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What are the 2 categories of Mood Disorders?
- 1. Depressive Disorders
- 2. Bipolar Disorders
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Kinds of Depressive Disorders
- Disruptive Mood Dysregulation Disorder
- Major Depressive Disorder
- Persistent Depressive Disorder (Dysthymia)
- Premenstrual Dysphroic Disorder
- Substance/Medicaion-Induced Depressive Disorder
- Mood Disorder Due to Another Medical Condition
- Unspecified Depressive Disorder
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Kinds of Bipolar Disorders
- Bipolar I Disorder
- Bipolar II Disorder
- Cyclothymic Disorder
- Bipolar and Related Disorder Due to Another Medical Condition
- Other Specified Bipolar and Related Disorder
- Unspecified Bipolar and Related Disorder
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Common Features to Despressive Disorders
- Sad, Empty or Irritable Mood
- Accompanying Somatic and Cognitive changes decreasing capacity to Function
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Major Depressive Episode - DSM-5
Five or more of the following symptoms have been present during the same 2 week period and represent achange from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss ofinterest or pleasure
- 1) Depressed mood most of the day nearly ever day
- 2) Marked diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
- 3) Significant weight loss or weight gain or decrease or increase in appetite nearly every day
- 4) Insomnia or hypersomnia nearly every day
- 5) Pscyhomotor agitation or retardation nearly every day
- 6) Fatigue or loss of energy nearly every day
- 7) Feelings of worthlessness or excessive or inappropriate guilt nearly every day
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Major Depressive Disorder
The first essential feature of MDD is either a depressed mood or anhedonia.
- Biological (or vegetative) signs and symptoms
- Appetite loss, unintentional weight loss or gain, sleep disturbance, change in energy, psychomotor retardation oragitation, and diminished libido.
- “Diurnal mood variation” – person feels worse in the morning and slightly better at night.
- Individuals with depression see the world through grey-tinted glasses.
- Ruminations over personal failures (real or imagined)
- Whereas the unhappiness of everyday life comes and goes, the dysphoria of MDD never leaves.
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Major Depressive Disorder
Diagnotic Criteria
- A. The presence of a Major Depressive Episode.
- B. The Major Depressive Episode is not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia or any other psychotic disorder
- C. There has NEVER been a Manic, Mixed or Hypomanic Episode.
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Major Depressive Disorder
Specifiers
- Single Episode or Recurrent?
- Mild
- Moderate
- Severe with Psychotic Features
- In Partial Remission
- In Full Remission
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Genetic Factors for Depression
- Monozygotic twins have a greater concordance rates for depressive disorders than dizygotic twins.
- Family studies also find that onset of depression is more likely in people with depressed relatives than those who do not have depressed family members.
- This genetic and familial propensity can be offset by learning and environmental influences.
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Prevalence of Depression
- The lifetime prevalence estimate for a mood disorder is 20.8%.
- 12 month prevalence estimate for depressive disorder 9.5%
- Early age of onset tends to be before age 20
- Greater association with family history of depression and other mood disorders
- Late onset in the mid-30s and is associated with fewer recurrent episodes.
- Depression increases the risk of heart attacks and is a serious complicating factor in stroke, diabetes and cancer
- MDD is the leading cause of disability in the United States
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Other Pathways to Depression
- Learned helplessness (Seligman)
- Loss and separation
- Stress
- Cognitive distortions
- Interpersonal PT of depression
- Nonreciprocal role expectations
- Unresolved grief
- Life-role transition
- Interpersonal skill deficits
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