Mood disorders

Question 1

Define mood

Answer 1

1. Mood - conscious state of mind or predominant emotion

Question 2

Define mood disorders

Answer 2

1. Mood disorders - abnormal elevation or lowering of mood

Question 3

How common are mood disorders

Answer 3

1. Leading cause of illness worldwide
2. Globally, more than 300 million people of all ages suffer from depression (WHO)
3. Suicide is the second leading cause of death in 15-29-year-olds.(WHO)

Question 4

How are mood disorders classified

Answer 4

1. DSM-5
2. Either bipolar or unipolar
3. Bipolar
   - Bipolar 1
   - Bipolar 2
   - Cyclothymia
4. Unipolar disorder
   - Major depression
   - Dysthymic disorder
   - ‘Persistant depressive disorder ‘ (Dysthymia)
5. Premenstrual dysphoric disorder

Question 5

Define depression

Answer 5

1. an abnormal mental condition characterised by feelings of severe despondency and dejection, with feelings of inadequacy and guilt, often accompanied by lack of energy and disturbance of appetite and sleep.
2. It can be progressive and unremitting

Question 6

What are the criteria for diagnosing major depression (DSM IV)

Answer 6

1. Either Depressed mood most of the day
2. Or Diminished interest/pleasure in everyday activities (anhedonia)
3. Plus 4 or more of the following
   a) weight loss (>5% in a month)
   b) insomnia/ hypersomnia
   c) psychomotor agitation/retardation
   d) fatigue and loss of energy
   e) worthlessness/excessive guilt
   f) impaired concentration
   g) recurrent thoughts of death or suicide

Question 7

Describe symptoms of bipolar

Answer 7

1. Usually involve episodes of depression
2. alternating with mania – difficult to recognize
3. Mania- States of intense elation or irritability
4. Mixed episode- Symptoms of both mania and depression in the same week
5. Hypomania

Question 8

What are symptoms of hypomania

Answer 8

1. Symptoms of mania but less intense
2. Four or more days of elevated mood
3. Doesn’t interfere with functioning
4. Hypomania alone is not a DSM diagnostic category

Question 9

What are symptoms of a manic episode

Answer 9

1. Elevated, expansive, or irritable mood
2. PLUS 3 of the following (4 if mood is irritable):
   - Psychomotor agitation or increase in goal-directed behavior
   - Excessive talking or pressured speech
   - Flights of ideas; racing thoughts
   - Reduced need for sleep
   - Grandiosity or inflated self esteem
   - Easily distractible
   - Excessive involvement in pleasurable activities with negative consequences e.g. spending sprees

Question 10

How long do symptoms need to last

Answer 10

For manic episode:
1. Symptoms last for 1 week OR require hospitalization
2. Symptoms cause significant distress or functional impairment
For hypomanic episode:
1. Symptoms last at least 4 days
2. Clear changes in functioning but impairment is not marked

Question 11

What counts as bipolar I

Answer 11

1. At least one episode or mania or mixed episode

Question 12

What counts as bipolar II

Answer 12

1. At least one major depressive episode with at least one episode of hypomania

Question 13

What counts as cyclothymia

Answer 13

1. Milder, chronic form of bipolar disorder
2. Lasts at least 2 years
3. Numerous periods with hypomanic and depressive symptoms

Question 14

What are further subtypes of depressive mood disorders

Answer 14

1. Seasonal (SAD)- Episodes happen regularly at a particular time of year
2. Rapid cycling (Bipolar I and II)- At least 4 episodes within past year
3. Postpartum onset- Within 4 weeks of giving birth
4. Catatonic features- Extreme physical immobility or excessive peculiar physical movement
5. Psychotic features- Delusions or hallucinations
6. Melancholic - Inability to experience pleasure (anhedonia)