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Mood Disorders I. Introduction II. Unipolar Depression III. Bipolar Depression IV. Theories of Mood Disorders V. Treatments for Mood Disorders
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Page 1: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Mood Disorders

I. Introduction

II. Unipolar Depression

III. Bipolar Depression

IV. Theories of Mood Disorders

V. Treatments for Mood Disorders

Page 2: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Mood Disorders/Major Affective Disorders

Bipolar Depression

Unipolar Depression

Major Depressive

Disorder

Dysthymic Disorder

Bipolar Disorder I & II

Cyclothymic Disorder

Page 3: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

II. Unipolar Depression

• Major Depressive Disorder (MDD)

• Dysthymic Disorder

Page 4: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Major Depressive Episode (5/9 for at least 2 weeks)

• Depressed mood

• Weight loss/gain

• Motor agitation or impairment

• Fatigue or loss of energy

• Feelings of worthlessness or guilt

• Change in sleep

• Concentration impairment

• Thoughts of death or suicide

• Loss of interest in previously pleasurable activities

Page 5: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Major Depressive Disorder

• Occurrence of a major depressive episode

• No history of a manic or hypomanic episode

Page 6: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Subtypes of Depression

• Atypical (overeating & oversleeping)

• Melancholic (severe somatic symptoms)

• Chronic (symptoms for at least 2 years)

• Catatonic

• Psychotic (hallucinations & delusions)

• Postpartum onset (onset after childbirth)

Page 7: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Symptoms of Dysthymic Disorder

• Depressed mood for more days than not for at least 2 years

• Two of more of the following symptoms – Poor appetite

– Insomnia/hypersomnia

– Low energy/fatigue

– Poor concentration/difficulty making decisions

– Feelings of hopelessness

• No Major Depressive Episode for first 2 years

Page 8: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

III. Bipolar Depression

• Bipolar Disorder I

• Bipolar Disorder II

• Cyclothymic Disorder

Page 9: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Manic Episode

• An elevated, expansive, or irritable mood for at least one week, plus at least three of these additional symptoms: – Inflated self-esteem or grandiosity

– Decreased need for sleep

– More talkative than usual/pressure to keep talking

– Flight of ideas and racing thoughts

– Distractibility

– Increased goal-directed activity

– Excessive involvement in dangerous activities

Page 10: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 11: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Bipolar I

• Occurrence of a manic episode

• (Major depressive episodes usually co-occur but aren’t required for the diagnosis)

Page 12: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Bipolar II

• Occurrence of a hypomanic episode

• Occurrence of a major depressive episode

Page 13: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Cyclothymic Disorder

• Occurrence of hypomanic symptoms and major depressive symptoms for at least 2 years

• No history of a manic episode, hypomanic episode, or major depressive episode

Page 14: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 15: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

IV. Theories of Mood Disorders

Page 16: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 17: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 18: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 19: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 20: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

V. Treatments for Mood Disorders

Page 21: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Antidepressants

• Tricyclic antidepressants

– Imipramine (Tofranil), Desipramine (Norpramin), Amitriptyline (Elavil)

• Monoamine Oxidase Inhibitors (MAOIs)

– Phenelzine (Nardil), Tranylcypromine (Parnate)

• Selective Serotonin Reuptake Inhibitors (SSRIs)

– Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Fluvoxamine (Luvox)

Page 22: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 23: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Schizophrenia

I. History

II. Symptoms

III. Other Psychotic Disorders

IV. Schizophrenia Subtypes

V. Prevalence

VI. Theories

VII.Treatments

Page 24: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

I. History

• Emil Kraepelin

• Eugene Bleuler

Page 25: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

II. Symptoms

Page 26: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Positive Symptoms

• Positive symptoms are defined by their presence or appearance

• Examples include:

– Delusions

– Hallucinations

– Disorganized thought & Speech

– Inappropriate Affect

• Type I Schizophrenia

Page 27: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 28: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Negative Symptoms

• Negative symptoms are defined by their absence or disappearance

• Examples include: – Alogia

– Affective flattening

– Avolition

– Social withdrawal

– Anhedonia

• Type II Schizophrenia

Page 29: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Other Symptoms

• Catatonia

• Attention deficits

Page 30: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 31: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Other Symptoms

• Prodromal & residual symptoms

Page 32: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

III. Other Psychotic Disorders

Page 33: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

IV. Schizophrenia Subtypes

• Paranoid

• Disorganized

• Catatonic

• Undifferentiated

• Residual

Page 34: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

V. Prevalence

Page 35: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Life Circumstance of People with Schizophrenia

Page 36: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

VI. Theories

Page 37: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 38: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Brain Abnormalities

Page 39: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Disorganization in the Hippocampus

Page 40: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

The Seasonality Effect

Page 41: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Adjusted Seasonality Effect

Page 42: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Expressed Emotion & Relapse (Bebbington & Kuipers, 1994)

0

10

20

30

40

50

60

70

High Contact Low Contact High Contact Low Contact

Family High in EE Family Low in EE

Percentage of Patients Relapsed

Page 43: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

VII. Treatments

Page 44: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 45: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Chlorpromazine

• A.k.a. Thorazine

• One of the first antipsychotic medications

• Works by blocking D1 & D2 dopamine receptors

• Side effects/drawbacks – Impairs motor activity (~Parkinson’s)

– Involuntary movements of the tongue and face (tardive dyskinesia)

– Not everyone responds

Page 46: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Clozapine

• Considered an “atypical” antipsychotic

• Works by blocking D4 dopamine receptors

• Also influences levels of serotonin, acetylcholine, epinephrine, & histamine

• A bit more effective at treating both positive and negative symptoms

Page 47: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 48: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Dissociative Disorders

I. Introduction

II. Dissociative Identity Disorder (DID)

III. Dissociative Fugue

IV. Dissociative Amnesia

Page 49: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

I. Introduction

Page 50: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

II. Dissociative Identity Disorder (DID)

Page 51: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Symptoms of DID

• The presence of two or more distinct identities or personality states

• Control of the person’s behavior recurrently taken by at least two of these identities or personality states

• An inability to recall important personal information that is too extensive to be explained by ordinary forgetfullness

Page 52: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 53: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Somatoform Disorders

I. Introduction

II. Conversion Disorder

III. Somatization Disorder

IV. Pain Disorder

V. Hypochondriasis

VI. Body Dysmorphic Disorder

Page 54: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

I. Introduction

Page 55: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

II. Conversion Disorder

Page 56: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

III. Somatization Disorder

Page 57: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

IV. Pain Disorder

Page 58: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

V. Hypochondriasis

Page 59: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

VI. Body Dysmorphic Disorder

Page 60: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Personality Disorders

I. Introduction

II. Cluster A: Odd-Eccentric Personality Disorders

III. Cluster B: Dramatic-Emotional Personality Disorders

IV. Cluster C: Anxious-Fearful Personality Disorders

V. Criticisms of Personality Disorders

Page 61: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

I. Introduction

Page 62: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

II. Odd-Eccentric Personality Disorders

• Paranoid P. D.

• Schizoid P. D.

• Schizotypal P. D.

Page 63: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Cluster A Personality Disorders & Schizophrenia

(adapted from Siever, 1992)

“Positive” symptoms: ideas of reference, magical

thinking, & perceptual distortions

“Negative” symptoms: social isolation, poor

rapport, & constricted affect

Paranoid P. D. Yes Yes

Schizoid P. D. No Yes

Schizotypal P. D. Yes Yes

Page 64: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

III. Dramatic-Emotional Personality Disorders

• Antisocial P. D.

• Borderline P. D.

• Histrionic P. D.

• Narcissistic P. D.

Page 65: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Ted Bundy & Jeffrey Dahmer

Page 66: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Antisocial P. D. & Rehabilitation (Rice et al., 1997)

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

Psychopaths Nonpsychopaths

TherapeuticCommunity

Prison

Rate of Violent Recidivism

Page 67: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

Narcissistic Personality Disorder

Page 68: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder
Page 69: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

IV. Anxious-Fearful Personality Disorders

• Avoidant P. D.

• Dependent P. D.

• Obsessive-Compulsive P. D.

Page 70: Mood Disorders · Theories of Mood Disorders V. Treatments for Mood Disorders . Mood Disorders/Major Affective Disorders Bipolar Depression Unipolar Depression Major Depressive Disorder

V. Criticisms of Personality Disorders

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