co-occurrence of depression and anxiety
65-78%
how many adults are affected my mood disorders?
1 in 3 adults at some point in there life
Prevalence and recurrence of MDD
30% lifetime risk
50% have 2+ episodes (5-9 avg)
MDD prevalence in women
1.5-3x more likely
depressive symptoms in adults
- memory, personality, physical aches
- fatigue, appetite, sleep problems, loss of sex drive
- wanting to stay home
- suicidal thinking (men)
What Are The Genetic Underpinnings Of Depression?
- 35% heritable
- polygenetic
How Is Stress Associated With Depression?
underlying vulnerabilities are activated by stress
mediator
direct effects
how and why
moderator
moderated effects
when and for whom
mediators and moderators of depression
- Poor executive function
- Maladaptive beliefs and schemas (e.g., negative views of the self, world, and future)
- High negative and low positive affectivity
- Autonomic dysregulation
What is GAD?
persistent and excessive worry about a number of things
anxiety genetic risk factors
30-35% heritable
polygenetic
major enviro risk factor for anxiety
STRESS
cognitive changes in anxitey
- WM
-EF
-trait anxiety - impairments in updating WM - attention bias towards threat info
brain changes in anxiety
- limbic areas involved in processing
- prefrontal areas in executive function
- amygdala hyperactivity to threatening stimuli
How are cognition and mood linked?
low executive function -> poor emotional regulation ->increased pathology
(mediator)
Links between depression and dementia/MCI
- depression is a risk factor for dementia (2x risk)
- prolonged damage to the hippocampus due to hypercortisolemia
- shared genetic basis
treatment of depression in MCI
Selective serotonin reuptake inhibitors (SSRI)
- decrease amyloid plaque
- +4 years tx. delayed progression to AD
what is depression a marker for?
prodromal dementia
depression differential diagnosis
subacute onset
fast fam recognition
pt admits
anhedonia
thought normal
idk responses
pt is concerned
dementia differntial diagnosis
insidious onset
slow fam recognition
pt denies
no anhedonia
thought impaired
near miss responses
pt hides it
