Mood Disorders

1. Major Depressive Disorder

   Annotations:

   •  15% die suicide
   1. Diagnostic Criteria

      Annotations:

      • Single episode of Major Depression Alteration in sleep, appetite, energy
      • 5 symptoms for 2 weeks 1 must be depressed mood or loss of interest and pleasure Sleep/Guilt/Energy/Concentration/appetite/Psychomotor/suicidality
      • Untreated Episodes: 6-12 months
   2. Epidemiology

      Annotations:

      • PR 5-20% Female-Male 2:1 IR 20-40  Decreases above 65
   3. Etiology

      Annotations:

      • Genetic/Personal Experience Deficiency in: NE - Alertness and enegry Serotonin - mood and imulse Dopamine - drive and motivation
      • Neuro-endocrine link Hypothalamic-Pituitary-Adrenal axis
      • Anti-hypertensives Cortisone Analgesics Hormones
      • Brain Tumors CVA High Potassium, Sodium Bicarb Calcium Low Vitamines B1,B6, C, D, Folic Acid
      1. Beck

         Annotations:

         • Pessimistic Views
      2. Hopelessness Theory
2. Persistent Depressive Disorder
3. Dysthymic Disorder

   Annotations:

   • Mild/Chronic MDD PR: 6% 2 years of chronically depressed mood
   1. Diagnostic Criteria

      Annotations:

      • Sleep Appetite Energy Concentration and Hopelessness Major Depressive Episodes may co-occur --> Double Depression

1. Bipolar 1

   Annotations:

   • Most serious At least 1 episode of mania and MD EPISODES
   1. Diagnostic Criteria
      1. Mania

         Annotations:

         • 3 to 4 of the below: esteem/sleep/speech/thoughts/attenntion/activity/Hedonism A week of elevated mood for one time
         • PR 0.4-1.6% Male=Female Early 20s Sleep/wake cycle
2. Bipolar 2

   Annotations:

   • PR 0.5% Women Cyclic  Suicide 15%
   1. Diagnostic Criteria

      Annotations:

      • Hypomania 3 days with 3 or 4 of the following symptoms: Grandiose-Decreased sleep-Pressured speech- Racing thoughts-Flight of ideas-easily distractible-psychomotor agitation
3. Cyclothymic
   1. Diagnostic Criteria

      Annotations:

      • Recurrent, Chronic, Mild  Hypomania and dysthymia Adolescents to early adulthood
      • PR 0.1-1% MEN=WOMEN Steroids, high dose anti-convulsants, amphetamines, narcotics
      • 1 episode of hypomania

1. Substance Induced
2. Due to a medical condition
3. Melancholic Depression

   Annotations:

   • Depression Guilt Remorse Loss of pleasure Vegetative Symptoms
4. Postpartum Depression

   Annotations:

   • 4 weeks of delivery
5. Seasonal Mood Disorders

   Annotations:

   • Depression worsen in the fall and improve in the spring and vice versa
6. Atypical

   Annotations:

   • Pattern of hyperinsomia, increased appetite and weight gain
7. Rapid Cycling

   Annotations:

   • 4 mood disturbances per year
8. Catatonic

Annotations:

• Childhood Bipolar Disorder Children up to 18 years

Annotations:

• The final week before the onset of menses, few weeks after its onset
• first 4 must be present Affective liability (swings) Irratibility Depression Anxiety

Annotations:

• Tunnel vision Constriction in their common cognitive state