Mood Disorders Flashcards
1
Q
Mood Disorders
A
A category of disorders that causes a significant change in a person’s mood and is not due:
- to any current problem in mental or physical status
- or problems with medication
- or pre-existing psychiatric disorders.
2
Q
Moods
Classified by?
Three Types?
Episodes:
How many symptoms?
How long?
Functioning?
A
Classified by episodes
Any period of time when a person feels unusually happy or unusually sad
3 kinds
- Major Depressive episode
- Manic episode
- Hypomanic episode
Episode
- 5 symptoms
- 2 weeks
- Decrease functioning
3
Q
Manic Episode Summary
A
- period of 1 week
- Mood: euphoric, excessively cheerful, high, or “feeling on top of the world”
- 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 or to another medical condition
- During a manic episode, individuals often do not perceive that they are ill or in need of treatment and resist efforts to be treated
4
Q
Hypomanic Episode
A
- lasting at least 4 consecutive days and present most of the day, nearly everyday
- The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.
- The disturbance in mood and the change in functioning are observable by others.
- The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization
- Episode not attrituable to physiological effects of substance
5
Q
Major Depressive Episode
A
- Five or more of the following symptoms present during the same 2-week period
- The symptoms cause significantly significant distress or impairment in social, occupational, or other important areas of functioning
- The episode is not attributable to the physiological effects of a substance or other medical condition
6
Q
Major Depressive Episode Symptoms
A
- Depressed mood – most of the day, nearly every day, as indicated by either subjective report or observation made by others
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly everyday
- Significant weight loss (not dieting) or weight gain, or decrease in appetite nearly everyday (change of more than 5% of body weight in a month
- Insomnia or hypersomnia nearly everyday
- Fatigue or loss of energy everyday
- Psychomotor agitation or retardation nearly everyday Feelings of worthlessness or inappropriate guilt nearly everyday
- Diminished ability to think or concentrate or indecisiveness nearly everyday
- Recurrent thoughts of death (not just fear of dying),
- recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
7
Q
Bipolar I Disorder
A
- Criteria have been met for at least one manic episode
- The occurrence of the manic and depressive episode(s) is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder
*
8
Q
Bipolar I Development and Course
A
- LifetimeMale-Femaleprevalenceratio: 1.1:1
- Mean age of onset for manic, hypomanic, or major depressive episode: 18 yrs. for Bipolar I
- More than 90%of individuals who have a single manic episode go on to have recurrent mood episodes
- 60% of manic episodes occur immediately before a major depressive episode
*
9
Q
Bipolar I Risk and Prognostic Factors
A
- Environmental
- High-income (1.4 vs. 0.7%)
- Separated, divorced, or widowed individuals
- Genetic and physiological
- Family history
- Course modifiers
- Initial manic episode with psychotic features
- Inter-episodes
- Culture-Related Diagnostic Issues
- Little information exist on cultural differences
- Gender-Related Diagnostic Issues
- Females
- rapid cycling and mixed states
- Different comorbidities
- > rates of eating disorders
- > depressive symptoms (Bipolar I or II)
- > lifetime risk of alcohol use disorder
- Females
- Suicide Risk: 15 x the general population
- Functional Consequences of Bipolar I disorder
- 30% with severe impairment in work function
- Perform more poorly on cognitive test
10
Q
Bipolar II Disorder
A
- Criteria have been met for at least one hypomanic episode and at least one major depressive episode
- There has never been a manic episode
- Is not better explained by another disorder
- Causes clinically significant distress or impairment in social, occupational, or other important functional areas.
- Diagnostic Features: characterized by a clinical course of recurring mood episodes consisting of one or more major depressive episodes and at least one hypomanic episode
- Major depressive episode must last at least 2 weeks, and the hypomanic episode must last at least 4 days
- Individuals with bipolar II typically present to a clinician during a major depressive episode and are unlikely to complain initially of hypomania
11
Q
Bipolar II Disorder Associated Features
A
- Prevalence
- 12 month prevalence internationally, 0.3%; US 0.8%
- Development and course
- Average age of onset = mid-20s
- Approximately 5 – 15% have multiple mood episodes within pervious 12 months
- Risk and Prognostic Factors
- Gender-Related Diagnostic Issues
- Suicide Risk: 1/3 report lifetime history of suicide attempts
- Functional Consequences
12
Q
Depressive Disorders
A
- Disruptive mood dysregulation disorder
- Major depressive disorder (including major
depressive episode)
- Persistent depressive disorder (dysthymia)
- Premenstrual dysphoric disorder
13
Q
Major Depressive Disorder
A
- Five or more of the following symptoms have been presented during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure
- Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
- Significant weight loss when not dieting or weight gain (5% of body weight in a one month period)
- Insomnia or hypersomnia nearly every day
- Psychomotor agitation or retardation nearly every day
- Fatigue or loss of energy every day
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day
- Diminished ability to think or concentrate, or indecisiveness, nearly every day
- Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide
- The symptoms cause clinically significant distress or impairment in social, occupational areas of functioning.
- The episode is not attributable to physiological effects of a substance or to another medical condition
- The occurrence not better explained
- There has never been a manic episode or hypomanic episode
14
Q
Major Depressive Disorder Associated Features:
A
- Prevalence
- 12 month prevalence in US 7%
- 18-29 yo prevalence is 3-fold higher than individuals 60 years of age
- Development and course
- US incidence peaks in 20s
- Course is variable
- Recovery typically begins within 3 months for 2 in 5 individuals
- Recovery with 1 year for 4 in 5 individuals
15
Q
Major Depressive Disorder Risk and Prognostic Factors
A
- Risk and Prognostic Factors
- Temperamental
- Environmental
- Genetic and physiological
- Culture-Related Diagnostic Issues
- Gender-Related Diagnostic Issues
- Suicide Risk: 1/3 report lifetime history of suicide attempts
- Functional Consequences
