Mood disorders: group of disorders involving serve and enduring disturbances in
emotionality ranging from elation to severe depression. Occurs in the absence of a
clearly identifiable trigger
Two extreme poles: extreme dysphoria (MDE) or extreme euphoria (ME)
Unipolar mood disorder (depression or mania – one extreme) vs bipolar mood
disorder (depression and mania – both extremes)
If feelings are abnormally prolonged or the persons daily functioning is impaired à
diagnoses is made
Duration of symptoms
Major depression – two weeks
Dysthymic disorder – two years
Bipolar disorder – one week
Cyclothymia – two years
History of mood disorders
Greeks à “melancholia” & “mania”
The term “depression” replaced “melancholia”
Bipolar used to be called Manic-depressive disorder
Karl Leonhard proposed the subclassification of bipolar disorders
Concepts:
Emotion à complex psychophysiological process
Feeling à conveys information about situations on both conscious and subconscious
levels
Affect à scientific term used to describe someone’s mood as displayed in their
behavioural response
Mood à sustained emotional states
Clinical episodes:
Depressive episode:
Morbid or pathological expression of depression, including depressed mood,
anhedonia, feelings of guilt and worthlessness, disturbances to sleep and appetite,
poor concentration or indecision and thoughts around death, suicide à at least two
weeks
Central indicators à neurovegetative symptoms along with behavioural and
emotional shutdown
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Manic episode:
Period of abnormally elevated, or irritable mood that may include inflated self-
esteem, decreased need to sleep, pressured speech/talk, flight of ideas,
agitation or self-destructive behaviour and may be accompanied by psychotic
symptoms à at least one week
Mixed episode:
Condition in which the individual experiences both elation and depression or anxiety
at the same time (also known as dysphoric manic episode) à one week
“mixed features” à term for a mood episode with some elements reflecting the
opposite valence of mood
Hypomanic episode:
Attenuated form of mania but less severe symptoms and less disruption but causes
a change in functioning uncharacteristic of the person (observable by others),
occurring for at least four days (defined bipolar II and cyclothymic disorders)
Mood disorder involving one or more major depressive episodes (separated by
periods of remission), recurrent episodes more common.
Onset = mean age of 30
Specifiers (extra info about symptoms):
1. Psychotic features (hallucinations and delusions)
2. Anxious distress (anxiety that meets the criteria for anxiety disorder)
3. Mixed features
4. Melancholic features (somatic symptoms)
5. Catatonic features (disturbance in motor behaviour – catalepsy)
6. Atypical features (symptoms that deviate from those typical of depression)
7. Peri-partum onset (period of time before and after giving birth)
8. Seasonal pattern (seasonal affective disorder)
Grief (major depression occurs as part of grieving process):
1. Acute grief à immediately after loss
2. Integrated grief à evolves from acute grief to acceptance and adjustment
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