Chapter 7 Mood Disorders

Question 1

What are the 2 key moods involved?

Answer 1

Depression: Feelings of extraordinary sadness and dejection
Mania: Intense and unrealistic feelings of euphoria and excitement

Question 2

What is a mixed episode?

Answer 2

When the person has symptoms of mania and depression in the same time period, and experiences rapidly alternating moods all within the same episode of illness

Question 3

Describe a depressive episode

Answer 3

Markedly depressed mood
Loss of interest in formerly pleasurable things
Must last for at least 2 weeks
Feelings of worthlessness

Question 4

Describe a manic episode

Answer 4

Markedly expansive/euphoric/elevated mood, often interrupted by occasional outbursts of irritability or even violence, when others refuse to go according to their wishes

Lasts for at least 1 week

Must show 3 or more of such symptoms in the same period;

• Behavioural: Goal-directed activity increases
• Mental: Grossly inflated sense of self-esteem, might speed up mental activity
• Physical: Decreased need for sleep or psychomotor agitation

Question 5

Describe hypomania.

Answer 5

Person experiences abnormally elevated, expansive or irritable mood for at least 4 days.
Must have also 3 other symptoms as stated above but to a lesser degree.
Much less impairment in social and occupational functioning.

Question 6

List the DSM-5 Criteria for a Manic Episode

Answer 6

Distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day for any duration if hospitalization is necessary

During the period of mood disturbance and increased energy or activity, 3 (or more) of the following symptoms (4 if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behaviour

Inflated self-esteem or grandiosity

Decreased need for sleep (eg feeling rested after only 3 hours of sleep)

More talkative than usual or pressure to keep talking

Flight of ideas or subjective experience that thoughts are racing

Distractibility, as reported or observed

Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (ie purposeless non-goal directed activity)

Excessive involvement in activities that have a high potential for painful consequences (eg engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

The episode is not attributable to the physiological effects of a substance (eg a drug of abuse, a medication, other treatment) or to another medical condition.

Note: A full manic episode that emerges during antidepressant treatment (eg: medication, electroconvulsive therapy) but persists at a fully syndromal level beyond the physiological effect of that treatment is sufficient evidence for a manic episode and therefore a bipolar 1 diagnosis.

Note: Criteria 1 - 4 constitute a manic episode, At least one lifetime manic episode is required for the diagnosis of bipolar 1 disorder.