Card Set Information
Mood vs. Affect
mood is defined as an internal emotional condition
affect refers to how that emotional condition is expressed
mood disorders are abnormalities of mood and affect
: mood disorders occur more frequently in single, divorced, and seperated ppl than in married ppl.
some pt's seem unaware of or may deny depression (i.e. "masked" depression) even though symptoms are present
cognitive impairment- pseudodementia
symptoms of depression in both major depressive disorder and bipolar disorder and similar.
Mania vs. Depression
Rapid, excited speech, decreased need for sleep, and feelings of self-importance(grandiosity)
depression: decreased energy, difficulty in concentrating and in sleeping, guilt, reduction in appetite, and suicidal thoughts.
altho pt's may be euphoric, excitable, and hyperactive, those experiencing a manic episode can also be irritable, angry, and hostile
in mania, mood congruent delusions include those of strength, exceptional abilties, and financial power
loosening of associations, flight of ideas, word salad, and neologisms
as a manic episode proceeds, speech becomes difficult to follow and comprehend
judgment is impaired during a manic episode laws are often broken
Nuerotransmitters and mood disorders- the activity of NE and serotonin, is altered in pt's with mood disorders
Dopamine activity may be decreased during depressive episode and increased during manic episodes
MHPG, VMA, 5-HIAA, HVA occur in the urine, blood, and CSF of many pt's with mood disorders
Ach levels may be abnormal in mood disorders
Life stressor may be related to the development of depression
the loss of a parent in the first decade of life and loss of spouse correlate with major depression.
misinterpretation of life events, low self-esteem, and loss of hope are involved in cognitive theories about the development of depression
cognitive therapy is particularly useful in treating these emotional problems
: unipolar (major depression)
: bipolar (manic-depression)
nonpsychotic depression-not severe enuff for hospitilzation
MILD DEPRESSED MOOD
loss of interest or pleasure
not severe enough for hosp.
: pt. is functional, but at a suboptimal level
chronic depressed mood for greater than/equal to 2 yrs. characterized by 2 or more of the following:
poor app. or overeating
low energy or fatigue
low self esteem
poor conc. or diff making decisions
often not recognized by the person
lifetime prevalence <1%
greater than or equal to 2 years with numerous periods of both : Dysthymic and hypomaniac symptoms
Does not meet dx criteria for bi-polar!!
Never symptom free for greater than or equal to 2 month period
never a MDE or a maniac episode
distinct period of elevated/irritable mood lasting > or = 4 days with
: greater than or equal to 3 symptoms of mania, NO MARKED DYSFUNCTION, no psychotic features.
chronic- may ultimatley have MDE or mania, which changes the diagnosis from cyclothymia to bipolar disorder (I or II)
Major Depressive Disorder
Mean age of onset= 40 years
occurs twice as often in women than in men
no correlation with social class
some evidence of genetic etiology
Mean age of onset = 30 years
occurs equally in women and men
higher incidence in upper socioeconomic groups
strong evidence of genetic etiology
Major Depressive Disorder (cont'd)
> or equal to one MDE
without the history of mania
one-half to three-fourths of patients with major depression have a second depressive episode
patients usually are mentally healthy b/w episodes of major depression
amont patients w/ major depression, an average of five or six depressive episodes commonly occur over a twenty-year period
Diagnositc criteria for an MDE
greater than or equal to 2 weeks of depressed mood or anhedonia
: greater than or equal to four-
loss of energy
decrease in conc.
: Sleep change
: Interest loss
: Energy problem
: Concentration poor
: Appetite change
: Psychomotor changes
: Suicidal ideation
First manic episode often occurs after about three episodes of depression
Manic episodes usually have a rapid onset and when untreated last about three months
Period of time b/w manic episodes becomes shorter as bipolar progresses
Period b/w episodes in bipolar illness is generally 6-9 months.
Symptoms of major depression plus symptoms of mania-
alternates b/w depression and mania
: mania more prominent
: recurrent depressive episodes plus hypomaniac episodes
: if alternates w/in 48/72 hours, called "rapid cycling bipolar disorder"
: greater than or equal to 1 manic episode
: at least one MDE and at least one hypomanic episode; NEVER a manic episode
greater than or equal to 1 week of elevated mood or irritability with greater than or equal to 3 symptoms:
inflated self-esteem (may be delusional)
decreased need for sleep
pressure of speech
flight of ideas
increased goal-directed avitivities or psychomotor acceleration
excessive involvment in pleasurable but risky axn's
Mood changes post-partum
"post-partum blues:" mild mood symptoms of short duration (<2 weeks)- this is NOT a psychiatric dx!
MDD with post-partum onset
: onset of MDE w/in 30 days after delivery.
MDD with psychotic features and post-partum onset
: onset of MDE with psychosis w/in 30 days after delivery. This is rare but serious condition associated with infanticide.
Seasonal Affective Disorder
depressive symptoms during the winter months
winter has shortest days/least amt. of light
: increased sleep, increased appetite, decreased energy
caused by abnormal melatonin metabolism; SAD related to seasonal depletion of light
treat with bright light therapy(phototherapy); (1-2 hrs/day) to suppress release of melatonin. Symptoms respond in 3-4 days
: not melatonin tablets