Mood disorder characterized by disturbance of mood. it includes mania or depressive syndrome. it includes definition, causes, sign and symptoms, treatment and nursing diagnosis etc.

2.  BY-
 PREETI SHARMA
 MSC. NSG. 1st YEAR

3.  Mood disorders are characterized by a disturbance of mood,
accompanied by a full or partial manic or depressive syndrome,
which is not due to any other physical or mental disorder. Mood
disorder is a mental health problem that primarily affects a
person's emotional state. It is a disorder in which a person
experiences long periods of extreme happiness, extreme
sadness, or both. It is normal for someone's mood to change,
depending on the situation.

4.  F30- F39 Mood disorders
F30 Manic episode
F31 Bipolar affective disorder
F32 Depressive episode
F33 Recurrent depressive disorder
F34 Persistent mood disorder
F38 Other mood disorder
F39 Unspecified mood disorder

6.  Mania is an affective disorder with consistent elevated mood
with increased physical and mental activity present in an
individual at least for few days or a week. When the mood is
elevated that person seems to be cheerful optimistic, irritable
easily become violent.

7.  Manic types are classified into three stages-
•HYPOMANIA
•ACUTE MANIA
•DELIRIOUS MANIA

8.  The exert mechanism by which mania occurs is not yet known.
• Biological Factors
• Genetic
• Monozygotic twins
• Bio chemical Factors
• Excess Level of norepinephrine and dopamine
• Social pressures
• Environmental influence
• Sociocultural factor

9. Elevated, expansive or irritable
mood
Psychomotor activity
Speech and thought
Goal-directed activity
Other features

10. Euphoria
(mild elevation of mood)
an increased sense of
psychological well-being
and happiness
Hypomania (stage I)
Elation
(mod elevation of mood)
A feeling of confidence
and enjoyment, increase
in psychomotor activity
Mania (stage II)
Exaltation
(sev elevation of mood)
Intense elation with
delusion of grandeur
Severe mania (stage III)
Ecstasy
(very sev elevation of mood)
Intense sense of rapture or blistfullness
Stupurous mania (stage III)

12.  History collection
 Mental status examination
 Psychological tests such as young mania rating scale
 Based on sign and symptoms

13. PHARMACOTHERAPY
ELECTROCONVULSIVE THERAPY (ECT)
PSYCHOSOCIAL TREATMENT

14.  Mood stabilizers:
 Lithium (900-2100mg/day)
 Carbamazepine (600-1800mg/day)
 Sodium valproate (600-2600mg/day)
 Antipsychotics:
 Olanzapine
 Chlorpromazine
 Haloperidole
 Sedtives/Hypnotics:
 Benzodiazepines (lorazepam, clonazepam)

15.  ECT can also be used for acute manic excitement if not
adequately responding to antipsychotics and lithium.

16.  Family and marital therapy is used to decrease interfamilial and
interpersonal difficulties and to reduce or modify stressors. The
main purpose is to ensure continuity of treatment and adequate
drug compliance.

18.  Depression is a mood disorder that causes a persistent feeling
of sadness and loss of interest. Also called major depressive
disorder or clinical depression, it affects how you feel, think
and behave and can lead to a variety of emotional and physical
problems.

19.  Mild depressive episode
 Moderate depressive episode
 Severe depressive episode

20.  BIOLOGICAL THEORIES:
• Neurochemical like norepinephrine and serotonin level is
decreased
• Genetic factors
• Changes in the body’s balance of hormones
 SOCIOLOGICAL THEORIES:
• Stressful life events e.g. death, marriage, financial loss

21.  PSYCHOSOCIAL THEORIES:
• According to Freud (psychoanalytic theory) due to loss of a loved object. In
this model, mania is viewed as a denial of depression.
• According to behaviour theory of depression connects depressive
phenomena to the experience of uncontrollable events.

22. A typical depressive episode is characterized by following
features, which should last for at least 2 weeks.
 Depressed mood:
- Sadness of mood
- Loss of interest
 Suicidal thoughts

23.  Depressive cognitions:
• Hopelessness
• Helplessness
• Worthlessness
• Unreasonable guilt
• Self blame
 Psychomotor activity:
• Think, walk and act slowly
• Answered after a long delay
• Feeling of uneasiness
 Psychotic features:
• Hallucination present
• Nihilistic delusions , delusion of
poverty and delusion of guilt is
present

24.  History collection
 Mental status examination
 Psychological tests such as Hamilton rating scale for assess
severity of depression
 Dexamethasone suppression test showing failure to suppress
cortisol secretions in depressive patient

25. PSYCHO PHARMACOLOGY
PHYSICAL THERAPIES
PSYCHOSOCIAL TREATMENT

26.  Selective serotonin reuptake inhibitors (SSRIS) like Citalopram,
fluoxetine
 Tricyclic antidepressants (TCAs) like Amitriptyline,
Imipramine, Doxepin
 Monoamine oxidase inhibitors (MAOIS) Isocarboxazid,
phenelzine

27.  ECT Therapy: Severe depression with suicidal risk is the
important indication for ECT
 Light therapy: Sometimes called phototherapy involves
exposing the patient to an artificial light source during winter
months to relieve seasonal depression.

28.  Psychotherapy- It is based on psychoanalytic interventions
emphasizes helping patients gain insight into the cause of their
depression.
 Cognitive therapy- It aims at correcting the depressive
negative cognitions like hopelessness, helplessness and replace
them with new cognitive and behavioural responses.

29.  Group therapy- It is useful for mild case of depression. In group therapy
negative feelings such as anxiety, anger, guilt and emotional growth is
improved through expression of their feelings.
 Family therapy- It is used to decrease intrafamilial and interpersonal
difficulties and to reduce or modify stressors which may help in faster and
more complete recovery.
 Behavioral therapy- It includes social skills training, problem solving
techniques, self control therapy and decision making techniques.

31.  This is characterized by recurrent episodes of mania and
depression in the same patient at different times. Typically, the
patient experiences extreme highs (mania) alternating with
extreme lows (depression).

32.  Precise cause unknown
 Genetic, biochemical and psychological factors
 Stressful events
 Hypothyroidism

34.  Based on sign and symptoms
 History taking

35.  Lithium
 Valporic acid
 Carbamazepine
 Antidepressants
 Antipsychotic

36. Nursing assessment:
 Severity of disorder.
 Knowing the causes.
 Resources available.
 Judging the effect of patient’s behaviour on other people.
 Mental status examination (MSE).

37.  Risk for violence related to manic excitement as evidence by
aggression towards his mother.
 Self-care deficit related to cognitive deficit as evidenced by
dirty clothes and appearance.
 Altered sleep and rest related to depressed mood and depressive
cognitions evidenced by difficulty in falling asleep, early
morning awakening.

38.  Mood disorders in children and adolescents: an epidemiologic
perspective
 Author Ronald C Kessler Shelli Avenevoli, Kathleen Ries Merikangas

39.  Epidemiologic studies show that major depression is comparatively rare
among children, but common among adolescents, with up to a 25%
lifetime prevalence by the end of adolescence. Mania is much less
common, with no more than 2% lifetime prevalence by the end of
adolescence.
 . Developmental studies that include assessments of both hormonal
changes and social changes through the pubertal transition are needed to
investigate joint biological and environmental influences on the
emergence of the gender difference in depression in puberty.
 This controversy is made more complex by methodological uncertainties
regarding inconsistent symptom reports obtained from parents, teachers,
and children and by the pervasive existence of co morbidity.

40.  Retrospective reports about age of onset in adult studies suggest that at
least 50% of youngsters with major depression and 90% of those with
mania continue to have adult recurrences.
 These recurrences are mediated by adverse role transitions, such as
truncated educational attainment and teenage child bearing, that typically
occur before the time of initial treatment. Aggressive outreach and early
treatment aimed at preventing the occurrence of adverse role effects
might help decrease the persistence of child and adolescent mood
disorders.

42.  Mood disorders is a group of psychiatric illnesses where a disturbance in
mood is considered the main underlying feature. Disturbances in mood can
take the form of either elevated mood, as it occurs in mania or hypomania,
or reduced (depressed) mood as it occurs in major depressive episodes.