Mood Disorders Flashcards
Kraepelinian definition of manic depressive illness?
ANY recurrent mood episodes of any kind
[depressive OR manic] constituted the diagnosis of MDI. Thus, MDI meant bipolar illness plus unipolar depressive illness
mood or affective disorder?
where the fundamental disturbance is a change in affect or
mood to depression (with or without associated anxiety) or to
elation > mood change is usually accompanied by a change in the
overall level of activity
lifetime rate of major depressive disorder?
10-20%
global epidemiology of major depressive disorder
reasonably consistently documented an increasing
rate of MDD with an earlier age of onset
gender distribution of bipolar I, bipolar II, major depressive disorder
F=M - bipolar I
F>M (2:1 for MDD) bipolar II, MDD
outline typical cycle of low mood (unipolar and bipolar depression)
thoughts ‘whats the point?’ > feelings ‘low, flat, irritable’ > physiological symptoms ‘exhaustion’ > behaviours ‘lie in bed and ruminate’
ALL ARE INTERCONNECTED TOO
list DSM-5 criteria for a depressive episode
2 wks + of depressed mood AND the presence of 4 of 8 out of the following: sleep alterations, appetite alterations, anhedonia, decreased concentration, low energy, guilt, psychomotor changes (agitation or retardation), suicidal thoughts
If no manic or hypomanic episodes in the past are identified, then the diagnosis of a
current major depressive episode leads to a longitudinal diagnosis of?
major depressive disorder
list subtypes in DSM-5 for MDD
Atypical features (which represent mainly increased sleep and appetite, along with heightened mood reactivity) Melancholic features (defined by no mood reactivity, along with marked psychomotor retardation and anhedonia) Psychotic features (the presence of delusions/hallucinations).
depression triad - core symptoms
low mood
anergia
anhedonia
depression triad - psychological symptoms
the world
the future
oneself
depression triad - biological symptoms
sleep
libido
appetite
outline the typical cycle of high mood
thoughts ‘im the best’ > feelings ‘elation, excitement’ > physiological symptoms ‘^energy’ > behaviours ‘impulsive, ^activity’
ALL ARE INTERCONNECTED TOO
manic episode criteria according to DSM-5
Euphoric or irritable mood with 3 or more of 7 manic criteria: Decreased need for sleep with increased energy, Distractibility, Grandiosity or inflated self-esteem, Flight of ideas or racing thoughts, Increased talkativeness or pressured speech, Increased goal-directed activities or psychomotor agitation, Impulsive behaviour (such as sexual impulsivity or spending sprees)
how is a manic episode diagnosed according to DSM-5 criteria?
symptoms are present for minimum 1 week with notable functional
impairment
diagnosis of a manic episode leads to what diagnosis?
type I
bipolar disorder
how is a hypomanic episode diagnosed according to DSM-5 criteria?
symptoms are present for at minimum 4 days, but without notable functional
impairment
how is type II bipolar disorder diagnosed according to DSM-5 criteria?
not a single manic episode had occurred ever, but only hypomanic episodes are
present, along with at least one major depressive episode
how is unspecified bipolar disorder diagnosed according to DSM-5 criteria?
manic symptoms occur for less than 4 days, or if other specific thresholds are not met for
manic or hypomanic episodes
how can manic episodes by characterised?
by psychotic features
If psychotic features are present, then ______ cannot be diagnosed
hypomania
(since such features
involve notable impairment by definition).
If manic or hypomanic episodes are caused by antidepressants, is bipolar diagnosis still made?
yes
what are the most consistent clinical features for diagnosis of bipolar disorders?
psychomotor changes
compare the illness course of bipolar I and bipolar II
bipolar I mood swings between mania and depression
bipolar II from depression but manic episodes not like bipolar I
