Mood disorders Flashcards
general characteristics of mood disorders
- disturbances in emotion
- assoc with panic attacks, subs abuse, sexual dysfunction, personality disorders
- co-morbidity increases severity + increases poor prognosis
signs + symptoms of depression
- emotional state marked by great sadness and feelings of worthlessness + guilt
- withdrawal from others, loss of sleep, appetite, sexual desire, loss of interest and pleasure in unusual activities
symptoms of depression across the lifespan
children: more somatic complaints
older adults: distractability, mem loss
symptoms vary across cultures
canada: emphasize somatic symptoms rather than emotional
- hard to have convos, neglect hygiene + appearance
length of depressive episodes
- recurrent, may dissipate with time
- if untreated, stretches for longer
- chronic? no snap-back to earlier functioning
what is mania
emotional state or mood of intense but unfounded elation accompanied by irritability, hyperactivity, talkativeness, flight of ideas, distractibility and impractical, grandiose plans
- sudden
- lasts days to months
two major mood disorders in DSM
major depressive disorder (bereavement exclusion dropped) bipolar disorder (bridge btw schizo + unipolar depression)
other mood disorders?
disruptive mood dysregulation disorder + Premenstrual dysphoric disorder.
DSM criteria for diagnosis of depression
5+ symptoms for at least 2 weeks
- Must have depressed mood or loss of interest/pleasure
a. sad,depressed mood
b. loss of interest/pleasure
c. difficulty sleeping
d. lethargic, shift in activity level
e. poor appetite + weight loss or increase both
f. loss of energy, fatigue
g. negative self-concept, worthlessness + guilt
h. difficulty concentrating
i. recurrent thoughts of death or suicide.
diagnosis of depression - controversy
- categorical (y/n), but dsm-5 incorporates dimensional ratings
- is 5 symptoms in 2-weeks distinctly different from 3 symptoms for 10 days.
is depression a category or continuum?
research suggests continuum
- diagnostic criteria = severe end of continuum.
- in children, continuum
- in adults, categorical evidence
prevalence of depression
- 2-17.1%: lifetime prevalence
- 2x more common in W >M
- gender gap emerges at age 14, maintained across the lifespan
- higher among younger than older persons
persistent depressive disorder
combining chronic depression + dysthymia
- lifetime prevalence of chronic depression lasting at least 2 years was 4.6% (co-morbid diagnosis, younger AoO, history of more frequent episodes of depression
financial cost of depression
- leading cause of disability-adjusted life years
- effects on work performance: 27 days off (uni), 65 days off (bipolar)
- 2.6 bill lost in 1998
DSM definition of bipolar disorder
episodes of mania or mixed episodes that include symptoms of both mania and depression.
- formal diagnosis requires the presence of elevated or irritable mood + abnormally + persistently increased goal-directed activity
symptoms of manic episode
- impair social + occupational functioning
- increase in goal-directed activity
- more talkative
- flight of ideas, subjective impression
- less than usual sleep
- inflated self-esteem
- distractibility
- excessive involvement in pleasurable activities
prevalence of bipolar disorder
- less often than mdd (uni)
- 4.4%
- onset: 20’s
- occurs equally in M+W
- tends to recur: 50% have recurrence in 12 months, 50% 4+ episodes
violent behaviours + bipolar disorder
– symptoms
- violence can occur during severe manic episodes
- lose insight into condition + can result in difficulties, subs abuse, marital/occupational failure
co-morbidity of bipolar disorder
anxiety - great impact on quality of life
- personality disorders predict poor outcome
heterogeneity in mood disorders
- problem in classification
- - diff symptoms btw ppl, mixed episode = full range in one day
bipolar II disorder
episodes of major depression accompanied by hypomania
- less extreme than full-blown mania
mood disorders with psychosis
- may be subject to delusions + hallucinations
- more severe than depression without delusions : more social impairment + less time between episodes
- delusion + depression wont respond to anti-D. other psycho-meds
what are melancholic features of heterogeneity?
- no pleasure in activity, unable to feel better temporarily when something good happens
- depressed mood is worse in the morning
- awaken about two hours too early, lose appetite + weight, lethargic or agitated
what is seasonal affective disorder?
seasonal if there is a regular relationship between an episode + particular time of the year
- most depression in winter
- linked to decrease in number of daylight hours
- detected in 11% of ppl diagnosed with depression
- inuit have high prevalence, icelanders have low