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 DEPRESSION AND MOOD DISORDERS © Dr. Carolyn H. Suppa, 2006 1. Read Chapter 7 of the Study Guide and Chapters 22 & 23 of Carlat 2. If you have access to the interview guides in the Zimmerman book, review those for Major Depression as well as the lists of medical illnesses causing depression and the list of medications causing depression. 3. Read the following lecture notes. The Mood Disorders section of the DSM is divided into 3 parts; 1) a descriptive section that “serves as building blocks for the diagnostic disorders;” 2) the criteria sets for the Mood Disorders; and 3) the specifiers used to describe either the most recent mood episode or the course of recurrent episodes. Chapter 7 of your study guide (SG) describes the Mood Disorders. I think it is most important to understand the difference between the 2 main mood disorders—major depression and bipolar disorder. This requires a complete knowledge of mania as well as the depressive symptoms. SIGECAPS is the mnemonic device for depressive symptoms used by most physicians including Carlat. You should know them and include them in EVERY initial evaluation regardless of the presenting problem. See: For mania symptoms, Carlat gives the mnemonic DIGFAST – D istractibility I ndiscretion G randiosity or inflated self-esteem F light of ideas or racing thoughts A ctivity increase (increase in goal-directed activity or psychomotor agitation) S leep deficit T alkativeness (pressured speech) Also, you need to know the difference between what is occasionally called “Minor Depression,” but is
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actually termed Dysthymia, and Major Depression. Dysthymia has symptoms similar to Major Depression but presents in a lesser degree in terms of severity, chronicity and persistence. There is also a “lesser form” of Mania termed Hypomania (p. 176 SG). Knowing about Hypomania is crucial to differentiating between Bipolar I & Bipolar II. But you need to find out what that difference is for yourself. It is part of the assignment for Mood Disorders. Once I was talking with a PCP about the fact that with children irritability can be a sign of depression and that I thought that irritability may be a first symptom of depression in pre- or peri- menopausal women and is often overlooked as “just hormonal. .” The PCP said that she liked to call this “dysthymia.” Of course I had to remind her that while I understood that this term often is used for minor or low grade depression, the DSM has clear time-related criteria with regard to the presence of depressive symptoms and a caveat that during this requisite 2 year period of depression, there must not have been an episode of major depression (or mania). She responded with, “I hate that book.” Believe it or not, I kept my mouth shut but I so desperately wanted to lecture her on the fact that it could provide her with a more accurate diagnosis that would not be considered a disorder. Think about that for later.
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This note was uploaded on 03/11/2010 for the course PSYCH 350 taught by Professor Toler during the Spring '10 term at Alvin CC.

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