The document discusses the history, definition, classification and symptoms of mood disorders. It notes that mood disorders have been described since ancient times and includes descriptions of depression, mania, bipolar disorder and their symptoms. Unipolar disorders involve only depression while bipolar disorders involve both depression and mania or hypomania. The document outlines the DSM-5 and ICD-10 classification criteria and diagnostic features of major depressive disorder, bipolar disorder, dysthymia and cyclothymia.

1. MOOD
DISORDERS
DJ VIC

2. HISTORY
• HIPPOCRATES (400 B.C.) USED THE TERMS MANIA AND MELANCHOLIA TO
DESCRIBE MENTAL DISTURBANCES
• ROMAN PHYSICIAN (30 A.D.) DESCRIBED MELANCHOLIA AS DEPRESSION CAUSED
BY BLACK BILE
• IN 1854, JULES FARLET DESCRIBED A CONDITION CALLED FOLIE CIRCULAIRE:
ALTERNATING MOODS OF DEPRESSION AND MANIA
• IN 1899, EMIL KRAEPELIN DESCRIBED MANIC-DEPRESSIVE PSYCHOSIS USING
MOST OF THE CRITERIA THAT PSYCHIATRISTS USE NOW

3. DEFINITION
MOOD :
- PERVASIVE AND SUSTAINED
- FEELING THAT IS EXPRESSED INTERNALLY
-THAT INFLUENCES A PERSON’S BEHAVIOUR AND PERCEPTION
OF THE WORLD
-DISTINGUISHED FROM AFFECT – IS THE EXTERNAL
EXPRESSION OF MOOD

4. MOOD DISORDERS :
ARE A GROUP OF CLINICAL CONDITIONS CHARACTERISED BY
LOSS OF THE SENSE OF CONTROL & A SUBJECTIVE
EXPERIENCE OF GREAT DISTRESS.
Elevated mood
-Expansiveness
-Flight of ideas
-Decreased
sleep
-Grandiose
ideas
Depressed mood
-Lack of energy /interest
-Feelings of guilt
-Difficulty in concentration
-Loss of appetite
-Thoughts of death
/suicide

5. UNIPOLAR MOOD
DISORDERS
BIPOLAR MOOD
DISORDERS

6. • UNIPOLAR MOOD DISORDER = PATIENT EXPERIENCE ONE OR MORE
(DEPRESSION) EPISODES OF LOW MOOD
• MANIA = PATIENT EXPERIENCE ELEVATED MOOD, AND INCREASE IN
QUANTITY AND SPEED OF PHYSICAL AND MENTAL
ACTIVITY
• BIPOLAR MOOD DISORDER = PATIENT EXPERIENCES BOTH LOW
MOOD (DEPRESSION) AND
ABNORMALLY ELEVATED MOOD
(HYPOMANIA OR MANIA)

7. OTHER ADDITIONAL CATEGORIES OF MOOD DISORDERS
HYPOMANIA - AN EPISODE OF MANIC SYMPTOMS THAT DOES
NOT MEET THE CRITERIA FOR MANIC EPISODE
CYCLOTHYMIA - DISORDER THAT REPRESENT LESS SEVERE
FORMS OF BIPOLAR DISORDER
DYSTHYMIA - DISORDER THAT REPRESENT LESS SEVERE FORMS
OF MAJOR DEPRESSION

8. CLASSIFICATION –ICD 10
F30 MANIC EPISODE
• F30.0 HYPOMANIA
• F30.1 MANIA WITHOUT PSYCHOTIC SYMPTOMS
• F30.2 MANIA WITH PSYCHOTIC SYMPTOMS
• F30.8 OTHER MANIC EPISODES
• F30.9 MANIC EPISODE, UNSPECIFIED
F31 BIPOLAR AFFECTIVE DISORDER
• F31.0 BIPOLAR AFFECTIVE DISORDER, CURRENT EPISODE HYPOMANIC
• F31.1 BIPOLAR AFFECTIVE DISORDER, CURRENT EPISODE MANIC WITHOUT PSYCHOTIC SYMPTOMS
• F31.2 BIPOLAR AFFECTIVE DISORDER, CURRENT EPISODE MANIC WITH PSYCHOTIC SYMPTOMS
• F31.3 BIPOLAR AFFCTIVE DISORDER, CURRENT EPISODE MILD OR MODERATE DEPRESSION
• F31.4 BIPOLAR AFFECTIVE DISORDER, CURRENT EPISODE SEVERE DEPRESSION WITHOUT PSYCHOTIC SYMPTOMS
• F31.5 BIPOLAR AFFECTIVE DISORDER, CURRENT EPISODE SEVERE DEPRESSION WITH PSYCHOTIC SYMPTOMS
• F31.6 BIPOLAR AFFECTIVE DISORDER, CURRENT EPISODE MIXED
• F31.7 BIPOLAR AFFECTIVE DISORDER, CURRENTLY IN REMISSION
• F31.8 OTHER BIPOLAR AFFECTIVE DISORDERS
• F31.9 BIPOLAR AFFECTIVE DISORDER, UNSPECIFIED

9. F32 DEPRESSIVE EPISODE
• F32.0 MILD DEPRESSIVE EPISODE
• F32.1 MODERATE DEPRESSIVE EPISODE
• F32.2 SEVERE DEPRESSIVE EPISODE WITHOUT PSYCHOTIC SYMPTOMS
• F32.3 SEVERE DEPRESSIVE EPISODE WITH PSYCHOTIC SYMPTOMS
• F32.8 OTHER DEPRESSIVE EPISODES
• F32.9 DEPRESSIVE EPISODE, UNSPECIFIED
F33 RECURRENT DEPRESSIVE DISORDER
• F33.0 RECURRENT DEPRESSIVE DISORDER, CURRENT EPISODE MILD
• F33.1 RECURRENT DEPRESSIVE DISORDER, CURRENT EPISODE MODERATE
• F33.2 RECURRENT DEPRESSIVE DISORDER, CURRENT EPISODE SEVERE WITHOUT PSYCHOTIC SYMPTOMS
• F33.3 RECURRENT DEPRESSIVE DISORDER, CURRENT EPISODE SEVERE WITH PSYCHOTIC SYMPTOMS
• F33.4 RECURRENT DEPRESSIVE DISORDER, CURRENTLY IN REMISSION
• F33.8 OTHER RECURRENT DEPRESSIVE DISORDERS
• F33.9 RECURRENT DEPRESSIVE DISORDER, UNSPECIFIED

10. F34 PERSISTENT MOOD [AFFECTIVE] DISORDERS
• F34.0 CYCLOTHYMIA
• F34.1 DYSTHYMIA
• F34.8 OTHER PERSISTENT MOOD [AFFECTIVE] DISORDERS
• F34.9 PERSISTENT MOOD [AFFECTIVE] DISORDER, UNSPECIFIED
F38 OTHER MOOD [AFFECTIVE] DISORDERS
• F38.0 OTHER SINGLE MOOD [ AFFECTIVE ] DISORDERS
• F38.1 OTHER RECURRENT MOOD [ AFFECTIVE ] DISORDERS
• F38.8 OTHER SPECIFIED MOOD [AFFECTIVE] DISORDERS
F39 UNSPECIFIED MOOD [ AFFECTIVE ] DISORDER

11. CLASSIFICATION – DSM 5
MOOD DISORDERS
• MAJOR DEPRESSIVE EPISODE
• MANIC EPISODE
• HYPOMANIC EPISODE
DEPRESSIVE DISORDERS
• MAJOR DEPRESSIVE DISORDER
• PERSISTENT DEPRESSIVE DISORDER
• DISRUPTIVE MOOD REGULATION (CHILDREN’S TEMPER TANTRUMS)
• PREMENSTRUAL DYSPHORIC DISORDER
• DEPRESSIVE DISORDER DUE TO ANOTHER MEDICAL CONDITION
• SUBSTANCE/MEDICATION-INDUCED MOOD DISORDER
• OTHER SPECIFIED, OR UNSPECIFIED DEPRESSIVE DISORDER
BIPOLAR AND RELATED DISORDERS
• BIPOLAR I DISORDER
• BIPOLAR II DISORDER
• CYCLOTHYMIC DISORDER

12. • SUBSTANCE/MEDICATION-INDUCED BIPOLAR DISORDER
• BIPOLAR DISORDER DUE TO ANOTHER MEDICAL CONDITION
• OTHER SPECIFIED OR UNSPECIFIED BIPOLAR DISORDER

13. DEPRESSION
• IS A STATE OF (PERSISTENT AND PERVASIVE) LOW MOOD WITH INTENSE DISLIKE
TO ACTIVITY OR APATHY THAT CAN AFFECT A PERSON'S THOUGHTS,
BEHAVIOUR, FEELINGS AND SENSE OF WELL-BEING.
• A PATIENT WITH DEPRESSION MAY EXPERIENCE VARIOUS SYMPTOMS SUCH AS
LOSE INTEREST IN ACTIVITIES THAT WERE ONCE PLEASURABLE, EXPERIENCE LOSS
OF APPETITE OR OVEREATING, HAVE PROBLEMS CONCENTRATING,
REMEMBERING DETAILS OR MAKING DECISIONS, EXPERIENCE RELATIONSHIP
DIFFICULTIES AND MAY CONTEMPLATE, ATTEMPT OR COMMIT SUICIDE,
INSOMNIA, EXCESSIVE SLEEPING, FATIGUE, ACHES, PAINS, DIGESTIVE PROBLEMS
OR REDUCED ENERGY MAY ALSO BE PRESENT.
• THE SYMPTOMS CAN BE DIVIDED IN THREE DIFFERENT GROUPS

14. SYMPTOMS OF
DEPRESSION
CORE SYMPTOMS
LOW MOOD, LOSS OF INTEREST IN
ENJOYMENT
PSYCHOLOGICAL
SYMPTOMS
POOR CONCERNTRATION, POOR
SELF-ESTEEM, INAPPROPRIATE GUILT,
PESSIMISM, RECURRING THOUGHTS
OF DEATH OR SUICIDE
PHYSICAL SYMPTOMS
SLEEP DISTURBANCE WITH OFTEN
EARLY MORING WAKING, FATIGUE,
LOSS OF APPETITE AND WEIGHT LOSS,
LOSS OF LIBIDO, ANHEDONIA,
AGITATION OR RETARDATION

15. DEPRESSIVE EPISODE
• HAS THREE DIFFERENT SEVERITY – MILD, MODERATE AND SEVERE
• FOR ALL THE THREE GRADES OF SEVERITY THE INDIVIDUAL SUFFERS FROM
THE COMMON SYMPTOMS SUCH AS DEPRESSED MOOD, LOSS OF INTEREST
AND ENJOYMENT AND REDUCED ENERGY LEADING TO FATIGABILITY AND
DIMINISHED ACTIVITY.
• DESPITE THE SEVERITY, THE DURATION OF THE SYMPTOMS SHOULD BE
PRESENT AT LEAST FOR 2 WEEKS ( REQUIRED FOR THE DIAGNOSIS)
• HOW TO DIAGNOSE MILD, MODERATE AND SEVERE DEPRESSIVE EPISODE?

16. ACCORDING TO DSM-5, FOR MAJOR DEPRESSIVE EPISODE TO BE MADE, FIVE OR
MORE SYMPTOMS OF DEPRESSION MUST HAVE BEEN PRESENT FOR A PERIOD OF AT
LEAST 2 WEEKS OR MORE.
AT LEAST ONE OF THE SYMPTOMS MUST BE EITHER DEPRESSED MOOD OR LOSS OF
INTEREST OR PLEASURE, AND THE SYMPTOMS MUST BE ASSOCIATED WITH
SIGNIFICANT DISTRESS OR IMPAIRMENT.
A DIAGNOSIS OF MAJOR DEPRESSIVE DISORDER, EITHER SINGLE EPISODE OR
RECURRENT, CAN ONLY BE MADE IN THE ABSENCE OF MANIC OR HYPOMANIC
EPISODES

17. MANIA
• IS A STATE OF ABNORMALLY ELEVATED AROUSAL, AFFECT, AND ENERGY LEVEL, OR A
STATE OF HEIGHTENED OVERALL ACTIVATION WITH ENHANCED AFFECTIVE
EXPRESSION TOGETHER WITH LABILITY OF AFFECT
MANIC EPISODE
• IS A DISTINCT PERIOD
• OF AN ABNORMALLY AND PERSISTENTLY ELEVATED, EXPANSIVE, OR IRRITABLE
MOOD
• LASTING FOR AT LEAST 1 WEEK, (OR LESS - IF A PATIENT MUST BE HOSPITALIZED )
HYPOMANIC EPISODE
• LASTS AT LEAST 4 DAYS
• SIMILAR TO A MANIC EPISODE
• EXCEPT THAT IT IS NOT SUFFICIENTLY SEVERE TO CAUSE IMPAIRMENT IN SOCIAL OR
OCCUPATIONAL FUNCTIONING
• NO PSYCHOTIC FEATURES ARE PRESENT.

18. BOTH ARE ASSOCIATED WITH
• INFLATED SELF-ESTEEM OR GRANDIOSITY
• DECREASED NEED FOR SLEEP,
• DISTRACTIBILITY
• GREAT PHYSICAL AND MENTAL ACTIVITY
• OVER INVOLVEMENT IN PLEASURABLE BEHAVIOUR
• MORE TALKATIVE THAN USUAL OR PRESSURE TO KEEP TALKING
• FLIGHTS OF IDEAS OR SUBJECTIVE EXPERIENCE THAT THOUGHTS ARE RACING
• INCREASE IN GOAL-DIRECTED ACTIVITY OR PSYCHOMOTOR AGITATION

19. ICD-10 CRITERIA
HYPOMANIA
• LESSER DEGREE OF MANIA
• PERSISTENT MILD ELEVATION OF MOOD- EUPHORIA
• MARKED FEELINGS OF WELL BEING AND EFFICIENCY
• INCREASED ENERGY AND ACTIVITY
• DECREASED NEED FOR SLEEP
• INCREASED SOCIABILITY AND TALKATIVENESS
• NOT LEADING TO SEVERE DISRUPTION OF WORK OR SOCIAL REJECTION
• PRESENT FOR SEVERAL DAYS ON END (4 DAYS)

20. MANIA WITHOUT PSYCHOTIC SYMPTOMS
• LAST FOR AT LEAST 1WEEK
• SEVERE ENOUGH TO DISRUPT ORDINARY WORK AND SOCIAL ACTIVITIES
• ELATED MOOD
• INCREASED ENERGY WITH OVER ACTIVITY
• PRESSURED SPEECH
• DECREASED NEED FOR SLEEP
• MARKED DISTRACTIBILITY
• DISINHIBITED, OVERSPENDING
• EXPANSIVE IDEAS

21. MANIA WITH PSYCHOTIC SYMPTOMS
• MORE SEVERE FORM
• DELUSIONS- GRANDIOSE AND/OR PERSECUTORY
• PERCEPTUAL ABNORMALITIES
• SEVERE AND SUSTAINED PHYSICAL ACTIVITY, EXCITEMENT
• FLIGHT OF IDEAS, INCOHERENCE
• IMPAIRED PERSONAL CARE

22. BIPOLAR MOOD DISORDERS
BIPOLAR I DISORDER
• CHARACTERIZED BY THE OCCURRENCE OF AT LEAST ONE MANIC OR MIXED EPISODE
MOST OF THE PATIENTS ALSO, SOMETIMES, HAVE ONE OR MORE DEPRESSIVE
EPISODES.
MIXED EPISODE
• A PERIOD OF AT LEAST 1 WEEK
• BOTH A MANIC EPISODE AND A MAJOR DEPRESSIVE EPISODE OCCUR ALMOST DAILY.
BIPOLAR II DISORDER
• A VARIANT OF BIPOLAR DISORDER
• EPISODES OF MAJOR DEPRESSION AND HYPOMANIA (RATHER THAN MANIA)

23. DYSTHYMIA AND CYCLOTHYMIA
DYSTHYMIC DISORDER
• AT LEAST 2 YEARS OF DEPRESSED MOOD
• NOT SUFFICIENTLY SEVERE TO FIT THE DIAGNOSIS OF MAJOR DEPRESSIVE
EPISODE.
CYCLOTHYMIC DISORDER
AT LEAST 2 YEARS OF FREQUENTLY OCCURRING
• HYPOMANIC SYMPTOMS CANNOT FIT THE DIAGNOSIS OF MANIC EPISODE
• DEPRESSIVE SYMPTOMS THAT CANNOT FIT THE DIAGNOSIS OF MAJOR
DEPRESSIVE EPISODE.

25. D/DX OF DEPRESSIVE DISORDER
• DEPRESSION
• DYSTHYMIA
• CYCLOTHYMIA
• BIPOLAR MOOD DISORDER
• MIXED AFFECTIVE STATES
• SCHIZOAFFECTIVE DISORDER
• SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS, INCLUDING
DEPRESSION SUPERIMPOSED UPON SCHIZOPHRENIA, NEGATIVE SYMPTOMS OF
SCHIZOPHRENIA, ADVERSE EFFECTS OF ANTIPSYCHOTIC

26. • ADJUSTMENT DISORDER
• SEASONAL AFFECTIVE DISORDER (SAD)
• POST-TRAUMATIC STRESS DISORDER (PTSD)
• GENERALIZED ANXIETY DISORDER
• OBSESSIVE-COMPULSIVE DISORDER
• EATING DISORDER

27. ORGANIC DIFFERENTIAL
NEUROLOGICAL
Stroke, Alzheimer’s disease and other Dementias,
Parkinson’s disease, Huntington disease, Multiple
sclerosis, Epilepsy, intracranial tumors
ENDOCRINE
Cushing’s syndrome, Addison’s disease, Hypothyroidism,
Hyperparathyroidism
METABOLIC
Iron deficiency, B12 or folate deficiency, Hypercalcaemia,
Hypomagnesaemia
INFECTIVE
Influenza, Infections mononucleosis, Hepatitis, HIV/AIDS
NEOPLASTIC
Non-metastatic effects of carcinoma
DRUGS
L-dopa, steroids, beta-blockers, digoxin,cocaine,
amphetamines, opioids, alcohol

28. D/DX OF MANIA AND BIPOLAR DISORDER
• SCIZOAFFECTIVE DISORDER
• SCHIZOPHRENIA
• PUERPERAL PSYCHOSIS
• CYCLOTHYMIA
• ATTENTION DEFICIT HYPERACTIVITY DISORDER
ORGANIC DIFFERENTIAL
• DRUGS SUCH AS ALCOHOL, ANTI-DEPRESSANT, L-DOPA, STEROIDS.
• SLEEP DEPRIVATION
• DELIRIUM
• BRAIN DISEASE OF THE FRONTAL LOBES SUCH AS DEMENTIA, STROKE, MULTIPLE
SCLEROSIS, TOMOUR, EPILEPSY, AIDS, NEUROSYPHLIS.

29. • ENDOCRINE DISORDERS SUCH AS HYPERTHYROIDISM, CUSHING’S SYNDROME
• SYSTEMIC LUPUS ERYTHEMATOSUS

30. EPIDEMIOLOGY
• INCIDENCE AND PREVALENCE:
DEPRESSIVE DISORDER – THE LIFETIME INCIDENCE OF DEPRESSIVE
DISORDERS IS ABOUT 15% AND POINT
PREVALENCE ABOUT 5%
• SEX:
WOMEN : MEN = 2:1. (MDD) ; 1:1(BPD)
THE HYPOTHESIS REASONING IT :
• HORMONAL DIFFERENCES,
• THE EFFECTS OF CHILDBIRTH,
• DIFFERING PSYCHOSOCIAL STRESSORS
• BEHAVIOURAL MODELS OF LEARNED HELPLESSNESS.

31. MANIC EPISODES ARE MORE COMMON IN MEN, AND DEPRESSIVE EPISODES
ARE MORE COMMON IN WOMEN.
WOMEN
• MORE LIKELY THAN MEN TO PRESENT A MIXED PICTURE
• HIGHER RATE OF BEING RAPID CYCLERS, DEFINED AS HAVING FOUR OR
MORE MANIC EPISODES IN A 1-YEAR PERIOD.
AGE:
• THE MEAN AGE OF ONSET FOR BIPOLAR I DISORDER = 30YRS.
• THE MEAN AGE OF ONSET FOR MAJOR DEPRESSIVE DISORDER = 40 YEARS
(50 % BETWEEN 20-50YRS)
• RECENT TREND: INCIDENCE OF MDD - INCREASING IN <20 YEARS OF
AGE – (ALCOHOL AND DRUGS OF ABUSE)

32. MARITAL STATUS
• POOR INTERPERSONAL RELATIONSHIPS
• DIVORCED OR SEPARATED
SOCIOECONOMIC AND CULTURAL FACTORS
• NO CORRELATION FOR MDD
• BPD 1 : UPPER SOCIO-ECONOMIC GROUP
COMORBIDITY
• MDD : INCREASED RISK OF HAVING ONE OR MORE ADDITIONAL
COMORBID AXIS I DISORDERS.
• ALCOHOL ABUSE OR DEPENDENCE,
• PANIC DISORDER,
• OBSESSIVE COMPULSIVE DISORDER (OCD),
• SOCIAL ANXIETY DISORDER.
• WORSEN THE PROGNOSIS AND INCREASE - RISK OF SUICIDE

33. ETIOLOGY
1.BIOLOGICAL FACTORS
• NOREPINEPHRINE
- DOWNREGULATION OR DECREASED SENSITIVITY OF ß-ADRENERGIC
RECEPTORS ; PRESYNAPTIC ß2- RECEPTORS
• SEROTONIN
- MOST COMMONLY ASSOCIATED WITH DEPRESSION
- DEPLETION OF SEROTONIN MAY PRECIPITATE DEPRESSION

34. • DOPAMINE
-REDUCED IN DEPRESSION; INCREASED IN MANIA; D1 RECEPTORS
AND MESOLIMBIC DOPAMINE PATHWAY.
• OTHERS
- ABNORMAL LEVELS OF CHOLINE
- REDUCTIONS OF GABA
- G PROTEINS OR OTHER SECOND MESSENGERS.
- HYPERCORTISOLEMIA (CUSHING’S)
- ELEVATED BASAL THYROID-STIMULATING HORMONE (TSH) LEVEL OR AN
INCREASED TSH RESPONSE TO A 500-MG INFUSION OF THE
HYPOTHALAMIC NEUROPEPTIDE THYROID-RELEASING HORMONE (TRH).

35. • ALTERATIONS OF SLEEP NEUROPHYSIOLOGY
-AN INCREASE IN NOCTURNAL AWAKENINGS,
-A REDUCTION IN TOTAL SLEEP TIME,
-INCREASED PHASIC RAPID EYE MOVEMENT (REM) SLEEP,
-INCREASED CORE BODY TEMPERATURE
-REDUCED REM LATENCY
• NEUROANATOMY:
-LIMBIC SYSTEM, BASAL GANGLIA AND THE HYPOTHALAMUS
• GENETIC
- IF ONE PARENT HAS A MOOD DISORDER, A CHILD WILL HAVE A
RISK OF BETWEEN 10% - 25% FOR MOOD DISORDER.

36. PSYCHOSOCIAL FACTORS
1. LIFE EVENTS AND ENVIRONMENTAL STRESS
-THE LIFE EVENT MOST OFTEN ASSOCIATED WITH DEVELOPMENT
OF DEPRESSION IS LOSING A PARENT BEFORE AGE 11.
-THE ENVIRONMENTAL STRESSOR MOST OFTEN ASSOCIATED WITH
THE ONSET OF AN EPISODE OF DEPRESSION IS THE LOSS OF A
SPOUSE.
2. PERSONALITY FACTORS
-PERSONS WITH CERTAIN PERSONALITY DISORDERS: OCD,
HISTRIONIC, AND BORDERLINE, MAY BE AT GREATER RISK FOR
DEPRESSION

37. 3.COGNITIVE THEORY
AARON BECK POSTULATED A COGNITIVE TRIAD OF DEPRESSION
THAT CONSISTS OF :
-VIEWS ABOUT THE SELF : A NEGATIVE SELF-PRECEPT;
-ABOUT THE ENVIRONMENT: A TENDENCY TO EXPERIENCE THE
-WORLD AS HOSTILE AND DEMANDING, AND
-ABOUT THE FUTURE : THE EXPECTATION OF SUFFERING AND
FAILURE.
4.HELPLESSNESS
-INTERNAL CAUSAL EXPLANATIONS ARE THOUGHT TO PRODUCE A
LOSS OF SELF ESTEEM AFTER ADVERSE EXTERNAL EVENTS.
-COGNITIVE MOTIVATIONAL DEFICIT AND EMOTIONAL DEFICIT

38. TREATMENT
AIM
PATIENT’S SAFETY MUST BE GUARANTEED.
COMPLETE DIAGNOSTIC EVALUATION
TREATMENT PLAN ADDRESSING NOT JUST IMMEDIATE
SYMPTOMS BUT PATIENT’S PROSPECTIVE WELL-BEING

39. HOSPITALIZATION
• THE NEED FOR DIAGNOSTIC PROCEDURES
• THE RISK FOR SUICIDE OR HOMICIDE
• HISTORY OF RAPIDLY PROGRESSING SYMPTOMS
• PATIENT’S USUAL SUPPORT SYSTEM INTERRUPTED
(RESPITE)

40. PSYCHOSOCIAL THERAPY
PHARMACOTHERAPY
DEPRESSIVE DISORDER
- MAOI’S, TCA’S, SSRI’S, SNRI’S
BIPOLAR DISORDERS
- LITHIUM, ANTICONVULSANTS, ANTIPSYCHOTICS

42. THANK YOU

43. RESOURCES
-DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, FIFTH EDITION
(DSM-5). AMERICAN PSYCHIATRIC ASSOCIATION. 2013.
-SALMANS, SANDRA (1997). DEPRESSION: QUESTIONS YOU HAVE – ANSWERS YOU
NEED. PEOPLE'S MEDICAL SOCIETY. ISBN 978-1-882606-14-6.
-ICD-10 CLASSIFICATION OF MENTAL AND BEHAVIOURAL DISORDERS
-NEEL BURTON THIRD EDITION, PSYCHIATRY ISBN 978 0 9929127 4 1
-OXFORD HANDBOOK OF PSYCHIATRY THIRD EDITION
- HTTPS://WWW.NCBI.NLM.NIH.GOV/BOOKS/NBK10847/