A condition in which a child has chronic negative moods such as anger and irritability without any accompanying mania. ○The purpose of this new addition is due to the increase of children being diagnosed with bipolar disorder ●Criteria ■Severe temper outbursts occurring frequently, against a backdrop of angry or irritable mood ■Diagnosed only in children 6-18 ■Criteria for manic/hypomanic episode are not met ■Designed in part to combat overdiagnosis of bipolar disorder in youth ●Cyclothymic Disorder vs. Bipolar I & II Disorders ○Bipolar I disorder ■Alternations between major depressive episodes and manic episodes ○Bipolar II disorder ■Alternations between major depressive episodes and hypomanic episodes ○Cyclothymic disorder ■Alternations between less severe depressive and hypomanic periods ●Prevalence of Mood Disorders ○Worldwide lifetime prevalence of MDD: 16%; 6% major depression in last year ○Sex differences ■Females are twice as likely to have major depression ■Bipolar disorders approximately equally affect males and females ■Women more likely to experience rapid cycling ■Women more likely to be in depressive period ○Occurs less often in prepubertal children ○Rapid rise in adolescents ○Adults over 65 have about 50% less prevalence than general population
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○Bipolar same in childhood, adolescents and adults ○Across Cultures ■Prevalence of depression seems to be similar across subcultures ●But experience of symptoms may vary ●E.g., some cultures more likely to express depression as somatic concern ●Higher prevalence among Native Americans: Four times the rate of the general population Causes of Mood DisordersGenetic Influences: Family studies ●Risk is higher if relative has a mood disorder ●Relatives of bipolar probands are more likely to have unipolar depression Twin studies ○Concordance rates are high in identical twins ○Two to three times more likely to present with mood disorders than a fraternal twin of a depressed co-twin ○Severe mood disorders have a strong genetic contribution ○Heritability rates are higher for females compared to males ○Some genetic factors confer risk for both anxiety and depression Neurobiological Causes of mood disorders Neurotransmitter systems ●Serotonin and its relation to other neurotransmitters; regulates norepinephrine and dopamine ●Mood disorders are related to low levels of serotonin The endocrine system ●Elevated cortisol ●Stress hormones decrease neurogenesis in the hippocampus > less able to make new neurons Sleep disturbance ●Hallmark of most mood disorders ●Depressed patients have quicker and more intense REM sleep ●Sleep deprivation may temporarily improve depressive symptoms in bipolar patients Treatment of Mood Disorders Medication: ●Antidepressants ●Selective serotonin reuptake inhibitors ●Tricyclic antidepressants ●Monoamine oxidase inhibitors ●Mixed reuptake inhibitors (e.g., serotonin/norepinephrine reuptake inhibitors) ●
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