Mood Disorders and Suicide Flashcards
Summary of Mood Disorders and Suicide (5 cards)
Understanding and Defining Mood Disorders
Mood disorders are among the most common psychological disorders, and the risk of developing them is increasing worldwide, particularly in younger people.
Two fundamental experiences can contribute, either singly or in combination, to all specific mood disorders: a major depressive episode and mania. A less severe episode of mania that does not cause impairment in social or occupational functioning is known as a hypomanic episode. An episode of mania coupled with anxiety or depression is known as a mixed episode or mixed state.
An individual who suffers from episoldes of depression only is said to have a unipolor disorder. An individual who alternates between depression and mania or hypomania, or experiences one or more episodes of mania or hypomania, has a bipolar disorder.
Major depressive disorder may be a single episode or recurrent, but it is always time-limited; in another form of depression, persistent depressive disorder (dysthymia), the symptoms are often somewhat milder but remain relatively unchanged over long periods.
In some cases, fewer symptoms are often somewhat milder but remain relatively unchanged over long periods. In some cases, fewer symptoms are observed than in a major depressive episode but they persist for at least two years (chronic major depressive episode). In cases of disorder, an individual experiences both major depressive episoldes and dysthymia.
Approximately 20% of bereaved individuals may experience a complicated grief reaction in which the normal grief response develops into a full-blown mood disorder.
The key identifying feature of bipolar disorders is the occurence of repeated episodes of mood disturbances, often an alternation of manic or hypomanic and major depressive episodes. Cyclothymic disorder is a milder but more chronic version of bipolar disorder characterised by minor depressions and hypomania.
Certain additional features or patters characterise mood disorders. These specifiers may predict the course or patient response to treatment, as does the temporal pattering or course of mood disorders. Atypical depression for example, predicts bipolarity.
Prevalence of Mood Disorders
The prevalence of depression is high, at more than 15%. Bipolar I disorder has a prevalence of 1%, similar to schizophrenia.
More females than males experience major depressive episodes.
Mood disorders in children are fundamentally similar to mood disorders in adults.
Symptoms of depression are increasing dramatically in our elderly population.
Causes of Mood Disorders
The causes of mood disorders lie in a complex interaction of biological, psychological and social factors. From a biological perspective, researchers are particularly interested in the stress hypothesis and the role of neurohormones. Psychological theories of depression focus on learnt helplessness and the drepressive cognitive schemas, as well as interpersonal disruptions.
Treatment of Mood Disorders
A variety of treatments, both biological and psychological, have proved effective for the mood disorders, at least in the short term. For those individuals who do not respons to antidepressant medications or psychosocial treatments, electroconvulsive therapy (ECT) is sometimes indicated.
The commonest antidepressant agents are selective serotonin reuptake inhibitors (SSRIs). Most antidepressants have similar efficacy. Choice is dictated by patient characteristics, inccluding response, tolerance of side-effects and medical risks.
Acute mania is managed with sedation, antimanic agents such as lithium and valproate and antipsychotic agents. Compliance with medications is a veritable management problem in bipolar disorders.
Two psychological treatements - cognitive theraphy and interpersonal psychotherapy - seem effective in treating depressive disorders.
Relapse and recurrence of mood disorders are common in the long term, and treatment efforts must focus on maintenance treatment; that is, on preventing relapse or recurrence.
Suicide
Suicide is often associated with mood disorder but can occur in their absence or in the presence of other disorders.
Globally, suicide is a leading cause of death.
In understanding suicidal behaviour, three indices are important: suicidal ideation (serious thoughts about committing suicide) , suicidal plans (a detailed method for killing oneself) and suicidal attempts (that are not successful). Important, too, in learning about risk factors for suicides is the psychological autopsy, in which they psychological profile of an individaul who has committed suicide is reconstructed and examined for clues.
