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Chapter 10

Chapter 10 – Mood Disorders

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Mark Schmuckler

B32: Abnormal Chapter 10 Mood Disorders GENERAL CHARACTERISTICS OF MOOD DISORDERS mood disorders disorders in which there are disabling disturbances in emotion - mood disorders are often associated with other psychological problems, such as panic attacks, substance abuse, sexual dysfunction, and personality disorders - the presence of other disorders can increase severity and result in poorer prognosis Depression: Signs and Symptoms depression a disorder marked by great sadness and apprehension, feelings of worthlessness and guilt, withdrawal from others, loss of sleep, appetite, sexual desire, loss of interest and pleasure in usual activities, and either lethargy or agitation; called major depression in DSM-IV and unipolar depression by others; it can be an associated symptom of other disorders - paying attention is exhausting for depressed people; conversation is a chore; they may speak slowly, after long pauses, using few words and a low, monotonous voice; many prefer to sit alone and remain silent; others are agitated and cannot sit still; they pace, wring their hands, continually sign and moan, or complain; depressed people may neglect personal hygiene and appearance and make numerous complaints of somatic symptoms with no apparent physical basis - symptoms and signs of depression vary somewhat across the lifespan - depression in children often results in somatic complaints, such as headaches or stomach aches - in older adults, depression is often characterized by distractibility and complaints of memory loss - depression is substantially less prevalent in China than in North America due in part to cultural mores (customstraditions) that make it less appropriate for Chinese people to display emotional symptoms - although its commonly believed that people from non-western cultures (eg: Chinese) emphasize somatic symptoms of depression, while people from Western cultures emphasize emotional symptoms, studies suggest that people from various cultures, including Canadians, tend to emphasize somatic symptoms rather than the emotional symptoms, especially when theyre being evaluated in a medical setting - overall 15% of depressed primary care patients in Canada are referred to as psychologizers (people who emphasize the psychological aspects of depression) - people in most cultures tend to emphasize physical symptoms - most depression, although recurrent, tends to dissipate with time - about 13 of depressed people suffer from chronic depression Mania: Signs and Symptoms mania an emotional state of intense but unfounded elation (great happiness) evidenced in talkativeness, flight of ideas, distractibility, grandiose plans, and spurts of purposeless activity - manias an emotional state or mood of intense but unfounded elation accompanied by www.notesolution.com irritability, hyperactivity, talkativeness, flight of ideas, distractibility, and impractical, grandiose plans - some people who experience episodic periods of depression may at times suddenly become manic - although there are clinical reports of individuals who experience mania but not depression, this condition is quite rare - the person in the throes (intense emotion) of a manic episode, which may last from several days to several months, is readily recognized by hisher loud and incessant stream of remarks, sometimes full of puns, jokes, rhyming, and interjections about objects and happenings that have attracted the speakers attention Formal Diagnostic Listings of Mood Disorders - 2 major mood disorders listed in the DSM-IV-TR: major depression, also referred to as unipolar depression, and bipolar disorder Diagnosis of Depression major depressive disorder (MDD) an extreme form of depression that satisfies the number of symptoms required for the category of depression to apply - MDD requires the presence of 5 of the following symptoms for at least 2 weeks; either depressed mood or loss of interest and pleasure must be 1 of the 5 symptoms: sad, depressed mood, most of the day, nearly everyday loss of interest and pleasure in usual activities difficulties in sleeping (insomnia); not falling asleep initially, not returning to sleep after awakening in the middle of the night, and early morning awakenings; or, in some patients, a desire to sleep a great deal of the time shift in activity level, becoming either lethargic (psychomotor retardation) or agitated poor appetite and weight loss, or increased appetite and weight gain loss of energy, great fatigue negative self-concept, self-reproach and self-blame, feelings of worthlessness, and guilt complaints or evidence of difficulty in concentrating, such as slowed thinking and indecisiveness recurrent thoughts of death or suicide - a study showed that even with fewer than 5 symptoms and a duration of less than 2 weeks, co-twins were also likely to be diagnosed with depression and patients were likely to have recurrences - other research suggests that depression exists on a continuum of severity - the issue of whether depression is best seen as being on a continuum or as a discrete diagnostic category is far from resolved - MDD is one of the most prevalent of the disorders described in this book - lifetime prevalence rates have ranged from 5.2% - 17.1% in some studies - in many countries, the prevalence of MDD increased steadily during the latter part of the 20 century - regardless of prevalence, MDD is about 2 times more common in women than in men www.notesolution.com
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