Mood disorders Flashcards
Define mood disorders
The fundamental disturbance is a change in affect or mood to depression (with or without anxiety) or elation
Mood change is usually accompanied by a change in overall level of activity
What is the onset and course of mood disorders like?
Most of these disorders tend to be recurrent and onset of each episode is often related to stressful events/ situations
What is the prevalence of MDD and bipolar?
MDD: 10-20%, but there’s evidence it’s increasing with earlier age of onset
Bipolar I: 1%
Bipolar II: 2%
What’s the gender distribution for bipolar I, II and MDD?
Bipolar I- F=M
Bipolar II and MDD- F>M, 2:1 for MDD
What % of disability-adjusted life years (DALYs) do mental and substance abuse disorders take up?
7%
Of this, MDD accounts for 40% and bipolar for 7%
Diagram of typical cycle of low mood (unipolar and bipolar depression)
What are the DSM-5 criteria for depressive episodes?
Occurrence of 2 or more weeks of depressed mood with at least 4/8 of the following:
Lack of pleasure/ anhedonia
Low energy
Sleep changes (insomnia, hypersomnia)
Appetite changes (Increased, decreased)
Poor concentration
Psychomotor changes (agitation, retardation)
Guilt
Suicidal thoughts
What are the three core symptoms of depressive episodes?
Anhedonia, anergia, low mood
What are the 3 biological symptoms/attributes affected in depressive episodes?
Sleep, appetite, libido
What are the 3 psychological symptoms/attributes affected in a depressive episode?
Oneself
The world
The future
When is a longitudinal diagnosis of MDD formed?
If no manic/ hypomanic episodes were identified in the past, diagnosis of a current major depressive episode leads to diagnosis of MDD
What are the 3 symptom subtypes in DSM-5 for MDD?
Atypical features (which represent mainly increase in sleep and appetite, along with heightened mood reactivity)
Melancholic features (no mood reactivity, anhedonia, marked psychomotor retardation)
Psychotic features (presence of delusions/ hallucinations)
Diagram of typical cycle of high mood
What are the symptomatic criteria for manic/ hypomanic episodes?
Elated or irritable mood and at least 3/7 of the following:
Decreased need for sleep or increased energy
Distractability
Grandiosity or inflated self esteem
Flight of ideas or racing thoughts
Increased talkativeness or pressure of thoughts
Increased goal directed activities or psychomotor agitation
Impulsive behaviour (sexual impulsivity, spending spree)
What pattern of symptoms leads to a DSM-5 diagnosis of type I bipolar disorder?
If these symptoms are present for minimum 1 week with notable functional impairment, a manic episode is diagnosed, leading to diagnosis of bipolar I
What pattern of symptoms leads to a diagnosis of a hypomanic episode?
If these symptoms are present for minimum 4 days without notable functional impairment, a hypomanic episode is diagnosed
What episodes are necessary for a DSM-5 diagnosis of type II bipolar disorder to be made?
only hypomanic episodes and at least 1 major depressive episode (no manic episodes)
What’s diagnosed if manic symptoms occur for less than 4 days or specific thresholds not met for manic or hypomanic episodes?
Unspecified bipolar disorder
When can’t hypomania be diagnosed?
- If psychotic features are present since they involve notable impairment by definition
- If patient is hospitalised- it’s a manic episode not hypomanic