Mood Disorders New

8/21/2019 Mood Disorders New

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Mood Disorders

Presentation By: Jessie Nilson


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Mood Episodes• Building blocks of mood

disorders

• Not diagnosable

• Helps in understanding

mood disorders

• Manic episode

• Mood is persistently

elevated, irritable, andexpansive.

• Leads to impaired

functioning.

At least 3 of te follo!ing

"ressured speec, psycomotoragitation, fligt of

ideas, decreasedneed for sleep,increased

involvement in goalorientated activities,distractibility,inflated self#esteem,

grandiosity.

Hig risk activities

Lasting at least $ !eek.


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Mood Episodes• Hypomanic episode

• %imilar to manic

• symptoms are less severe but still interfere !it

functioning.• distinct period of

persistently expansive,

irritable, elevated mood

• Lasting at least & days butless tan $ !eek.

• At least 3 of te follo!ing

• "ressured speec

'ncreased goal#oriented

activities

"sycomotor agitation

(istractibility

(ecreased need for sleep

)randiosity

*isk taking


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Mood Episodes

•

Ma+or (epressive pisode• (epressed mood - !eeks

• r loss of pleasure

• At least &, - !eeks• %leep disturbance

• Appetite disturbance

• /atigue

• "sycomotor activity

cange

• 0oncentration issues

• 1ortlessness

• )uilt

• %uicide ideation

•

'rritable mood

Mixed episodeAlternating sadness,

irritability, and euporia

Lasts at least $ !eek

Meet criteria for manic and

depressive episodes


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Depressive Disorders

•A2A unipolar disorders

•"revalence

•-#4 of cildren

•-54 of tose over 5

•$6#-54 of adults

•0ommon cold of MH

•

(epressive (isorders•Ma+or (epressive (isorder

•(stymic disorder

(epressive (isorder Notter!ise %pecified

1orld Healt rgani7ation8

$-6 million ppl depressive

disorders9%A 36 million ppl

$4 !ill ave

Less tan -54 ave proper

access to care.

56#:64 go undiagnosed

;64 !ill relapse


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•

-ere as never been a Manic pisode, a Mixed

pisode, or a Hypomanic pisode, Note8 >is

exclusion does not apply if all of te manic#like ,mixed#like, or ypomanic#like episodes are substance

or treatment induced or a re due to te direct

pysiological effects of a general medical condition.


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• -ere as never been a Manic pisode, a Mixedpisode, or a Hypomanic pisode, Note8 (oes not

apply if episodes are substance or treatment induced or a

re due to te direct pysiological effects of a general

medical condition.


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• Ma+or (epressive (isorder

@ (epressed mood most of te

day nearly everyday

@ Must effect social,occupational, educational, or

oter important functioning.

@ *isk factors

Biological relative !o asdepression.

%tressful early life

>raumatic events


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•

366.& (ystymic (isorder A= (epressed Mood most of te day, more days tan not for at

least - years.

B= >!o ?or more= of te follo!ing8 appetite disturbance, sleep

disturbance, fatigue, lo! self#esteem, poor concentration ordifficulty making decisions, and opelessness

0= never !itout te symptoms for more tan - monts at a time.

(= No Ma+or (epressive pisode during te - years= No Manic, Mixed, or Hypomanic. No 0yclotymic (isorder.

/= No %ci7oprenia or (elusional (isorder.

)= %ignificant distress in social, occupation, etc. functioning


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•

(ystymic (isorder • 0ronic course

• >ougt not as severe,

same conseuences.

• 0an occur in cildren

• differs from adults

• Mood is often irritable

•

Agitation, pessimism,lo! self#esteem.

• (uration of $ year

• 'mpaired scool and

social functioning.

(iagnosis can cange toma+or depressive

disorder.

(ouble depression8 full

criteria for (ystymic(isorder C later meets

te criteria for Ma+or

depressive disorder.

Dmood disorder tat can

act like personality

disorderE


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•

(epressive (isorder N%• "remenstrual dysporic disorder8 most menstrual cycles8

depressed mood, anxiety, affective lability, decreased interest

in activities. %tops by onset of menses. absent $ !eek

• Minor depressive disorder8 episodes of at least - !eeks ofdepressive symptoms, less tan te five M(( symptoms

• *ecurrent brief depressive disorder8 depressive episodes from- days to - !eeks, at least once a mont for $- monts.

• "ostpsycotic depressive disorder of %ci7oprenia8 occurs in

residual pase of %ci7oprenia

• (uring (elusional (isorder, "sycotic (isorder N%, oractive pase of %ci7oprenia


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•

(epressive (isorder Notter!ise %pecified

• %ymptoms interfere !it

functioning

• (oes not meed criteria foroter disorders

• 0aracteri7ed by lo! mood,

lo! self#esteem, loose of

pleasure in activities

• Not related to medical

condition or substance abuse


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Bipolar Disorders•

A2A manic depression. bipolar affective disorder

•severe recurrent

•

mood s!itces fromdepression to mania

•"revalence

•3#54 of 9.%. "opulation

•suicide rate 6 times

iger tan general

population

Hig ospitali7ation,comorbidity, disability,

morbidity

*isk takingMa+ority are unable to

maintain long term

remission.

!it good medmaintenance ;54

!ill relapse !itin

5 years

Bipolar Disorders


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Bipolar Disorders

• *esponsible for 5#$54 of

ne! C longer psyciatricospitali7ation

• Must ave manic symptom?s=

•

ven if client presents onlymanic assumed depression

!ill follo!.

• (epressive pase

indistinguisable from M((.

• (epression is leading cause

of impairment and deat.

Bipolar disorders

includeBipolar '

Bipolar ''

0yclotymia

Bipolar disorder

not oter!ise

specified


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Bipolar Disorders

• -


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Bipolar Disorders

•

-


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Bipolar Disorders

•

-ere as never been a Manic or Mixed.

(= %ymptoms not accounted for by %ci7oaffective

(isorder ,%ci7oprenia, %ci7opreniform (isorder,(elusional (isorder, or "sycotic (isorder N%

= >e symptoms cause clinically significant distress or

impairment in social occupational.


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Bipolar Disorders• Bipolar '' (isorder

• Manic or Mixed pisode rules out

tis disorder

• "resence of a Hypomanic pisode

defferinates bet!een te t!o

conditions.

• %ymptoms must cause impairment

• %ometimes ypomanic symptoms

may not cause impairment• More common in !omen

• 1omen !it te disorder are at riskfor developing episodes during

postpartum.


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Bipolar Disorders

•

36$.$3 0yclotymic (isorder A= /or at least - years, te presence of numerous periods of

ypomanic symptoms C periods !it depressive symptoms.

B= not !itout symptoms for more tan - monts at a time.

0= No Ma+or (epressive pisode, Manic pisode, or Mixedpisode during te - years.

(= >e symptoms are not accounted for by %ci7oaffective

(isorder, %ci7oprenia, %ci7opreniform (isorder, (elusional(isorder, or "sycotic (isorder N%.

= not due to substance use or medical condition.

/= >e symptoms cause clinically significant distress.


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Bipolar Disorders

• 0yclotymic (isorder

• Milder symptoms

• 0onsidered a cronic

condition• %ymptoms more

consistent

• 0lients !it only

depressive symptomssould not be

diagnosed !it

0yclotymic (isorder.


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Bipolar Disorders• Bipolar (isorder Not ter!ise %pecified

• (isorders !it bipolar features not meeting criteria

xamples8

$. *apid alternation ?over days= bet!een manic and depressivesymptoms tat meet symptom criteria but not minimal duration

for Manic, Hympmanic or Ma+or (epressive pisodes.

-. *ecurrent Hypomanic pisodes !itout depressive symptoms.

3. A Manic or Mixed pisode superimposed on (elusional(isorder, residual %ci7oprenia, or "sycotic (isorder N%.

&. Hypomanic pisodes, along !it cronic depressivesymptoms, tat are too infreuent for 0yclotymic (isorder

5. 1en te clinician believes Bipolar (isorder is present but isunable to determine rule out medical condition or substance.


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Rapid Assessment Instruments

Beck (epression 'nventory #''?B('#''=

By Arron >. Beck, *obert

A. %teer, )regory 2. Bro!n

"ublised by "earson

5 mins to administer

%elf report

Ages $3#:6nglis and %panis

assesses depression

-$ items

Asks about symptomsover last t!o !eeks as

in (%M#'

%coring

6#$3 minimal

$$< mild

-6#-: moderate

-


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>e Mood (isorder Juestionnaire

By Hirscfeld, 1illiams, %pit7er, 0alabrese,et al. ?-666=

$3#item cecklistdesigned to elp determine if a client is likely

to ave B(.

%creening instrument

)ood sensitivity and specificity

0orrectly identify ; out of $6 patients !it B(

< of $6 !itout B( !ill be correctly screenedout.


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Semantic Deferential Feelings and MoodScales (SDFMS)

Maurice Lorr and Richard !underlichMeasures mood states

"# items $n a one%to%fi&e scale 'hich mood is

closer as fi&e factors elated%de*ressed+ Brela,ed - an,ious+ . confident% unsure+

D energetic - fatigued+ / 0 goodnatured% grouchy

Relia1ility coefficients of 234


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Beck Hopelessness %caleBy Aaron Beck

"ublised by "earson

5#$6 mins to administer

Ages $;#:6 years

nglis or %panis

predicts eventual suicide

measures tree ma+or aspects

of opelessness8 feelings

about te future, loss of

motivation, and expectations.

%elf# report measure

-6 true or false items

%coring

verlay

6#3 normal

: mild


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Beck %cale for %ucide 'deation ?B%%=

By Aaron Beck

"ublised by "earson

5#$6 mins to complete

%elf#report

/or $; years and older

nglis and %panis

patientKs suicidal intent/ive %creening 'tems, -$ >est 'tems

/ive screening items reduce te lengt and te

intrusiveness for patients !o are nonsuicidal.

Date post:	07-Aug-2018
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