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Mood Disorder

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Slide 1 :

Mood Disorders Theodore M. Godlaski College of Social Work University of Kentucky

Slide 2 :

Mood Disorders · Major Depressive Episode · Manic Episode · Mixed Episode · Hypomanic Episode · Major Depressive Disorder · Dysthymic Episode · Bipolar I Disorder · Bipolar II Disorder · Cyclothymic Disorder · Bipolar NOS · Mood Disorder Due to General Medical Condition · Substance-Induced Mood Disorder · Mood Disorder NOS

Slide 3 :

Major Depressive Episode A. Five or more of the following SX present during the same 2 week period & represent a change from previous functioning. AND at least one of the SX is either: 1) depressed mood or 2) loss of interest or pleasure. 1. depressed mood most of the day, nearly every day 2. markedly diminished interest or pleasure in all or almost all activities nearly every day 3. significant weight loss when not dieting 4. insomnia or hypersomnia

Slide 4 :

Slide 5 :

Major Depressive Episode 5. psychomotor agitation or retardation 6. fatigue or loss of energy 7. feelings of worthlessness or excessive or inappropriate guilt 8. diminished ability to think, to concentrate, to make decisions 9. recurrent thoughts about death B. The SX do not meet criteria for a Mixed Episode C. The SX cause clinically significant distress or impairment in social, occupational, or other areas of functioning. D. The SX are not due to physiological effects of a substance or general medical condition. E. The SX are not better accounted for by Bereavement (SX continue longer than 2 months, etc)

Slide 6 :

Major Depressive Disorder Characterized by one or more major depressive episodes without a manic or hypomanic episode. With multiple episodes, must be at least 2 months between. Can be mild, moderate, severe without psychotic features, severe with psychotic features (either mood congruent or mood incongruent). The actual diagnosis for an episode is Major Depressive Disorder, Single Episode. For two or more episodes it is Major Depressive Disorder, Multiple Episodes.

Slide 7 :

Major Depressive Disorder 15% of those with HX of MDD die by suicide. Lifetime risk in women is 25% Lifetime risk for men is 12% 60% of those with MDD may experience complete end of the disorder after TX. Other data suggests that among those who do not meet MDD criteria, 20% have depressive SX, just not the full disorder.

Slide 8 :

Major Depressive Disorder 40% still have SX one year later. Other studies suggest that 50 – 60% have a recurrence of MDD within two years (even with aggressive TX). Individuals with one episode have a 50% chance of a second, after the second, chances for a third increase to 70%, a third episode increases the chances of subsequent episodes to 90%. There is a high degree of co-occurrence with alcohol abuse and dependence.

Slide 9 :

Dysthymic Disorder A. Depressed mood for most of the day, for more days than not as indicated by subjective account or observation by others for at least 2 years. B. Presence, while depressed of 2 or more of the following: 1. Poor appetite or overeating 2. Insomnia or hypersomnia 3. Low energy or fatigue 4. Low self-esteem 5. Poor concentration or difficulty making decisions 6. Feelings of hopelessness

Slide 10 :

Dysthymic Disorder C. During the 2-year period (1 year for children or adolescents) of the disturbance, the person has never been without the SX’s above for more than 2 months at a time. D. No MDE has been present during the first 2 years of the disturbance (1 year for children and adolescents) –i.e., it is not better accounted for by chronic MDD E. No Manic, Mixed, or Hypomanic episodes ever (has not met criteria for Cyclothymic Disorder

Slide 11 :

Dysthymic Disorder F. The disturbance does not occur exclusively during a chronic Psychotic Disorder. G. Not due to substance use, medication, or medical disorder. H. Symptoms are clinically significant and cause significant impairment or distress. You can specify “Early Onset” if onset before age 21, or “Late Onset” if after 21.

Slide 12 :

Manic Episode A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week. B. During the period of mood disturbance, 3 or more of the following have persisted (4 if the mood is only irritable) and have been present to a significant degree:

Slide 13 :

Manic Episode 1. Inflated self-esteem or grandiosity 2. Decreased need for sleep (e.g., 3 hours) 3. More talkative than usual – pressure of speech 4. Flight of ideas or subjective belief that ideas are racing 5. Distractibility 6. Increase in goal-directed activity 7. Excessive involvement in pleasurable activities that have high likelihood of negative consequences

Slide 14 :

Manic Episode C. The SX do not meet criteria for Mixed Episode D. The mood disturbance is severe enough to cause marked impairment, risk of harm, or requires hospitalization E. The SX are not due to a general medical condition or use of a substance

Slide 15 :

Mixed Episode A. The criteria are met both for a Manic Episode and MDE (except for duration) nearly every day during at least a 1-week period. B. The mood disturbance is sufficiently severe to cause marked impairment in occupational or usual social activities or relationships or to necessitate hospitalization to prevent harm to self or there are psychotic features. C. The symptoms are not due to the direct physiological effects of a substance or general medical condition.

Slide 16 :

Hypomanic Episode A. A distinct period of persistently elevated, expansive, or irritable mood, lasting at least 4 days that is clearly different from the non-depressed mood. B. During the period of mood disturbance, 3 or more of the following SX’s have persisted (4 if the mood is irritable) and have been present to a significant degree:

Slide 17 :

Hypomanic Episode 1. Inflated self-esteem or grandiosity 2. Decreased need for sleep (3 hours) 3. More talkative than usual – pressure of speech 4. Flight of ideas 5. Distractibility 6. Increase in goal-directed activity 7. Excessive pursuit of pleasurable activities

Slide 18 :

Hypomanic Episode C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic. D. The disturbance in mood and the change in functioning are observable by others. E. The episode is Not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization and there are not psychotic features. F. The SX’s are not due to the effects of a substance or a general medical condition.

Slide 19 :

Bipolar Disorder I Presence of Manic Episodes (can alternate with Hypomanic Episodes) and MDE. Most often begins with depressive episode: 67% for men, 75% for women. About 10% - 20% of individuals experience only manic episodes. Untreated, manic episodes last about 3 months. Eventual interval between manic episodes is 6 – 9 months.

Slide 20 :

Bipolar Disorder I Can be single episode or recurrent Recurrent comes in 5 types: Most recent episode hypomanic Most recent episode manic Most recent episode mixed Most recent episode depressed Most recent episode unspecified About 10% to 15% of individuals with recurrent depressive episodes will eventually have a manic episode.

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Desc : Mood Disorders related to bipolar disorders. types of disorders and changes seen in mood and someti more Mood Disorders related to bipolar disorders. types of disorders and changes seen in mood and sometimes becomes very particular. It can be dangerous sometimes too. people suffering from bipolar disorders and mood disorders often are unpredictable.- Slides less