Mood Disorders Notes

Mood disorders

Depression / unipolar- most burdosome neuropsychiatric disorder

The two most commonly used criteria for diagnosis are the

• -DSM-5 – American psychiatric association diagnostic and statistical manual

• -ICD-10 : World Helath organisation’s international classification of diseases version 10

Major depressive disorder is characterised by a history of one or more major depressive episodes and no history of mania

• Primary feature: low mood, reduced energy, reduced enjoyment (3 cardinal symptoms)

• Secondary features: physical/ psychological/social

• Must have 5 or more symptoms persisting for at least 2 consecutive weeks

• Impairment in functioning

• Exclusions: not due to substance misuse (alcohol/drugs) or physical disorder (brain tumour, hypothyroidism) or other disorder that should feature in differential diagnosis

-Low mood + psychological symptoms

• Hopelessness, helplessness – future

• Low self esteem- present

• Guilt of past

• Reduced motivation

• Reduced interest

• Reduced enjoyment- anhedonia

• Diurnal variation in mood-in the morning it is the worst

• Early morning wakening = terminal insomnia

• Mood congruent delusions + hallucinations

• Recurrent thoughts of death or suicidal ideation, or a suicide attempt

• Decreased ability to concentrate, think, or make decisions, nearly every day

-Low mood and physical symptoms

• Reduced appetite

• Reduced weight

• Constipation

• Reduced libido

• Reduced energy

• Amenorrhoea

• Psychomotor retardation or agitation nearly every day that is observable by others

• Fatigue or low energy, nearly every day

-Low mood and social symptoms

• Social withdrawal

• Absence from work

• Reduced performance at work

• Reduced interest in hobbies or other interests

-In addition symptoms cause significant distress or psychosocial impairment

Prevalence

• 10-20% lifetime prevalence

• Major cause of mortality >40% of suicides have a depressive disorder

Aetiology

• Due to emotional weakness -71%

• Caused by bad parenting – 65%

• Result of sinful behaviour -35%

• Involves the brain- 10%

Risk factors

• Genetic

• Gender- female x2 more likely

• Childhood disadvantage

• Life events- especially loss

• Life difficulties

• Neurotic temperament

• Dysfunctional attitudes

• Chronic or severe illness

• Substance misuse

• Previous history of depression

Pathophysiology of depression

• Genetic

• Neurochemical

• Cortisol hypersecretion

• Abnormalities in neural circuitry involved in experience and mood

• Abnormal cognitions (negative emotional bias)

Treatment

• Cognitive therapy

  • Give a card with list of instructions- this is targeted at patient’s belief of treatment and illness and increases compliance and decreases helplessness. The card gives an impression of caring. RCT showing that giving a card makes more people take the drug

  • Suggest a book to read- recommend a chapter to read and come back and talk about it- encourages the participant to...

Buy the full version of these notes or essay plans and more in our Psychology Notes.