Summary #3 Blue & beyond
mood disorders: severe alterations in mood for longer periods of time. The disturbances of
mood are intense and persistent enough to lead to serious problems in relationships and
work performance.
unipolar depressive disorders
= a person only experiences depressive episodes.
Bipolar disorders
= a person experiences both depressive and manic episodes.
Depression: mood disorder that is expressed by various cognitive, behavioral, physical,
motivational symptoms (e.g.; negative views of self and world, cognitive biases,
sleepdisturbance, general pain, lack of initiative, paralysis of will, lethargy, sadness,
emptiness & other negative emotions)
Mania: boundless, frenzied energy and feelings of euphoria.
mixed-episodes: rapidly alternating moods such as sadness, euphoria, and irritability, all
within the same episode of illness.
Hypomania: abnormally elevated, expansive, irritable mood for 4+ days. Must have 3+ other
symptoms similar to those involved in mania but to a lesser degree. less impairment in social
and occupational functioning
, Major Depressive Disorder/unipolar major depression
Important is that in order to diagnose major depressive disorder, no (hypo)manic episodes
should (have) be(en) present.
Episode: last 6-9 months
Relapse
= return of symptoms within fairly short period of time, the underlying episode of depression
has not yet run its course
recurrence
= onset of a new episode of depression, occurs in approximately 40-75% of people who
experience a depressive episode
The more prior episodes & comorbidity = the higher probability of recurrence
Multiple episodes? Usually not totally symptom free in between
Epidemiology
Typical age of onset 27 (late adolescence – middle adulthood): period of great turmoil.
Prevalence 5-17%
Drop is depression above 65 years, rise in depression after 85 years
Why drop?
- Many of those with depression predisposition have low life expectancy
- Older more life experience cope better
- These people from a generation which was less prone but also less openminded
about depression (less report)
- Often medical illness = less focus on mental health; hard to diagnose
Though, it varies
- Culture (stigma, different expression in non-western countries)
o Generation one was born is before 1915 or after 1955
o Gender (2X more in females)
60% of depression also anxiety
Cultural variation due to stigma, somatization (people only reporting physical complaints),
subjectivity of diagnosis, recall failure.
Subtypes/specifiers of depression
o Melancholic features
= low pleasure, depressed mood, worse in the morning (early awakening),
psychomotor retardation, weightloss, guilt.
o Psychotic features
= delusions & hallucinations that may or may not be related to depressive themes.
o Catatonic features
= bizar motor changes. (psychomotor retardation/agitation = slowed down, aroused)
o Atypical features
= some positive responsiveness, overeating, hypersomnia, interpersonal rejection.
o Seasonal features
= 2 years of depression during specific seasons (especially, winter)
o Peripartum features
mood disorders: severe alterations in mood for longer periods of time. The disturbances of
mood are intense and persistent enough to lead to serious problems in relationships and
work performance.
unipolar depressive disorders
= a person only experiences depressive episodes.
Bipolar disorders
= a person experiences both depressive and manic episodes.
Depression: mood disorder that is expressed by various cognitive, behavioral, physical,
motivational symptoms (e.g.; negative views of self and world, cognitive biases,
sleepdisturbance, general pain, lack of initiative, paralysis of will, lethargy, sadness,
emptiness & other negative emotions)
Mania: boundless, frenzied energy and feelings of euphoria.
mixed-episodes: rapidly alternating moods such as sadness, euphoria, and irritability, all
within the same episode of illness.
Hypomania: abnormally elevated, expansive, irritable mood for 4+ days. Must have 3+ other
symptoms similar to those involved in mania but to a lesser degree. less impairment in social
and occupational functioning
, Major Depressive Disorder/unipolar major depression
Important is that in order to diagnose major depressive disorder, no (hypo)manic episodes
should (have) be(en) present.
Episode: last 6-9 months
Relapse
= return of symptoms within fairly short period of time, the underlying episode of depression
has not yet run its course
recurrence
= onset of a new episode of depression, occurs in approximately 40-75% of people who
experience a depressive episode
The more prior episodes & comorbidity = the higher probability of recurrence
Multiple episodes? Usually not totally symptom free in between
Epidemiology
Typical age of onset 27 (late adolescence – middle adulthood): period of great turmoil.
Prevalence 5-17%
Drop is depression above 65 years, rise in depression after 85 years
Why drop?
- Many of those with depression predisposition have low life expectancy
- Older more life experience cope better
- These people from a generation which was less prone but also less openminded
about depression (less report)
- Often medical illness = less focus on mental health; hard to diagnose
Though, it varies
- Culture (stigma, different expression in non-western countries)
o Generation one was born is before 1915 or after 1955
o Gender (2X more in females)
60% of depression also anxiety
Cultural variation due to stigma, somatization (people only reporting physical complaints),
subjectivity of diagnosis, recall failure.
Subtypes/specifiers of depression
o Melancholic features
= low pleasure, depressed mood, worse in the morning (early awakening),
psychomotor retardation, weightloss, guilt.
o Psychotic features
= delusions & hallucinations that may or may not be related to depressive themes.
o Catatonic features
= bizar motor changes. (psychomotor retardation/agitation = slowed down, aroused)
o Atypical features
= some positive responsiveness, overeating, hypersomnia, interpersonal rejection.
o Seasonal features
= 2 years of depression during specific seasons (especially, winter)
o Peripartum features
