A condition in which a child has chronic negative moods such as anger and

A condition in which a child has chronic negative

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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 Disorders Genetic 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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  • Fall '09
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