Depression is an under-recognized condition. Approximately one-third of people with depression do not seek treatment. Reasons include not recognizing symptoms as a illness, believing the symptoms will improve on their own, and embarrassment. General practitioners manage most cases of mental illness but often miss diagnoses of depression. It may take multiple consultations to correctly identify depression in patients. Both doctors and patients are reluctant to discuss psychological issues, and appointments often do not allow enough time.
Depression is more common in females than males by a ratio of 2:1, and most often affects people ages 20-50, averaging 40 years old. In addition to major depressive disorder, other mood disorders include dysthymic disorder, bipolar disorders I
This document discusses various mood disorders including major depressive disorder, dysthymic disorder, bipolar I disorder, and bipolar II disorder. It covers the diagnostic criteria, epidemiology, etiology, course, treatment options, and differential diagnoses for each. Key points include the diagnostic requirements for a major depressive episode, hypomanic episode, and patterns of mood episodes. Treatment involves pharmacotherapy with antidepressants, mood stabilizers, or antipsychotics as well as psychotherapy.
- Affective disorders include persistent mood disorders like depression that cause socio-occupational dysfunction. Depression is the most common mental disorder.
- The document outlines depression and bipolar affective disorder, their diagnostic criteria, clinical features, management, and when to refer patients. Depression is a leading cause of disability and its early identification and treatment improves outcomes. Bipolar disorder involves episodes of mania or hypomania with or without depression.
Mood disorders are a category of mental illnesses that involve serious changes in mood. There are several types of mood disorders including major depressive disorder, dysthymic disorder, bipolar I, bipolar II, and cyclothymic disorder. Mood disorders are among the most common mental illnesses and have a lifetime prevalence of 5-20%. Females are twice as likely as males to experience a mood disorder. The highest incidence rates occur between the ages of 20-40 years old. Mood disorders are a major cause of disability and suicide worldwide. Biological, psychological, and environmental factors all contribute to the development of mood disorders.
Disorders of Mood include affective psychosis, bipolar disorder, and depression. They are fundamentally disorders of inappropriate depression or elation that causes distress or impairment. Depression has a lifetime prevalence of 5-20% and bipolar disorder has a prevalence of 1%. Females are diagnosed twice as often as males. Mood disorders have a significant economic impact due to direct healthcare costs and indirect costs from reduced productivity. They are classified as either unipolar or bipolar and have genetic, biochemical, and environmental contributors. Symptoms include changes in mood, sleep, appetite, and energy levels. Treatment involves medication, electroconvulsive therapy, cognitive behavioral therapy, and counseling. The course involves self-limiting episodes but
This document provides an overview of mood disorders, including bipolar disorder and major depressive disorder. It discusses the classification, symptoms, diagnostic criteria, epidemiology, pathophysiology, etiology, presentation, differential diagnoses, screening tests, and management of mood disorders. The learning objectives are to describe mood and affect, classify mood disorders, identify the sources of mood disorders, determine the diagnostic criteria for depression, and describe proper management of depressive disorders.
Mood disorders:major depressive and bipolar disorderNandu Krishna J
a basic description about mood disorders mainly MDD and bipolar disorder. Can be made useful in presentations and theory exams. Subject was imbibed from different presentations and DSM IV manual. Thanks for viewing.
The document provides information about mood disorders including major depressive disorder and bipolar disorder. It discusses the classification, signs and symptoms, epidemiology, etiology, differential diagnosis, and treatment options for mood disorders. Treatment involves risk assessment, hospitalization if needed, psychotherapy, pharmacotherapy, and addressing any medical causes.
Bipolar disorder is a common mental illness that affects approximately 2% of the world population. It is characterized by episodes of mania or hypomania and depression. It is classified into Bipolar I, Bipolar II, and Cyclothymia based on the types of episodes experienced. Genetics plays a strong role in bipolar disorder, with heritability estimates around 80-85%. Environmental stressors can also contribute to its development. Neuroimaging and neuropsychological studies have found abnormalities in brain regions involved in mood regulation such as the prefrontal cortex and limbic structures. Cognitive deficits are also seen both during mood episodes and during periods of remission, suggesting they may be traits or endophenotypes
This document discusses various mood disorders including major depressive disorder, dysthymic disorder, bipolar I disorder, and bipolar II disorder. It covers the diagnostic criteria, epidemiology, etiology, course, treatment options, and differential diagnoses for each. Key points include the diagnostic requirements for a major depressive episode, hypomanic episode, and patterns of mood episodes. Treatment involves pharmacotherapy with antidepressants, mood stabilizers, or antipsychotics as well as psychotherapy.
- Affective disorders include persistent mood disorders like depression that cause socio-occupational dysfunction. Depression is the most common mental disorder.
- The document outlines depression and bipolar affective disorder, their diagnostic criteria, clinical features, management, and when to refer patients. Depression is a leading cause of disability and its early identification and treatment improves outcomes. Bipolar disorder involves episodes of mania or hypomania with or without depression.
Mood disorders are a category of mental illnesses that involve serious changes in mood. There are several types of mood disorders including major depressive disorder, dysthymic disorder, bipolar I, bipolar II, and cyclothymic disorder. Mood disorders are among the most common mental illnesses and have a lifetime prevalence of 5-20%. Females are twice as likely as males to experience a mood disorder. The highest incidence rates occur between the ages of 20-40 years old. Mood disorders are a major cause of disability and suicide worldwide. Biological, psychological, and environmental factors all contribute to the development of mood disorders.
Disorders of Mood include affective psychosis, bipolar disorder, and depression. They are fundamentally disorders of inappropriate depression or elation that causes distress or impairment. Depression has a lifetime prevalence of 5-20% and bipolar disorder has a prevalence of 1%. Females are diagnosed twice as often as males. Mood disorders have a significant economic impact due to direct healthcare costs and indirect costs from reduced productivity. They are classified as either unipolar or bipolar and have genetic, biochemical, and environmental contributors. Symptoms include changes in mood, sleep, appetite, and energy levels. Treatment involves medication, electroconvulsive therapy, cognitive behavioral therapy, and counseling. The course involves self-limiting episodes but
This document provides an overview of mood disorders, including bipolar disorder and major depressive disorder. It discusses the classification, symptoms, diagnostic criteria, epidemiology, pathophysiology, etiology, presentation, differential diagnoses, screening tests, and management of mood disorders. The learning objectives are to describe mood and affect, classify mood disorders, identify the sources of mood disorders, determine the diagnostic criteria for depression, and describe proper management of depressive disorders.
Mood disorders:major depressive and bipolar disorderNandu Krishna J
a basic description about mood disorders mainly MDD and bipolar disorder. Can be made useful in presentations and theory exams. Subject was imbibed from different presentations and DSM IV manual. Thanks for viewing.
The document provides information about mood disorders including major depressive disorder and bipolar disorder. It discusses the classification, signs and symptoms, epidemiology, etiology, differential diagnosis, and treatment options for mood disorders. Treatment involves risk assessment, hospitalization if needed, psychotherapy, pharmacotherapy, and addressing any medical causes.
Bipolar disorder is a common mental illness that affects approximately 2% of the world population. It is characterized by episodes of mania or hypomania and depression. It is classified into Bipolar I, Bipolar II, and Cyclothymia based on the types of episodes experienced. Genetics plays a strong role in bipolar disorder, with heritability estimates around 80-85%. Environmental stressors can also contribute to its development. Neuroimaging and neuropsychological studies have found abnormalities in brain regions involved in mood regulation such as the prefrontal cortex and limbic structures. Cognitive deficits are also seen both during mood episodes and during periods of remission, suggesting they may be traits or endophenotypes
Diagnosis and management of major depressive disorderNeurologyKota
This document provides information on major depressive disorder and dysthymic disorder, including their symptoms, classifications, prevalence, risk factors, pathophysiology, diagnostic criteria, sleep abnormalities seen in depression, and treatment options. It discusses antidepressant medications like TCAs, MAOIs, SSRIs, SNRIs, augmentation therapies, psychosocial therapies, and ECT in the treatment of depressive disorders.
1) Bipolar disorder causes greater disability during depressive episodes, as patients spend more time depressed than manic. Selecting treatment requires considering a patient's preferences as well as efficacy and side effects.
2) Treatment for bipolar depression involves collaborative care between doctors and patients to establish a treatment plan through shared decision making. The urgency of a patient's symptoms must be weighed against concerns about side effects.
3) Lurasidone is approved to treat bipolar I depression and has shown efficacy with tolerability. Proper diagnosis and treatment of bipolar depression is important to prevent disability, suicide risk, and switching between mood states.
Mood disorders are characterized by disturbances in emotional and behavioral responses ranging from elation to depression. They include depressive disorders like major depression and dysthymia, as well as bipolar disorders characterized by episodes of mania and depression. Potential causes include genetic and biological factors. Management involves psychopharmacological treatment with mood stabilizers or antidepressants, as well as nursing care, psychotherapy, and electroconvulsive therapy.
Mood disorders include conditions like depression and bipolar disorder. They are caused by biological factors like chemical imbalances, medical conditions, substance abuse, and genetics. Common symptoms include changes in mood, sleep, appetite, concentration, and energy levels. Mood disorders are classified based on symptoms and include types of depression like major depressive disorder and bipolar disorder. Diet and lifestyle factors can help manage mood disorders while early detection and treatment can reduce severity and improve quality of life.
This document discusses mood disorders and depression. It covers the classification of mood disorders according to ICD-10 codes, as well as the etiology of mood disorders from biological, psychological, and social perspectives. The etiology is complex and multifactorial, involving genetics, neurotransmitters like serotonin and norepinephrine, stress, and social support systems. Recurrent depression is associated with neuronal damage over time from repeated episodes.
Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.
This document provides information on bipolar disorder, including its symptoms, diagnosis, epidemiology, etiology, pathophysiology, clinical presentation, treatment goals, and treatment options. Bipolar disorder is a mood disorder characterized by one or more episodes of mania or hypomania often accompanied by one or more major depressive episodes. Correct diagnosis and early treatment are important to prevent complications and maximize treatment response. Treatment involves mood stabilizing medications like lithium, anticonvulsants, and atypical antipsychotics, as well as psychotherapy. The goals of treatment are to reduce symptoms, prevent recurrence, and improve quality of life.
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.
Major depressive disorder and bipolar disorder are mood disorders that affect millions of people worldwide. Both disorders involve periods of depression, though bipolar disorder also includes manic episodes where a person feels abnormally elevated or irritable. The causes are complex and involve genetic, biological, psychological, and environmental factors. Treatments include medication and psychotherapy to manage symptoms and prevent relapse.
Bipolar disorder is a chronic illness that causes major shifts in mood and energy, impairing various areas of life. While not curable, effective treatment exists to control symptoms and the course of the disorder. Treatment may include hospitalization if the person is a danger to self or others or unable to function. Pharmacotherapy focuses on acute symptom suppression, continuation treatment to prevent symptom return, and maintenance treatment to prevent recurrence. Treatment options include mood stabilizers, antipsychotics, antidepressants, anticonvulsants, and combination drugs. Prognosis depends on factors like episode duration, age of onset, and substance abuse history. Psychotherapy and support groups can also help manage the disorder.
The document summarizes the classification of mood disorders according to the ICD-10. It describes the diagnostic categories for mood disorders including major depressive disorder, bipolar disorder, persistent mood disorders like dysthymia and cyclothymia. It also discusses the differences between unipolar and bipolar disorders, and assessments involved in diagnosing and distinguishing mood disorders from other conditions.
Depression is a state of low mood and loss of interest that affects thoughts, feelings, and physical health. It is characterized by feelings of sadness, anxiety, guilt, and fatigue. Depression is a common disorder that affects about 15% of the population. It has various causes such as genetic factors, neurotransmitter imbalances, life stressors, and lack of social support. Treatments include antidepressant medication, psychotherapy, and physical therapies like electroconvulsive therapy. Preventing depression involves managing stress, getting social support, and maintaining a healthy lifestyle.
Mood disorders include depressive disorders like major depressive disorder and bipolar disorders. Major depressive disorder involves one or more major depressive episodes without a history of mania. Bipolar I disorder involves one or more manic or mixed episodes. Etiology may include genetics, neurotransmitter imbalances, stress, negative thought patterns, and interpersonal problems. Treatment involves psychotherapy like cognitive behavioral therapy and interpersonal therapy as well as medication like SSRIs, tricyclics, lithium, and ECT.
This document discusses mood disorders such as major depression and bipolar disorder. It covers their symptoms, epidemiology, pathophysiology, diagnosis, treatment options and duration. The two most common types of mood disorders are major depression, which involves one or more depressive episodes without mania, and bipolar disorder. Treatment involves pharmacotherapy, usually antidepressants from classes like SSRIs, SNRIs and TCAs, as well as psychotherapy. Treatment duration is divided into acute, continuation and maintenance phases to prevent relapse.
Affective disorders ( MANIA and BIPOLAR DISORDERS)Tejashreesujay
Affect refers to mood or emotional state.
Affective disorders are a set of psychiatric disorders, also called mood disorders.
This includes :
Depression
Bipolar and unipolar disorder
Mania and hypomania
Depression is the leading cause of disability world wide and is a major contributor to the overall global burden of diseases .At its worst depression can cause suicide .
There are effective psychological and pharmacological treatments for depression
Abstract of depression assessment:
- How to assess
- Differential diagnosis for physiologic causes vs. psychological
- Rating scales
*There are notes provided in some slides
This slide contains information regarding Bipolar and affective disorder. Bipolar disorder, formerly called manic depression, causes extreme mood shifts ranging from mania to depression. Here information regarding "mania" is only included. You can find about depression in my next upload with the title "Mood disorder and depression". This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
The document provides information about mood disorders including statistics, types of mood disorders, diagnostic criteria, and features of specific disorders. Some key points:
- 15% of those diagnosed with major depressive disorder or bipolar disorder commit suicide, making it a leading cause of death.
- Major depressive disorder and bipolar disorder are characterized by episodes of depression and for bipolar disorder, episodes of mania or hypomania.
- Dysthymic disorder involves chronic depressed mood for most of the day for at least two years.
- Bipolar I disorder includes manic episodes that cause severe symptoms and impairment in functioning. It has a lifetime prevalence of about 1% and often involves other conditions as well
Este documento presenta un resumen de 1 Corintios 11:1-16 sobre el uso del velo por parte de las mujeres cristianas. Argumenta que el velo simboliza la sumisión de la mujer al hombre y a Dios, y que tanto hombres como mujeres deben orar y profetizar de manera consistente con esta enseñanza bíblica. Explica que el hombre debe hacerlo con la cabeza descubierta para revelar a Cristo, mientras que la mujer debe usar velo para no revelar su propia gloria sino la de su cabeza, el hombre.
Diagnosis and management of major depressive disorderNeurologyKota
This document provides information on major depressive disorder and dysthymic disorder, including their symptoms, classifications, prevalence, risk factors, pathophysiology, diagnostic criteria, sleep abnormalities seen in depression, and treatment options. It discusses antidepressant medications like TCAs, MAOIs, SSRIs, SNRIs, augmentation therapies, psychosocial therapies, and ECT in the treatment of depressive disorders.
1) Bipolar disorder causes greater disability during depressive episodes, as patients spend more time depressed than manic. Selecting treatment requires considering a patient's preferences as well as efficacy and side effects.
2) Treatment for bipolar depression involves collaborative care between doctors and patients to establish a treatment plan through shared decision making. The urgency of a patient's symptoms must be weighed against concerns about side effects.
3) Lurasidone is approved to treat bipolar I depression and has shown efficacy with tolerability. Proper diagnosis and treatment of bipolar depression is important to prevent disability, suicide risk, and switching between mood states.
Mood disorders are characterized by disturbances in emotional and behavioral responses ranging from elation to depression. They include depressive disorders like major depression and dysthymia, as well as bipolar disorders characterized by episodes of mania and depression. Potential causes include genetic and biological factors. Management involves psychopharmacological treatment with mood stabilizers or antidepressants, as well as nursing care, psychotherapy, and electroconvulsive therapy.
Mood disorders include conditions like depression and bipolar disorder. They are caused by biological factors like chemical imbalances, medical conditions, substance abuse, and genetics. Common symptoms include changes in mood, sleep, appetite, concentration, and energy levels. Mood disorders are classified based on symptoms and include types of depression like major depressive disorder and bipolar disorder. Diet and lifestyle factors can help manage mood disorders while early detection and treatment can reduce severity and improve quality of life.
This document discusses mood disorders and depression. It covers the classification of mood disorders according to ICD-10 codes, as well as the etiology of mood disorders from biological, psychological, and social perspectives. The etiology is complex and multifactorial, involving genetics, neurotransmitters like serotonin and norepinephrine, stress, and social support systems. Recurrent depression is associated with neuronal damage over time from repeated episodes.
Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.
This document provides information on bipolar disorder, including its symptoms, diagnosis, epidemiology, etiology, pathophysiology, clinical presentation, treatment goals, and treatment options. Bipolar disorder is a mood disorder characterized by one or more episodes of mania or hypomania often accompanied by one or more major depressive episodes. Correct diagnosis and early treatment are important to prevent complications and maximize treatment response. Treatment involves mood stabilizing medications like lithium, anticonvulsants, and atypical antipsychotics, as well as psychotherapy. The goals of treatment are to reduce symptoms, prevent recurrence, and improve quality of life.
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.
Major depressive disorder and bipolar disorder are mood disorders that affect millions of people worldwide. Both disorders involve periods of depression, though bipolar disorder also includes manic episodes where a person feels abnormally elevated or irritable. The causes are complex and involve genetic, biological, psychological, and environmental factors. Treatments include medication and psychotherapy to manage symptoms and prevent relapse.
Bipolar disorder is a chronic illness that causes major shifts in mood and energy, impairing various areas of life. While not curable, effective treatment exists to control symptoms and the course of the disorder. Treatment may include hospitalization if the person is a danger to self or others or unable to function. Pharmacotherapy focuses on acute symptom suppression, continuation treatment to prevent symptom return, and maintenance treatment to prevent recurrence. Treatment options include mood stabilizers, antipsychotics, antidepressants, anticonvulsants, and combination drugs. Prognosis depends on factors like episode duration, age of onset, and substance abuse history. Psychotherapy and support groups can also help manage the disorder.
The document summarizes the classification of mood disorders according to the ICD-10. It describes the diagnostic categories for mood disorders including major depressive disorder, bipolar disorder, persistent mood disorders like dysthymia and cyclothymia. It also discusses the differences between unipolar and bipolar disorders, and assessments involved in diagnosing and distinguishing mood disorders from other conditions.
Depression is a state of low mood and loss of interest that affects thoughts, feelings, and physical health. It is characterized by feelings of sadness, anxiety, guilt, and fatigue. Depression is a common disorder that affects about 15% of the population. It has various causes such as genetic factors, neurotransmitter imbalances, life stressors, and lack of social support. Treatments include antidepressant medication, psychotherapy, and physical therapies like electroconvulsive therapy. Preventing depression involves managing stress, getting social support, and maintaining a healthy lifestyle.
Mood disorders include depressive disorders like major depressive disorder and bipolar disorders. Major depressive disorder involves one or more major depressive episodes without a history of mania. Bipolar I disorder involves one or more manic or mixed episodes. Etiology may include genetics, neurotransmitter imbalances, stress, negative thought patterns, and interpersonal problems. Treatment involves psychotherapy like cognitive behavioral therapy and interpersonal therapy as well as medication like SSRIs, tricyclics, lithium, and ECT.
This document discusses mood disorders such as major depression and bipolar disorder. It covers their symptoms, epidemiology, pathophysiology, diagnosis, treatment options and duration. The two most common types of mood disorders are major depression, which involves one or more depressive episodes without mania, and bipolar disorder. Treatment involves pharmacotherapy, usually antidepressants from classes like SSRIs, SNRIs and TCAs, as well as psychotherapy. Treatment duration is divided into acute, continuation and maintenance phases to prevent relapse.
Affective disorders ( MANIA and BIPOLAR DISORDERS)Tejashreesujay
Affect refers to mood or emotional state.
Affective disorders are a set of psychiatric disorders, also called mood disorders.
This includes :
Depression
Bipolar and unipolar disorder
Mania and hypomania
Depression is the leading cause of disability world wide and is a major contributor to the overall global burden of diseases .At its worst depression can cause suicide .
There are effective psychological and pharmacological treatments for depression
Abstract of depression assessment:
- How to assess
- Differential diagnosis for physiologic causes vs. psychological
- Rating scales
*There are notes provided in some slides
This slide contains information regarding Bipolar and affective disorder. Bipolar disorder, formerly called manic depression, causes extreme mood shifts ranging from mania to depression. Here information regarding "mania" is only included. You can find about depression in my next upload with the title "Mood disorder and depression". This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
The document provides information about mood disorders including statistics, types of mood disorders, diagnostic criteria, and features of specific disorders. Some key points:
- 15% of those diagnosed with major depressive disorder or bipolar disorder commit suicide, making it a leading cause of death.
- Major depressive disorder and bipolar disorder are characterized by episodes of depression and for bipolar disorder, episodes of mania or hypomania.
- Dysthymic disorder involves chronic depressed mood for most of the day for at least two years.
- Bipolar I disorder includes manic episodes that cause severe symptoms and impairment in functioning. It has a lifetime prevalence of about 1% and often involves other conditions as well
Este documento presenta un resumen de 1 Corintios 11:1-16 sobre el uso del velo por parte de las mujeres cristianas. Argumenta que el velo simboliza la sumisión de la mujer al hombre y a Dios, y que tanto hombres como mujeres deben orar y profetizar de manera consistente con esta enseñanza bíblica. Explica que el hombre debe hacerlo con la cabeza descubierta para revelar a Cristo, mientras que la mujer debe usar velo para no revelar su propia gloria sino la de su cabeza, el hombre.
Java soporta tipos de datos primitivos como números, caracteres y valores booleanos. Los números con punto flotante se consideran double por defecto, pero pueden especificarse como float agregando una f o F al final. Los tipos primitivos soportados son double, float, boolean y los tipos de caracteres.
Pecadores en las manos de un Dios airadoPedro Santos
1) El documento discute cómo los pecadores están constantemente expuestos a la destrucción y al castigo divino, aunque Dios los mantiene por su misericordia.
2) Los pecadores merecen ser condenados al infierno por su impiedad, pero solo la voluntad soberana de Dios evita que caigan inmediatamente.
3) Ninguna acción o plan de los pecadores puede garantizar su escape del infierno, ya que su seguridad depende completamente de la voluntad de Dios.
Este documento presenta conceptos básicos de lógica proposicional. Define proposición, proposiciones compuestas y diferentes conectivos lógicos como la negación, conjunción, disyunción y condicional. Incluye tablas de verdad para cada conectivo y ejemplos para ilustrar su uso.
Kaspersky Anti-Virus ofrece protección básica contra virus, software malicioso y amenazas emergentes de Internet de manera proactiva a través de análisis inteligentes y actualizaciones frecuentes. Incluye funciones como defensa antiphishing, teclado virtual, modo para juegos y acceso fácil al estado de seguridad. Requiere aproximadamente 480 MB de espacio y conexión a Internet para la activación, y el autor encontró que brinda protección minuciosa sin afectar el rendimiento.
Administración de Empresas -Diapositivas-fabianm1938
Este documento presenta una introducción al curso de Administración de Empresas 1. Explica brevemente los objetivos, profesores, programa y metodología del curso. Además, define conceptos clave como qué es una empresa, sus objetivos, y la diferencia entre administrar y dirigir. Finalmente, introduce herramientas para analizar la situación económica y financiera de una empresa como la cuenta de resultados y la previsión de tesorería.
The National Council on Interpreting in Healthcare convened a workgroup in 2012 to establish best practices for tracking interpreter encounters. The workgroup conducted a survey of 24 interpreter services managers to understand current tracking practices. Based on the survey results, the workgroup preliminarily concluded that effective tracking requires measuring both time interpreted and number of providers served, and accounting for unsuccessful encounters and different types of work time. The workgroup aims to standardize key data tracking elements to facilitate reimbursement processes and define encounters based on universal tracking data.
Bipolar disorders are characterized by marked variations in mood, from manic episodes to major depressive episodes. Bipolar I disorder involves at least one manic episode in addition to major depressive episodes. The document provides diagnostic criteria for manic episodes, hypomanic episodes, and major depressive episodes based on the DSM-5 and ICD-11. It also discusses differential diagnoses between bipolar disorders and other conditions like major depressive disorder, anxiety disorders, substance-induced disorders, and ADHD.
This document summarizes mood disorders including major depressive disorder, bipolar disorder, dysthymic disorder, and cyclothymic disorder. It discusses the symptoms, diagnostic criteria, prevalence, etiology, treatment goals, and pharmacotherapy options for these conditions. Key points include that major depressive disorder is more prevalent in women while bipolar disorder is equal between men and women; biological and psychosocial factors can contribute to the development of mood disorders; and treatment may involve hospitalization, psychotherapy, cognitive behavioral therapy, and medications like SSRIs, SNRIs, lithium, and antipsychotics depending on the specific diagnosis.
Bipolar disorder is a debilitating illness characterized by abnormal mood states such as depressive, elevated, or mixed episodes that typically relapse and remit over one's lifespan. It can cause functional impairment, psychosocial disability, and diminished well-being. Bipolar disorder involves disturbances in mood, vital sense, and self-attitude. It is often misdiagnosed as unipolar depression and careful evaluation of a patient's history is required to properly diagnose and differentiate it from other conditions. The lifetime prevalence of bipolar disorder is approximately 1% with onset typically in the teens or early twenties.
This PPT discusses the Mood Disorders. The Major Depressive Disorder as well as Bipolar Disorder with it's types. It throws light on the treatment of the disorders as well. The medical conditions associated with these disorders are also discussed. Hope these slides will help you.
- Major depressive disorder is characterized by at least one major depressive episode involving depressed mood and/or loss of interest/pleasure plus at least 5 other symptoms lasting at least 2 weeks.
- Bipolar disorder involves alternating periods of mania/hypomania and depression and includes bipolar I, bipolar II, and cyclothymia.
- Treatment involves managing acute episodes with medications like lithium, SSRIs, or antipsychotics and long-term maintenance therapy to prevent future episodes.
Bipolar disorder distance learning ceu wo vidsOneHEARTT
At the completion of this course, participants will be able to:
1.Describe the various presentations of Bipolar Disorders
2.List treatment interventions as well as clinically apply them
3.Define the differential diagnoses that are often considered when diagnosing Bipolar Disorders
Major depressive disorder and bipolar disorder are mood disorders characterized by disturbances in mood and behavior ranging from depression to mania. Major depressive disorder involves at least two weeks of depressed mood or lack of interest in activities along with other symptoms. Bipolar disorder involves extreme mood swings between episodes of mania and depression. Both have genetic and biological factors and are treated with medication and psychotherapy. Accurate assessment and monitoring of symptoms is important for nursing care.
Cyclothymia, also known as cyclothymic disorder, is a mood disorder involving numerous periods of hypomanic symptoms alternating with periods of depressive symptoms. For a diagnosis of cyclothymic disorder, these mood periods must occur for at least two years in adults (or one year in children and adolescents) and cannot be severe enough or long enough to be classified as major depressive or hypomanic episodes. Cyclothymia has a prevalence of about 1% worldwide and commonly develops during adolescence or early adulthood. Its causes involve genetic and environmental factors, and treatment focuses on lifestyle changes, psychotherapy, and mood stabilizing medications.
Mood disorders involve disturbances in emotions that cause discomfort and impair functioning. Depression is characterized by sadness and withdrawal, while mania involves elevated mood and hyperactivity. Mood disorders can be unipolar, involving only depression, or bipolar, involving both manic and depressive episodes. Depression is more common than mania and affects females more than males. Risk of recurrence increases with each mood episode. Treatment involves medication, psychotherapy, and electroconvulsive therapy. Suicide is often associated with mood disorders and involves intentional self-harm as an escape from psychological pain. Risk factors include depression, substance abuse, and communication of suicidal intent.
The document summarizes mood disorders and their classification. It describes the main features of manic episodes, depressive episodes, bipolar mood disorder, recurrent depressive disorder, and persistent mood disorder. Manic episodes are characterized by elevated mood and increased psychomotor activity. Depressive episodes involve depressed mood, loss of interest, and feelings of worthlessness. Bipolar disorder involves recurrent episodes of mania and depression. Treatment involves medications like antidepressants, lithium, antipsychotics as well as psychosocial therapies.
The document summarizes mood disorders and their classification. It describes the main features of manic episodes, depressive episodes, bipolar mood disorder, recurrent depressive disorder, and persistent mood disorder. Manic episodes are characterized by elevated mood and increased psychomotor activity. Depressive episodes involve depressed mood, loss of interest, and feelings of worthlessness. Bipolar disorder involves recurrent episodes of mania and depression. Treatment involves medications like antidepressants, lithium, antipsychotics as well as psychosocial therapies.
Management of MDD (based on Malaysia CPG, may 2007)snich
Major depressive disorder is a significant mental health problem characterized by depressed mood and loss of interest or pleasure that impairs functioning. While antidepressants help many patients, MDD often has a recurrent course. According to the document, MDD has a lifetime prevalence of 4.9-17.1% globally and 5.6% in Malaysia based on studies. Screening involves asking two questions regarding depressed mood and interest level. The DSM-5 criteria for diagnosing MDD include having five or more symptoms for at least two weeks. Treatment involves antidepressants in acute, continuation, and maintenance phases, along with psychotherapy and electroconvulsive therapy for treatment-resistant cases.
This document discusses mood disorders and provides details about different types of mood disorders. It defines mood disorders as severe alterations in mood that last for long periods of time and are maladaptive. The two key moods involved are mania and depression. There are two main types of mood disorders - unipolar depressive disorders, which only involve depressive episodes, and bipolar disorder, which involves both manic and depressive episodes. Several types of depression and bipolar disorders are described, along with their diagnostic criteria.
The document defines and describes various mood disorders including major depressive disorder, bipolar disorder types I and II, dysthymic disorder, and their diagnostic criteria and features. It covers topics such as mood episodes, the main mood disorders, criteria for major depressive and manic/hypomanic episodes, course and treatment options. Medical causes and substance-induced varieties are also discussed.
This document provides information on mood disorders including depressive disorders and bipolar disorders. It defines key terms like major depressive episode and manic episode. It describes the diagnostic criteria for major depressive disorder, dysthymic disorder, bipolar I disorder, bipolar II disorder, and cyclothymic disorder. It also provides case studies and discusses epidemiology, subtypes, course, and comorbidities of various mood disorders.
Major depressive disorder is one of the most common psychiatric disorders, affecting nearly 17% of the population. It is characterized by depressed mood or loss of interest/pleasure for at least two weeks, along with other symptoms such as changes in appetite, sleep, energy levels, concentration, feelings of worthlessness and thoughts of death or suicide. Biological factors like abnormalities in neurotransmitter systems, hormones, and sleep patterns are implicated in its etiology. Treatment involves medications and psychotherapy.
The document discusses mood disorders including unipolar depressive disorders, symptomatology of depressive disorders, DSM-IV categories of unipolar depressive disorders, subtypes of depression, bipolar disorder, gender and age differences in depression, the course of depression, and biological theories of mood disorders.
A 42-year-old man is experiencing a recurrent major depressive episode. He had previously responded well to treatment with imipramine but did not tolerate the anticholinergic side effects. Given his history of responding well to antidepressants and preference to avoid side effects, an SSRI with fewer anticholinergic effects would be a suitable first-line treatment option for this episode. Close monitoring would also be important given his risk of recurrence.
The document provides information on bipolar disorders, including:
1. It describes the classification of bipolar disorders according to DSM-IV criteria including Bipolar I, Bipolar II, and Cyclothymic disorder.
2. It outlines the diagnostic criteria for manic, hypomanic, mixed, and major depressive episodes.
3. It discusses the treatment of bipolar disorders including mood stabilizers like lithium, carbamazepine, valproate, benzodiazepines, antipsychotics, antidepressants, electroconvulsive therapy, and psychotherapy.
Physiology and chemistry of skin and pigmentation, hairs, scalp, lips and nail, Cleansing cream, Lotions, Face powders, Face packs, Lipsticks, Bath products, soaps and baby product,
Preparation and standardization of the following : Tonic, Bleaches, Dentifrices and Mouth washes & Tooth Pastes, Cosmetics for Nails.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
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The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
2. Depression-An under-recognized condition
Non- attendance
(A) The Epidemiological Catchment Area Study carried out in the USA suggests that
approximately one third of people suffering from depression do not seek help or
treatment
(B) A European survey of 80,000 people also revealed third of people with major
depression had not consulted a health-care specialist.
Men were less likely to consult a medical specialist than women.
Many believed --------They would get better by themselves
Some--------------------Too embarrassed to seek help
Other reasons why patients don’t consult doctors include:
• They may not recognise they have an illness
• They may regard their symptoms as appropriate in their circumstances
• Many people do not know depression can be treated easily
• Misconceptions over treatment
Poor recognition
• GPs manage about 80 per cent of all mental illness, but evidence suggests that
depression is frequently missed in general practice.
1. Half of patients severe depression -----------not recognised at the first consultation.
2. A further 10%------------- Recognised in subsequent consultations.
3. 20%--------------------------Remit during this time.
4. The remaining 20%-------- may remain unrecognised even after six months
5. Recognising difficulty -----------presentations with somatic symptoms -
70% cases - and of depression related to physical disorders
1. Other factors include an aversion on the part of both GPs and patients to
talk about psychological problems and inadequate time for
consultations
2
3. MAJOR DEPRESSIVE DISORDER
OR
AFFECTIVE DISORDER( DEPRESSIVE EPISODE)
INCIDENCE
Male 5-12%
Female 10-25%
More in females, the ratio 2:1
Age 20-50 years
Average 40 years
3
4. Lifetime Prevalence of Various Mood Disorders
Mood Disorder Lifetime Prevalence
Depressive disorders
Major depressive disorder (MDD) 10–25% for women
5–12% for men
Recurrent, without full 25–30% of persons with MDD
interepisode recovery,
superimposed on dysthymic disorder (double depression)
• Dysthymic disorder 3–6%
Bipolar disorders
• Bipolar I disorder 0.4–1.6%
• Bipolar II disorder <1%
• Bipolar I disorder or bipolar II 5–15% of persons with
disorder, with rapid cycling bipolar disorder
Cyclothymic disorder 0.4–1.0%
4
5. ICD-10 Criteria for Depressive Episode
A. Five (or more) of the following symptoms have been
present during the same 2-week period and represent
a change from previous functioning;
At least one of the symptoms is either (1) depressed
mood or (2) loss of interest or pleasure.
.
(1)Depressed mood most of the day, nearly every day,
Either subjective report (e.g., feels sad or empty) or
Observation made by others (e.g., appears tearful).
Note: in children and adolescents, can be irritable mood.
(2) Markedly diminished interest or pleasure in all, or almost
all, activities most of the day, nearly every day
(as indicated either by subjective account or observation made by others)
(3) Significant weight loss when not dieting or
Weight gain (e.g., a change of more than 5% of body
weight in a month), or
Decrease or increase in appetite nearly every day.
Note: in children, consider failure to make expected
weight gains.
(4) Insomnia or hypersomnia nearly every day
(5) Psychomotor agitation or retardation nearly every day
5
6. (6) Fatigue or loss of energy nearly every day
(7) Feelings of worthlessness or excessive or inappropriate
guilt (which may be delusional) nearly every day
(8) Diminished ability to think or concentrate, or
indecisiveness, nearly every day
(either by subjective account or as observed by others)
(9) Recurrent thoughts of death (not just fear of dying),
recurrent suicidal ideation without a specific plan, or
A suicide attempt or a specific plan for committing
suicide
B. The symptoms do not meet criteria for a mixed episode.
C. Significant distress or impairment in social,
occupational, or other important areas of functioning.
D. Not due to the direct physiological effects of a
Substance
General medical condition (e.g., hypothyroidism).
E. Not better accounted for by bereavement,
6
7. Somatic syndrome
Some depressive symptoms are widely regarded as having special
clinical significance and are here called "somatic." (Terms such as
biological, vital, melancholic, or endogenomorphic are used for this
syndrome in other classifications.)
(1) Marked loss of interest or pleasure in activities that are normally
pleasurable;
(2) Lack of emotional reactions to events or activities that normally
produce an emotional response;
(3) Waking in the morning 2 hours or more before the usual time;
(4) Depression worse in the morning;
(5) Objective evidence of marked psychomotor retardation or agitation
(remarked on or
reported by other people);
(6) Marked loss of appetite;
(7) Weight loss (5% or more of body weight in the past month);
(8) Marked loss of libido. 7
8. Criteria for Seasonal Pattern
With seasonal pattern
can be applied to:-
Major depressive episodes in bipolar I disorder, bipolar II disorder,
or
Major depressive disorder, recurrent)
A. There has been a regular temporal relationship between the
onset of and a particular time of the year (e.g., regular appearance
of the major depressive episode in the fall or winter)
B. Full remissions (or a change from depression to mania or
hypomania) also occur at a characteristic time of the year
(e.g., depression disappears in the spring).
C. In the last 2 years, two major depressive episodes have
occurred that demonstrate the temporal seasonal relationships
defined in criteria A and B, and no non seasonal major depressive
episodes have occurred during that same period.
D. Seasonal major depressive episodes (as described above)
substantially outnumber any non seasonal major depressive
episodes that may have occurred over the individual's lifetime.
8
9. • Recurrent depressive disorder, current episode mild
Without somatic syndrome
With somatic syndrome
• Recurrent depressive disorder, current episode
moderate
Without somatic syndrome
With somatic syndrome
• Recurrent depressive disorder, current episode
without psychotic symptoms
• Recurrent depressive disorder, current episode severe
with psychotic symptoms
With mood-congruent psychotic symptoms
With mood-incongruent psychotic symptoms
• Recurrent depressive disorder, currently in remission
• Other recurrent depressive disorders
• Recurrent depressive disorder, unspecified
• Persistent mood [affective] disorders
9
10. Diagnostic Criteria for Dysthymic Disorder
A Depressed mood for most of the day, for more days than
not, for at least 2 years.
B. Presence, while depressed, of two (or more) of the
following:
(1) Poor appetite or overeating
(2) Insomnia or hypersomnia
(3) Low energy or fatigue
(4) Low self-esteem
(5) Poor concentration or difficulty making decisions
(6) Feelings of hopelessness
C. Never without symptoms for more than two months during
the last 2-year period
D. No major depressive episode has been present during the
first 2 years of the disturbance (1 year for children and
adolescent
Early onset------------Before 21 years of age
Late onset-------------21 years or older
10
11. ICD-10 Diagnostic Criteria for
Adjustment Disorders
A. Onset of symptoms must occur within 1 month of
exposure to an identifiable psychosocial stressor, not
of an unusual or catastrophic type.
. Symptoms may be variable in both form and
severity.
The predominant feature of the symptoms may be
further specified as:-
Brief depressive reaction
A transient mild depressive state of a duration not
exceeding 1 month.
Prolonged depressive reaction
A mild depressive state occurring in response to a
prolonged exposure to a stressful situation but of a
duration not exceeding 2 years.
Mixed anxiety and depressive reaction
Both anxiety and depressive symptoms are
prominent, but at levels no greater than those
specified for mixed anxiety and depressive disorder
or other mixed anxiety disorders.
11
12. Bipolar affective disorder
Episodes are demarcated by a switch to an episode of opposite or mixed
polarity
Bipolar affective disorder, current episode hypomanic
A. The current episode meets the criteria for hypomania.
B. There has been at least one other affective episode in the past, meeting the
criteria for hypomanic or manic episode, depressive episode, or mixed
affective episode.
Bipolar affective disorder, current episode manic without psychotic
symptoms
The current episode meets the criteria for mania without psychotic symptoms.
.
Bipolar affective disorder, current episode manic with psychotic symptoms
The current episode meets the criteria for mania without psychotic symptoms.
• . With mood-congruent psychotic symptoms
• With mood-incongruent psychotic symptoms
Bipolar affective disorder, current episode moderate or mild depression
A. The current episode meets the criteria for a depressive episode of either mild
or moderate severity.
1. Without somatic syndrome
2. With somatic syndrome
Bipolar affective disorder, current episode severe depression without
psychotic symptoms
Bipolar affective disorder, current episode severe depression with psychotic
symptoms
1. With mood-incongruent psychotic symptoms
2. With mood-congruent psychotic symptoms
Bipolar affective disorder, current episode mixed
. Both manic and depressive symptoms must be prominent most of the time
during a period of at least 2 weeks.
Bipolar affective disorder, currently in remission
The current state does not meet the criteria for depressive or manic episode of any severity or
for any other mood [affective] disorder (possibly because of treatment to reduce the risk of
12
15. ICD-10 Diagnostic Criteria for Mood [Affective] Disorders
Manic episode
.Mania without psychotic symptoms
A. Mood must be predominantly elevated, expansive, or irritable,
Change must be prominent and sustained for at least 1 week (unless it is
severe enough to require hospital admission).
B. At least three of the following signs must be present (four if the mood is
merely irritable), leading to severe interference with personal
functioning in daily living:
(1) increased activity or physical restlessness;
(2) increased talkativeness ("pressure of speech");
(3) flight of ideas or the subjective experience of thoughts racing;
(4) loss of normal social inhibitions, resulting in behavior that is inappropriate
to the circumstances;
(5) decreased need for sleep;
(6) inflated self-esteem or grandiosity;
(7) distractibility or constant changes in activity or plans;
(8) behavior that is foolhardy or reckless
e.g., spending sprees, foolish enterprises, reckless driving;
(9) Marked sexual energy or sexual indiscretions.
C. There are no hallucinations or delusions, although perceptual
disorders may occur
D.The episode is not attributable to psychoactive substance use or to any
organic mental disorder.
15
16. Mania with psychotic symptoms
.
Delusions or hallucinations are present,
The commonest examples are those with grandiose, self-
referential, erotic, or persecutory content.
.
Congruent with the mood:
With mood-congruent psychotic symptoms
Example: - Grandiose delusions or voices telling the
individual that he or she has superhuman powers)
With mood-incongruent psychotic symptoms
Example: -voices speaking to the individual about affectively
neutral topics, or delusions of reference or persecution)
16
17. Hypomania
A. The mood is elevated or irritable to a degree that is
definitely abnormal for
The individual concerned and
Sustained for at least 4 consecutive days.
B. At least three of the following signs must be
present, leading to
some interference with personal functioning in daily
living:
(1) Increased activity or physical restlessness;
(2) Increased talkativeness;
(3) Distractibility or difficulty in concentration;
(4) Decreased need for sleep;
(5) Increased sexual energy;
(6) Mild overspending, or other types of reckless or
irresponsible behavior;
(7) Increased sociability or overfamiliarity.
17
18. Table 14.6-7. DSM-IV Criteria for Manic Episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood,
lasting at least 1 week (or any duration if hospitalization is necessary).
B. During the period of mood disturbance, three (or more) of the following symptoms have
persisted
(1) inflated self-esteem or grandiosity
(2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
(3) more talkative than usual or pressure to keep talking
(4) flight of ideas or subjective experience that thoughts are racing
(5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external
stimuli)
(6) increase in goal-directed activity (either socially, at work or school, or sexually) or
psychomotor agitation
(7) excessive involvement in pleasurable activities that have a high potential for painful
consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish
business investments)
C. The symptoms do not meet criteria for a mixed episode.
D. The mood disturbance is sufficiently severe to cause marked impairment in
occupational functioning or in usual social activities or relationships with others, or to
necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
E. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug
of abuse, a medication, or other treatment) or a general medical condition (e.g.,
hyperthyroidism).
Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment
(e.g., medication, electroconvulsive therapy, light therapy) should not count toward a
diagnosis of bipolar I disorder. 18
20. . Medical Conditions Physiologically Associated With Affective Disorders
Endocrine Disorders
• Hypothyroidism
• Hyperthyroidism
• Parathyroid disorders
• Cushing's syndrome
Neurologic Disorders
• Cerebrovascular accidents
• Central nervous system (CNS) lesions
• Neurosyphilis
• Multiple sclerosis
• Neurosarcoidosis
• CNS vasculitis
• HIV-associated CNS pathology
Other Disorders
• Vitamin deficiencies (e.g, folate and vitamin B12)
• Anemia
• Hypoxia
• End-stage renal disease
• Systemic lupus erythematosus and other connective tissue
diseases
• Occult malignancy (eg, pancreatic cancer)
20
21. Differentiating Characteristics of Bipolar and Unipolar Depressions
Bipolar Unipolar
History of mania or hypomania Yes No
(definitional)
Temperament/personality Cyclothymic/extroverted Dysthymic/introverted
Sex ratio Equal More women than men
Age of onset Teens, 20s, and 30s 30s, 40s, 50s
Postpartum episodes More common Less common
Onset of episode Often abrupt More insidious
Number of episodes Numerous Fewer
Duration of episode 3 to 6 months 3 to 12 months
Psychomotor activity Retardation > agitation Agitation > retardation
Sleep Hypersomnia > insomnia Insomnia > hypersomnia
Family history
Bipolar disorder Yes ±
Unipolar disorder Yes Yes
Alcoholism ± Yes
Pharmacological response
Cyclic antidepressants Induce hypomania-mania ±
Lithium carbonate Acute antidepressant effects Ineffective
21
22. Basic principles of prescribing in depression
• Discuss with the patient: -
1) Choice of drug and
2) utility/availability of other, non-pharmacological
treatments
• Discuss with the patient likely outcomes. e.g.
Gradual relief from depressive symptoms over several
weeks
• Prescribe a dose of antidepressant (after titration, if
necessary) that is likely effective
• Continue treatment for at least 4—6 months after
resolution of symptoms
• Withdraw antidepressants gradually;
Always inform patients of the risk and nature of
discontinuation symptoms
Treatment of affective illness
Depression
22
23. •Episode: A period lasting longer than 2 weeks (as defined
by the DSM-IV-R) during which the patient is consistently
within the fully symptomatic range of a sufficient number of
symptoms to meet syndromal criteria for the disorder.
•Partial remission: A period during which an improvement of
sufficient magnitude is observed that the individual is no
longer fully symptomatic
•Response: The point at which a partial remission begins. A
response, unlike a partial remission, does require treatment
and thus implies that the cause of the change in the patient's
condition is known, which may not be a valid assumption.
•Full remission: A relatively brief period during which an
improvement of sufficient magnitude is observed that the
individual is asymptomatic
•Recovery: A remission that lasts for a specified period of
time. Relapse: A return of symptoms satisfying the full
syndrome criteria for an episode that occurs during the period
of partial or full remission, but before recovery as defined
above. A relapse signals a need for treatment intervention or
modification of ongoing treatment.
•Recurrence: The appearance of a new episode of major
depressive disorder occurring during a recovery.
Definitions of terms related to the course of depression
23
25. STRATEGIES FOR TREATMENT
When initiating acute-phase treatment, practitioners decide where the
patient should be treated (e.g., outpatient, day hospital, or
inpatient). Treatment location is dictated by factors such as
(1) the imminent risk of suicide,
(2) the capacity of the patient to recognize and follow instructions or
recommendations (adherence, psychosis),
(3) the level of psychosocial resources,
(4) the level of psychosocial stressors, and
(5) the level of functional impairment.
Next, one chooses among the four common acute-phase
treatments
(A) Medication
.
(B) The combination of medication and psychotherapy.
(C) Electroconvulsive therapy [ECT]).
(D) For some, light therapy alone or in combination with medications
may also be an option.
25
26. Treatment Plan
A treatment plan for depression consists of three
distinct phases
Phase 1: - Acute treatment, relieves the immediate
symptoms of depression.
Phase 2, Continuation treatment, preserves the gains
achieved initially and protects the patient
from sliding back into depression.
Phase 3, Maintenance treatment, guards against
future episodes.
Treatment Phases and Goals
Phase Length Treatment goal
Acute 6–12 weeks Achieve remission
Continuation 16–24 weeks Prevent relapse
Maintenance Varies Protect against recurrence
Remission = Return to level of symptoms and functioning that
existed before illness.
Relapse = Re-emergence of significant depressive symptoms.
Recurrence = Another major depressive episode.26
27. Relation of Diagnosis to Treatment Selection
Diagnosis Treatment Recommendations
•Major depressive Episode Medication or time-limited
(mild-to-moderate severity) psychotherapies*
No maintenance-phase treatment
•Major depressive disorder, recurrent Consider maintenance-phase treatment
•Major depressive disorder Antipsychotic plus antidepressant
with psychotic features medications
Electroconvulsive therapy
•Major depressive disorder with melancholic Medications essential
or severe features
•Depression with atypical features Nontricylic drugs preferred
Monoamine oxidase inhibitors
•Depression with seasonal pattern Light therapy or medications
•Dysthymic disorder Medications; time-limited, depression-
targeted psychotherapies; or their
combination
Consider maintenance-phase therapy
•Complex or chronic depressions Medication plus psychotherapy‡
Interpersonal psychotherapy,
cognitive therapy, or behavior therapy.27