Mood Disorders

Describe the symptoms, diagnostic criteria, and epidemiology of mood disorders

  • Mood: Long lasting affective states


  • Mood disorder: Mental health condition characterised by persistent, clinically significant disruption in a person's emotional state

  • Emotional states impair functioning, affect energy levels, and later sleep and thinking

  • Symptoms:

    • Depressed or dysmorphic mood

    • Cognitive impairments

      • Attention

      • Processing speed

      • Executive functioning

      • Learning and memory

      • Verbal fluency

      • Social cognition

    • Behavioural symptoms

      • Social withdrawal

      • Reduced activity

      • Reduced productivity

      • Neglect of self-care

      • Avoidance behaviours

      • Reduced sexual interest or activity

    • Somatic symptoms

      • Appetite changes

      • Weight loss or gain

      • Insomnia or hypersomnia

      • Psychomotor agitation or retardation

      • Fatigue or loss of energy

      • Pain

    • Anhedonia: Loss of interest or pleasure

      • Severe anhedonia: Formerly enjoyable activities bring no enjoyment or even aversion, apathy towards expression of others' love and friendships



 


 


 

 

Discuss the genetic, neurobiological, social, an psychological features associated with mood disorders

  • Genetic

    • Heritability is between 30-40%

    • No single 'depression gene'

    • Polygenic (many genes with small effect)

  • Neurobiological

    • Synaptic function and neuronal communication

    • Stress-response pathways

  • Social

    • Interpersonal factors

  • Psychological

    • Beck's theory:


 

Identify medication and psychological treatments for mood disorders

  • Pharmacotherapy

    • Efficacy:

      • 50-60% respond to first antidepressant

      • 1/3 people require multiple treatment trials

      • 20-30% are treatment resistant

    • Can improve mood and reduce depressive symptoms

    • Takes 2-6 weeks for full therapeutic effect

    • Significant side-effects: Gastro symptoms, headache, sleep, sexual dysfunction, weight gain


 

  • ECT

    • Last resort for severe or treatment resistant depression

    • Procedure:

      • General anaesthesia

      • Pass electronic current 70-130 volts

      • 2-3 times a week

      • Mechanisms not well understood

      • 70-90% response rates

      • Side effects: Short-term confusion, memory loss, lingering cognitive deficits

  • Cognitive-Behavioural Therapy

 

Explain the DSM-5 approach to classifying mood disorders and understand the various subtypes of mood disorders


  • Bipolar disorder is highly heritable (60-85%)

    • Psychological factors:

      • Cognitive factors (rumination and perfectionism)

      • Emotional regulation

      • Behavioural factors (impulsivity and risk-taking behaviours)

      • Trauma

      • Personality and temperament

      • Stress and coping

      • Sleep and circadian disruption

    • Treatment:

      • Pharmacotherapy

      • Psychological therapy (psychoeducation, CBT)