Mood Disorders Flashcards
Mood disorders
- a serious disturbance in mood or internal state
- mood is doctored or inconsistent with everyday functioning and interferes with it
2 categories of mood disorders
- depressive disorders
2. bipolar and related disorders
criteria for major depressive episode
- 5+ symptoms in the same 2 week period
- sleep: insomnia or hypersomnia
- anhedonia
- guilt
- fatigue
- decreased concentration
- weight change
- psychomotor retardation or agitation
- suicidal thoughts
Major Depressive Disorder (MDD)
- presence of a major depressive episode
- not better explained by another diagnosis
- no history of mania/hypomania/mixed episode
- significant distress to daily life
average onset mid 20s
often comorbid with anxiety
Disruptive Mood Dysregulation Disorder
Children between 6-18yrs (onset before 10yrs)
•Persistent irritability and frequent episodes of out of control behavior
•Added to address concerns that bipolar was being over diagnosed
Persistent Depressive Disorder
Dysthymia (mild symptoms but longer period of time -2 yrs)
Includes chronic major depression
Premenstrual Dysphoric Disorder
more severe form of premenstrual syndrome (PMS)
other depressive disorders
Substance/Medication Induced depressive disorder
depressive disorder due to another medical condition
other specified or unspecified depressive disorder
Bipolar I Disorder
manic-depressive disorder that can exist both with and without psychotic features
Bipolar II Disorder
Depressive and manic episodes which alternate, are typically less severe, and do not inhibit function
Cyclothymic Disorder
Cyclic disorder that causes brief episodes of hypomania and depression that are recurrent >2 years but not severe to meet other criteria
other bipolar disorders
Substance/Medication-Induced Bipolar and Related Disorder •Bipolar and Related Disorder Due to Another Medical Condition •Other Specified Bipolar and Related Disorder •Unspecified Bipolar and Related Disorder
Manic episode
- Elevated (or irritable) mood for >1 week for most of the day 3+ of: - Grandiosity - Decreased need for sleep - Pressured speech - Flight of ideas, racing thoughts - Distractibility - Increased goal-directed activity - Excessive involvement in pleasurable activities with high risk
Bipolar I Disorder criteria
- ***more severe
- 1+ manic or mixed episode lasting at least a week OR mania so severe it requires hospitalization
- no need for prior depressive episode
Bipolar II Disorder criteria
- 1+ hypomanic episode
- 1+ previous major depressive episode
- less severe, but more difficult to diagnose
Assessment and Evaluation
- intensity, severity, and duration of symptoms are obtained by observation, interview, and history
- life events inventory can be helpful to identify triggering/significant events
- mania easily observed
Scales
- Beck Depression Inventory-II (BDI-II)
- Geriatric Depression Scale
- Patient Health Questionnaire (PHQ-2, PHQ-9)
- Mini Mental Status Exam (MSE)
- Self-Rating Scales
- OT Interview and Occupational Profile - Occupational Performance History Interview-2 (OPHI-2, COPM)
Interventions - psychopharmacology
Antidepressants
•Selective Serotonin Reuptake Inhibitors (SSRIs) •Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
Mood Stabilizers
•Used to treat hypomanic and manic episodes
Antipsychotics
•Lithium is the most used to treat bipolar disorder when mood stabilizers are not effective
Interventions - non pharmacological
Psychotherapy
Cognitive-Behavioral Therapy (CBT)
•Focuses on the identification and management of negative thoughts, beliefs, and behaviors
Interpersonal Psychotherapy (IPT) •Learn to improve relationships with others by accurately communicating their feelings
Brain stimulation techniques
- Transcranial Magnetic Stimulation (TMS)
- Electroconvulsive Therapy (ECT)
- Deep Brain Stimulation
