* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Atypical Melancholic Mixed Feature Specifiers in Mood Disorders
Survey
Document related concepts
Spectrum disorder wikipedia , lookup
Child psychopathology wikipedia , lookup
History of mental disorders wikipedia , lookup
Schizoaffective disorder wikipedia , lookup
Postpartum depression wikipedia , lookup
Behavioral theories of depression wikipedia , lookup
Biology of depression wikipedia , lookup
Evolutionary approaches to depression wikipedia , lookup
Major depressive disorder wikipedia , lookup
Bipolar disorder wikipedia , lookup
Bipolar II disorder wikipedia , lookup
Transcript
Gross Deviations in Mood Depression: “The Low” – The “Common Cold” of Mental Illness – Major Depressive Episode is Most Common Mania: “The High” – Abnormally Exaggerated Elation, Joy, or Euphoria Mania Depression Unipolar Mood Disorder – Either Depression or Mania Bipolar Mood Disorder – Alternates Between Depression and Mania Important to Determine the Course – Temporal Patterning of the Episodes Depressive Disorders – Major Depression – PDD, formerly Dysthymic Disorder – “Double Depression” - - dysthymia punctuated by period of major depression Bipolar I and Bipolar II Disorders – Cyclothymic Disorder Clinical Description Extremely Depressed Mood – Lasting at Least 2 Weeks Cognitive Symptoms Anhedonia Vegetative Symptoms Single or Recurrent Episode – No Manic or Hypomanic Episodes Clinical Description Similar to Major Depression BUT With a Different Course – Symptoms are Milder – Symptoms can Last 20-30+ Years Persistently Depressed Mood for 2+ Years – Cannot be Symptom Free > 2 Months Facts and Statistics Mean Age of Onset Early 20s Onset Prior to Age 20 – Greater Chronicity – Poor Prognosis Major Depressive Episodes are Common Clinical Description Suffer From Both – Major Depression Episodes – PDD - Dysthymic Disorder Dysthymia Usually Begins First Associated With Severe Pathology A Problematic Future Course Clinical Description Dysthymia Dysthymia Major Depression Major Features Experience Both – Manic Episodes – Major Depressive Episodes Roller Coaster of Mood What are Manic Episodes? Mania and Hypomania Elevated Mood Grandiosity Increased Activity Varied Impairment Clinical Description Mania Major Depression Clinical Description Major Depressive Episodes Alternate With Hypomanic Episodes Clinical Description Milder Depressive Episodes Alternate With Hypomanic Episodes Clinical Description Hypomania Dysthmia General Facts and Statistics Bipolar I – Onset Around 18 Years Bipolar II – Onset Around 22 Years 16% Commit Suicide Cyclothymia – Typically Chronic Descriptions of Recent Episode and Pattern Varies 1. Atypical – Pertains to Depressive Episodes and Dysthymia, not Manic Episodes – Typically Overeat and Oversleep Recent Episode and Pattern Atypical (overeat, oversleep, wght gain – keep interested, can experience pleasure) 2. Melancholic – Pertains to Major Depressive Episode Only – More Severe Symptoms – Strong Biological Component Recent Episode and Pattern Atypical Melancholic 3. Mixed Features – With some mania symptoms Recent Episode and Pattern Atypical Melancholic 4. Catatonic Mixed – Can be part of Major Depression and Mania – Very Serious Condition – Catalepsy (“Muscle Rigidity”) Recent Episode and Pattern Atypical Catatonic Melancholic Mixed 5. Psychotic – Hallucinations and Delusions – Very Rare but Serious Condition – Poor Treatment Response Recent Episode and Pattern Atypical Melancholic Catatonic Mixed 6. PeripartumPsychotic – Major Depression and Mania – Prior to…Four Weeks Following Birth…and up to a year: high % – Mood Episodes of a Psychotic Nature Relatively Rare Recent Episode and Pattern Atypical Melancholic Catatonic Mixed Peripartum Psychotic Anxious Distress Course and Pattern Rapid-Cycling Seasonal Pattern – Bipolar and Recurrent Major Depression – Episodes During Certain Seasons Other Depressive Disorders new to DSM-5 • Premenstrual Dysphoric Disorder (PMDD) – 2- 5% of women meet criteria • Disruptive Mood Dysregulation Disorder – Children: increased diagnosis for bipolar, up 40% between 1995 and 2005 • Bipolar (NOS) About 16% Lifetime Global Prevalence MDD Past Year: Bipolar-.8% Maj Depression-6% Females > Males – Major Depression and Dysthymia Females = Males – Bipolar Disorders Biological Dimensions Family Studies Twin Studies – As Severity Increases, so Does the Genetic Connection No Single Genetic Link Neurotransmitters The Serotonin Connection Endocrine Function Elevated Cortisol Dexamethasone Suppression Test: cortisol suppressed in nondepressed people, not in severely depressed….but…. Sleep and Circadian Rhythms Sleep Disturbances are Common More intense and earlier start to REM Sleep among the Depressed Diminished Deep Sleep Disruption of Circadian Rhythms Stressful Life Events; Loss Learned Helplessness Attributional Style Internal Stable Global Negative Cognitive Biases Beck’s Cognitive Triad Negative Schema About Self, World, & Future In the United States: About 30,000 Kill Themselves Annually More Die from Suicide Each Year Than Homicide (about 20,000) More Common Among Whites, Native Americans Increasing in Adolescents (3rd leading cause of death) & Elderly (globally, the elderly have highest suicide rate, esp. males) Males > Females in Killing Themselves Females > Males in Attempts Approximately 500,000 people each year require ER treatment as a result of attempted suicide Suicidal behavior typically occurs in the presence of mental illness or substance use disorders Firearms account for 59% of all suicide deaths Website of Extreme and Urgent Interest suicidology.org Medications Tricyclic Antidepressants Imipramine (Tofranil) Amitriptyline (Elavil) Block Neurotransmitter Reuptake Side Effects Medications MAO Inhibitors Block Enzyme MonoAmine Oxidase The Result? More Neurotransmitter is Available Side Effects and Complications Medications SSRIs Block Reuptake of Serotonin- Prozac SSNRIs Medications - Bipolar Lithium, Depakote, Lamictal…Effective for Manic Episodes Lithium Must be Carefully Regulated Other Medical Treatments Electroconvulsive Therapy (ECT) TMS Psychological Interventions Combined Treatments?