Mood Disorders (from Lecture)

Question 1

What are different diagnoses of mood disorders?

Answer 1

• Major depressive disorder
• Persistent depressive disorder
• Disruptive mood dysregulation disorder

Question 2

Describe a major depressive episode

Answer 2

Five or more of following present during 2 week period
Change from previous functioning, and 1 symptom must be one of the 1st two (depressed mood or loss of interest or pleasure).

Question 3

What are symptoms of a major depressive episode?

Answer 3

-Depressed mood most of day, nearly every day
‒ Markedly decreased interest or pleasure in activities most of day, nearly
every day
‒ Insomnia or hypersomnia
‒ Psychomotor agitation or retardation
‒ Fatigue or energy loss
‒ Feelings of worthlessness or excessive guilt
‒ Decreased concentration or indecisiveness
‒ Recurrent thoughts of death
-Distress or impairment in social, occupation or other functioning

Question 4

What is the DSM-5 definition of major depressive disorder?

Answer 4

One or more instances of a major depressive episode.

Question 5

Describe persistent depressive disorder

Answer 5

• Similar features of major depressive disorder, but symptoms are less severe and chronic (at least 2 years) rather than episodic
• Periods of social withdrawal, reduced activity & productivity

Question 6

Describe a manic episode

Answer 6

Mania – abnormally elevated, expansive or irritable mood (at least 1 week’s duration, present most of day, nearly every day).

Question 7

What are symptoms of a manic episode?

Answer 7

-Inflated self esteem or grandiosity
‒ decreased need for sleep
‒ pressured speech
‒ distractibility
‒ Flight of ideas (or racing thoughts)
‒ Increased goal directed activity or psychomotor agitation
‒ involvement in high-risk activities
-Impairment in social or occupational functioning

Question 8

Describe a hypermanic episode

Answer 8

Less intense - periods of elevated, expansive or irritable mood AND elevated activity and energy levels (at least 4 consecutive days)

Question 9

What are symptoms of a hypermanic episodes?

Answer 9

‒ Inflated self esteem or grandiosity
‒ Decreased need for sleep
‒ Pressured speech
‒ Distractibility
‒ Flight of ideas (or racing thoughts)
‒ Increased goal directed activity or psychomotor agitation
‒ Involvement in high-risk activities

Question 10

What is Bipolar I?

Answer 10

The manic episode may be preceded by and followed

by hypomanic or major depressive episodes..

Question 11

What is Bipolar II?

Answer 11

• Criteria met for at least 1 hypomanic episode and at least 1 major depressive episode
• Has never been a manic episode
• Unpredictability of symptoms causes significant distress or impairment in social or occupational functioning

Question 12

Describe cyclothymic disorder?

Answer 12

At leat 2 years (1 year in children), there have been various periods of time with hypomanic symptoms (do not meet criteria for hypomanic episode) and with depressive symptoms (do not meet criteria for major depressive episode).

• For the 2 years, symptoms present at least half the time, and symptoms should not be absent for more than 2 months at a time.
• Not attributable to another condition or a substance.

Question 13

What are possible causes of mood disorders?

Answer 13

Life events – stress, abusive relationships, unemployment, significant loneliness, discrimination, early infant attachment, trauma

• Personal factors (family history, personality, substance misuse, serious illness)
• Changes in brain (i.e. serotonin, dopamine levels, excess cortisol secretion).

Question 14

What is the impact of depression on occupational performance?

Answer 14

• Feel extremely sad, anxious, agitated or tearful
• Have difficulty concentrating on simple tasks/making decisions
• Lose interest in things they usually enjoy and have no motivation
• Move and talk slowly
• Sleep poorly or sleep excessively and still feel extremely tired
• Either lose or gain weight, or lose interest in eating
• Feel hopeless, guilty and that life is not worth living - seriously contemplate suicide.

Question 15

What are examples of evidence-based therapies used for mood disorder patients?

Answer 15

• Psychoeducation
• Family focused interventions
• CBT
• Interpersonal and Social Rhythm Therapy (IPSRT)

Question 16

What does psycho education address?

Answer 16

• Taking medication
• Avoidance of substance abuse,
• Early symptom detection,
• interventions to prevent relapse,
• Facilitates individual coping strategies for illness management,
• Skills to cope with stress and interpersonal difficulties
• Decreasing stigma and increasing acceptance of illness

Question 17

What do family focused interventions focus on?

Answer 17

Aim to reduce family over-involvement and high expressed emotion (high hostility and criticism)

• Also need consistent caregiving, to establish stable routines and medication adherence
• Helps to recognise and manage stressors that trigger episodes, and re-establish family relationships.

Question 18

What does CBT focus on?

Answer 18

• Targets self-perpetuating cycle of reactions to cognitive & affective symptoms that impede functioning & exacerbate stressors
• Challenges negative self-statements, interpretations of life events & dysfunctional belief systems to help clients: recognise and respond to prodromal symptoms, maintain medication routine, make lifestyle changes, resolve and prevent psychotic problems.