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T/F. Mood disorders (M.D) are among the common diagnoses in psychiatry.



Describe mood disorders

Pt. is in a persistent emotional state


3 Major mood categories

- Unipolar M.D
- Bipolar M.D
- M.D w/ known etiology


Neural basis for M.D

altered function in the HPA axis and in multiple neurotransmitter systems

Specific affected regions include the hippocampal formation, the amygdala, the cingulate gyrus (anterior portions), and the prefrontal cortex (especially dorsolateral prefrontal cortex)


What are the TWO unipolar disorders?

- Major Depressive Disorder
- Dysthymic Disorder


How is pt diagnosed with Major Depressive Disorder?

Diagnosed after a single episode of major depression.

Characterized by emotional changes, primarily depressed mood, and by so-called vegetative changes, consisting of alterations in sleep, appetite, and energy levels.


What NT evidence is there for Major Depressive Disorder?

abnormalities in amine neurotransmitters as mediators of depressive states

the evidence is strongest for deficiencies in norepinephrine and serotonin.


Major depression is frequently ______



depressive episode for those pts with Major depression can last ________ (time)

6-12 months


What is the treatment for Major Depression?

Psychotheraphy (CBT) and pharmacotherapy (tricyclic antidepressants, SSRIs, MAOIs, and atypical antidepressants. In addition, lithium, thyroid hormone, and psychostimulants may
be used as augmentative treatments.


What is Dysthymic disorder?

a mild, chronic form of major depression.


What does a dysthymic disorder diagnosis require?

an individual experience a minimum of 2 years of chronically depressed mood most of the time


Treatment for dysthymic disorder?

Same as major depression CBT plays a LARGER role along with tryclic antidepressants, SSRIS, etc.


What are the 3 types of bipolar mood disorders?

- Bipolar I
- Bipolar II
- Cyclothymia


How is Bipolar I characterized?

***At least 1 episode of mania.
Pts can also experience MAJOR depression throughout their life


Management of Bipolar I?

Antipsychotics in conjunction with benzodiazepines (for rapid tranquilization) and initiation of mood stabilizer (Lithium commonly used)


How is Bipolar II characterized?

Similar to bipolar I disorder except that mania is absent in bipolar II disorder, and hypomania (a milder
form of elevated mood than mania) is the essential diagnostic finding.


Treatment of Bipolar II?

Same at bipolar I; Antipsychotics, benzodiazepines and mood stabilizer . Treatment for mania is not AS agressive


What is cyclothymic disorder?

Recurrent, chronic, mild form of bipolar disorder in which mood typically oscillates between hypomania and dysthymia. (Extremes of mania and major depression are absent).


Treatment for cyclothymic disorder?

Psychotherapy, mood stabilizers, and antidepressants


What are the two M.D with known etiology?

- Substance-induced M.D
- M.D resulting from general medical condition


How is substance-induced M.D caused?

medications, other psychoactive substances, ECT, or phototherapy are proximate events and the likely cause of the mood disturbance.


What is M.D resulting from general medical condition?

mood disturbances apparently caused by a medical illness.


What are some example of mood disturbances caused by a medical illness?

-Melancholic; associated with guilt, remorse, loss of pleasure, and extreme vegetative symptoms.

- Postpartum; occurs within 4 weeks of childbirth.

- Seasonal; how a consistent seasonal pattern of variation. The most common pattern is a worsening of depression during the fall and winter with improvement in the spring

- Atypical; show a pattern of hypersomnia, increased appetite or weight gain, mood reactivity, long- standing rejection sensitivity, anergia, and leaden paralysis

- Rapid Cycling; four mood disturbances per year must be present.

- Catatonic; pronounced movement abnormalities, including motoric immobility or excessive purposeless motor activity, maintenance of a rigid posture, mutism, stereotyped movement, echolalia (repetition of a word or phrase just spoken by another person), and echopraxia (repetition of movements made by another person).