mood disorder - Mood Disorder Depressive disorders Major...

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1 Mood Disorder Depressive disorders Major depressive disorder (MDD) Dysthymic disorder Biopolar Disorder Mood disorder due to a medical condition Substance-induced mood disorder
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2 Kluger, J. & Song, S. (Aug. 19, 2002). Young and bipolar. Time, 160(8), 38-47.
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3 Psychopathology of Mood Disorders - Depression Not diagnosed or misdiagnosed - a lot Prevalence - 9-20% in general population Female - 10-20%; male - 5-12% (life time) Recurrence rate - 50% - 80% Seeking professional help - 16-23% Suicide rate 1% for general population; 18% for MDD higher for people over 50-year-old
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4 General picture of depression Cognitive- attention memory thinking Impulse control – suicide, homicide Behavior - withdrawal, lack of pleasure, fatigability Physiological – multiple complaints ie headache, stomachache, muscle tension Social functioning – isolation, Daily pattern changes – sleep, appetite, weight, libido
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5 Assessment History of onset Comorbid substance - alcohol, med. Physical examination - senile, meta. dis. Non mood psychiatric disorders Secondary or reactive depression Presence and/or level of suicidal ideation Others - measurement scales, biological measures (cortisol, hormone, sleep pattern)
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6 Measures of Depression- Nonbiological assessment Beck Depression Inventory – self- report Diagnostic Interview Schedule – structured interview Structured clinical interview for Axis I – semi-structured interview
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7 Measures of Depression – Biological assessment Dexamethasone Suppression Test (DST) – function of hypothalmic-pituitary-adrenal axis; urine and blood sample are collected for 24 hrs monitor of cortisol; Growth hormone – for children Polysomnographic findings (exam of sleep patterns; REM) – use in adult; not proven valid for children and adolescent
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8 Diagnosis Criteria for Depression Duration: 2weeks↑ Depressed mood and/or anhedonia sleep disturbance, psychomotor disturbance, fatigue, weight change, feelings of worthless & guilt, indecisiveness, recurrent death or suicidal thoughts
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9 Dysthymic Disorder Duration: 2 years (chronicity + severity) Differentiate Dx: organic and drug-related causes S & S: depressed mood, appetite disruption, sleep problems, low energy, low self- esteem, poor concentration, feelings of hopelessness Subjective & objective data
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10 Diagnosis Criteria for Major Depression Duration: 2 weeks↑ Depressed mood and/or anhedonia Sleep disturbance, psychomotor disturbance, fatigue, weight change, feelings of worthless & guilt, indecisiveness, recurrent death or suicidal thoughts Impaired social/occupational functioning
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11 Etiology of Depression Biological theories – neurochemical, genetic, endocrine, circadian rhythm Psychological theories – psychoanalytic (loss),
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mood disorder - Mood Disorder Depressive disorders Major...

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