can be used as maintenance treatment in elderly people who are depressed. It is not contraindicated, though care must be taken with regard to cardiac and antimuscarinic side-effects.

BNF

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7. False - I believe the action on sleep of SSRIs is likely to be mediated via 5HT7 receptors which are important in depression and circadian functions.

5HT2a receptors are excitatory, found in the cortex and are associated with sensory perception.

Fundamentals of Clinical Psychopharmacology (p.22)

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8. True - sleep-walking can be seen in depression. The 2 are not mutually exclusive.

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9. False - the difference in scores between BDI and HAM-D are due to the way they are conducted (self-rating v. observer-rated) as well as different symptom emphasis and scoring systems.

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10. and 11. both True - depression is more common in homosexual compared to heterosexual population and this is not simply accounted for by stigma etc.

healthyplace.com

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SSRI inhibit the reuptake of 5-HT. They do not act on any 5-HT receptors.

5HT1A - autoreceptors

5HT2 - insomnia, agitation and sexual dysfn.

5HT3 - nausea, headaches

7. SSRIs cause their effect on sleep by acting on 5HT2A receptors - True

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