Mood Disorders

Mood Disorders Overview

  • Focus of the course PSY 314 taught by Dr. Stephen W. Koncsol.

Depressive Disorders

Major Depressive Disorder (MDD)

  • May occur once or recur multiple times.

  • Requires at least one major depressive episode.

Symptoms of MDD (must be present for at least two weeks):

  • Persistent sadness or low mood affecting interest and engagement in enjoyable activities.

  • Feelings of worthlessness.

  • Extreme guilt.

  • Disruption in sleep patterns, appetite, and sexual drive.

Special Considerations:

  • In children, symptoms may manifest as irritability or hostility.

Atypical Depression

  • May involve temporary relief of mood in response to positive events.

Prolonged Grief Disorder

  • Grief symptoms that persist beyond what is considered normal.

Persistent Depressive Disorder (Dysthymia)

  • Chronic and milder form of depression that lasts for two or more years.

  • Symptoms must not be absent for more than two months.

  • Can lead to social isolation and higher suicide risk.

  • May co-occur with major depressive episodes, referred to as double depression.

Depressive Disorders Related to Reproductive Events

Premenstrual Dysphoric Disorder (PMDD)

  • Symptoms include sadness, anxiety, irritability, and panic attacks.

  • Affects 1% to 8% of women of reproductive age.

  • Recognized in DSM-5.

Major Depressive Disorder with Peripartum Onset

  • Similar symptoms to MDD, affecting mothers’ connection with their child.

  • Prevalence: 6.5% to 12.9%.

  • Increased risk with birth complications and linked to adverse effects on children's health.

Epidemiology

Prevalence of Depression

  • Lifetime prevalence of Major Depressive Disorder is approximately 20.6%.

  • Median age of onset is 29.1 years.

  • Persistent depressive disorder has a prevalence of about 1% to 6%.

  • Women experience depression rates nearly twice that of men.

  • Socio-economic factors contributing to higher rates in women, including financial stress and limited education.

Ethnic and Cultural Differences

  • Higher rates of MDD among Non-Hispanic Whites compared to Non-Hispanic Black and Hispanic populations.

  • Ethnic identity and religious participation serve as protective factors.

  • Individuals from diverse cultures may express psychological and physical symptoms differently.

Developmental Factors

  • Mean age of onset for MDD is around 29 years.

  • Vulnerable groups include children, adolescents, individuals with chronic illnesses, and the elderly.

  • Untreated depression can lead to poor educational and occupational outcomes.

Risk Factors in Developmental Phases

  • Neuroticism, hormonal changes, and adverse childhood experiences increase risks.

  • Approximately 4% to 10% of individuals over 50 face depression.

  • Among the elderly, factors include trauma history, lack of social support, and dementia symptoms.

Comorbidity in Depressive Disorders

  • Commonly coexist with medical conditions, significantly associated with incidents of cardiovascular, metabolic, and neurological disorders.

  • High prevalence of comorbidity with psychological disorders, especially generalized anxiety disorder.

Bipolar and Related Disorders

Definitions and Symptoms

  • Mania: Characterized by elevated mood, excessive behaviors, and dangerous impulsivity.

  • Bipolar Disorder: Involves manic episodes, which may be preceded/followed by depressive episodes.

Types of Bipolar Disorder:

  • Bipolar I: At least one manic episode; depressive episodes may or may not occur.

  • Bipolar II: Involves hypomanic episodes coupled with major depressive episodes.

  • Rapid Cycling: Defined as four or more severe mood disturbances within a year.

  • Cyclothymic Disorder: Periodic hypomanic and depressive symptoms that last for two years.

Epidemiology of Bipolar Disorder

  • Lifetime prevalence of Bipolar I: 0.6%; Bipolar II: 0.4%.

  • Higher rates observed in the Americas vs. Africa/Asia.

  • Average age of onset: 17 years.

  • Comorbid with disorders like substance use and anxiety, with similar rates in both genders.

Developmental Factors in Bipolar Disorder

  • Increased bipolar diagnosis rates in children, whose symptoms often differ from adults.

  • Childhood mania may be more chronic, and symptoms include consistent irritability and behavioral challenges.

Disruptive Mood Dysregulation Disorder (DMDD)

  • Controversial diagnosis for children aged 6-18 involving severe temper outbursts that are disproportionate.

  • Concerns have been raised about the definition and applicability of DMDD.

Suicide and Mood Disorders

General Facts

  • Suicide is closely linked to depressive and bipolar disorders; it ranks as the 10th leading cause of death in the U.S.

  • Significant gender differences exist in suicide rates, with men at higher risk.

Risk Factors for Suicide

  • Include chronic physical illnesses, psychological disorders, and environmental factors.

  • Male individuals are substantially more likely to engage in serious attempts and succeed.

Prevention Strategies

  • Focused on crisis intervention and societal-level prevention targeting at-risk groups.

  • Emphasis on reducing access to means, leveraging digital technologies for prediction, and engaging in critical debriefings.

Treatment of Depressive and Bipolar Disorders

Depressive Disorders Treatments

Biological Treatments

  • Include medications such as tricyclics, SSRIs, MAOIs, and ECT.

Psychological Treatments

  • Primarily include Cognitive Behavioral Therapy (CBT) and intervention-focused therapies.

Bipolar Disorders Treatments

Medications

  • Lithium as a first-line treatment, often combined with anticonvulsants and atypical antipsychotics.

Psychological Treatments

  • Include CBT, psychoeducation, family therapy, and interpersonal therapies.