DSM5 - Mood disorder Flashcards
DSM criteria for Bipolar I
Required - one or more manic episodes that lasts 1 week or requires hospitalisation
Optional - minor or major depressive episodes
Optional - Hypomania
Mood disturbance sufficiently severe to cause marked impairment to social, relational, and/or occupational functioning
Bipolar II criteria
Required - One or more major depressive episodes last 2 weeks.
Required - One or more hypomanic episodes lasting 4 consecutive days and present most of the day, nearly every day
Never - Manic episode
Significant impairment in ROSE.
Cyclothymic criteria
Duration: 2 years adult and 1 year child and not without symptoms for greater than 2 months at a time
Sub-clinical hypomanic symptoms
Sub-clinical depressive symptoms
No full hypomanic or major Depressive episodes
Substance-induced Bipolar and related disorders
Observable and long term disturbance of mood resulting in elevated, expansive, or irritable mood.
depression may or may not be present
Behavior may develop due to withdrawal
Diminished interest in activities
Impairment of ROSE - Relational, Occupational, Social and Educational functioning
Bipolar and related disorders due to another medical condition.
A differential diagnosis that requires the presence of a medical condition which is the cause of the mood episodes.
Specifiers for mood disorders
Tim related
Current or most recent episode
Manic (mild, moderate, or severe if criteria for Manic are met) add with psychotic features if applicable
Current or most recent hypomanic
Current or most recent depressed (mild, moderate, or severe if criteria for major depression are met) add with psychotic features if applicable
In partial remission (some but not all cirterea are met OR less than 2 months have passed)
Full remission (2 months or more have passed since symptoms were present)
Specifiers for Bipolar disorders and mood disorders
Mood modifiers
With mood-congruent psychotic features
With mood-incongruent features
With rapid cycling
With mixed features
With melancholic features
With catatonia
With atypical features
With peripartum onset
With seasonal pattern
With anxious distress (mild, moderate, severe)
What is a Manic episode?
A period of high energy, elevated, expansive or irritable mood.
Symptoms (3 or more) are present and represent a notable change from usual behaviour:
rapid talking,
needs less sleep
high-risk behaviour,
inflated self-esteem, grandiosity
increase in activities
easily distracted
racing thoughts;
episode is severe enough to cause serious impairment in functioning; hospitalization may be required, and psychotic symptoms may be present;
Duration - must last at least one week.
What is a Hypomanic episode?
Same symptoms as manic, but hypomanic episode is NOT severe enough to cause serious impairment in functioning.
Duration: must last at least four days.
What is a major depressive episode?
When does it become a disorder?
A period of low energy, with symptoms including:
depressed mood most of the time
loss of pleasure in activities
weight loss
sleep issues
fatigue
difficulty thinking or concentrating,
feeling worthless
thoughts of death or suicidal ideation, and purposeless motions;
Duration must last at least two weeks. Most day most of the day.
For MDD - 5 or more symptoms must be present during the same 2-week period. Must include depressed mood or loss in pleasure.
Hypomanic and depressive symptoms vs episodes
Symptoms are not distinct episodes; the individual has some symptoms of hypomania and depression but does NOT meet the full criteria (ex. duration, severity, number of symptoms) for them to be considered as actual hypomanic or major depressive episodes.
Assessment tools for Bipolar/Mood disorders
Structured clinical interview of DSM-5-Clinical version - (Diagnostic tool)
Mood disorder questionnaire (screening)
Hypomania checklist (screening)
Beck depression inventory
Beck-Rafaelson Mania Rating Scale
Hamilton rating scale for depression
Mood disorders most common treatment?
CBT
Family psychoeducation
Interpersonal therapy
Differentials to Bipolar?
BP and related disorder due to another medical condition
Medicine induced bipolar and related disorder.
Major depressive disorder
Panic disorder and other anxiety disorders
Psychotic disorder
personality disorder
cyclothymic disorder
ADHD
Dysthymic disorder
Dysthymic Disorder/PDD
Dysthymic Disorder is an older term that is now referred to as Persistent Depressive Disorder (PDD) in the DSM-5-TR. It is characterized by a chronic form of depression that is less severe than major depressive disorder (MDD) but persists for a much longer period.
