[ Psychiatric ] Mood disorders 1

Major depressive episode – DSM-5 criteria

5 or more symptoms for at least 2 weeks, must include depressed mood or anhedonia.

Manic episode – impact

Causes significant distress or social/occupational impairment, with or without psychosis.

Manic episode – diagnostic requirement

3 or more DIG FAST symptoms for at least 1 week (or any duration if hospitalization is required).

Hypomanic episode – duration and psychosis

Lasts at least 4 days, with no psychotic features.

MDD – key diagnostic exclusion

No history of manic or hypomanic episodes.

MDD – epidemiology

F more than M (2:1), prevalence 15%, any age, peak in the mid-20s.

MDD – neurotransmitter theory

Decreased CSF 5-HIAA (serotonin metabolite) and decreased serotonin, norepinephrine, and dopamine.

MDD – endocrine finding

High cortisol.

MDD – genetics

1st degree relatives have 2 to 4 times the risk.

MDD – sleep architecture

Decreased REM latency, decreased slow wave sleep (N3), and increased total REM.

Atypical depression (most common subtype) – features

Hypersomnia, hyperphagia, and leaden paralysis (heavy feeling in the arms and legs).

Seasonal depression – criteria and season

MDEs in a particular season for 2 or more consecutive years, most commonly in winter.

Seasonal depression – treatment

Light therapy plus standard MDD therapy.

Psychotic depression – key feature and treatment

Psychosis occurs only with the MDE, treated with atypical antipsychotics plus MDD therapy.

Catatonic depression – treatment

Lorazepam plus standard MDD therapy.

Peripartum depression – onset

During pregnancy or within 4 weeks after delivery.

MDD – main treatments

Antidepressants (SSRI) and psychotherapy (CBT).

Dysthymia (persistent depressive disorder) – duration

Depressive symptoms lasting 2 years or more.

Dysthymia – most effective treatment

Psychotherapy.

Normal bereavement – normal perceptual phenomena

Illusions or hallucinations of the deceased, as long as the patient recognizes them as such.