BY: SATHISH RAJAMANI M.

SC (N), LECTURER, BKIN, DAUDHAR

INTRODUCTION
y Emotions can be described as two main

types, Affect Short Lived Emotional Response to an idea or an Event. Mood Sustained and pervasive emotional response which colors the whole psychic life.

DEFINITION
yMood

disorders are characterized by a disturbance of mood, accompanied by a full or partial manic or depressive syndrome, which is not due to any other physical or mental disorder.

PREVALENCE

The prevalence rate of mood disorder is 1.5 it is percent and uniform throughout the world.

CLASSIFICATION
F 30

MANIC EPISODE
BIPOLAR AFFECTIVE DISORDER DEPRESSIVE EPISODE
RECURRENT DEPRESIVE DISORDER

F 31

F 32

F 33

F 34

PERSISTENT MOOD DISORDER OTHER MOOD DISORDER UNSPECIFIED MOOD DISORDER

F 38

F 39

MANIC EPISODE
yMania refers to syndrome in

which the central features are over activity, mood change, (elation or irritability) and self important ideas.

MANIA CLASSIFICATION
Manic Episode

Hypomania
Mania without Psychotic symptoms

Mania with psychotic symptoms

Other manic episodes

Manic episodes unspecified

ETIOLOGY
I.

Neurotransmitter Structural Hypothesis

and

II.

Genetic Considerations

III. Psychodynamic Theories

NEUROTRANSMITTER AND STRUCTURAL HYPOTHESIS

y Increased level of Dopamine and NE y Imbalance in cholinergic and Nor

adrenergic y Deficiency of 5 HT.

y Lesions in Right hemisphere of the

brain, Bilateral, Subcortical Periventricular Grey Matter.

and

GENETIC HYPOTHESIS
y Monozygotic Twins More than Dizygotiic

Twins. y First Degree relatives 5 10% Chance. y Identical Twins with BPD has 40 70 % chance.

PYSCHO DYNAMIC THEORIES

y Faulty Family Dynamics. y Defense against or denial of depression.

CLINICAL FEATURES
An acute manic episode is characterized by the following features, 1. Elevated, Expansive or Irritable Mood 2. Psychomotor Activity 3. Speech and Thought 4. Other Features 5. Symptoms of Hypomania 6. Stages of Elevated Mood

FOUR STAGES OF ELEVATED MOOD

Ecstasy
Exaltation Elation

Euphoria

y EUPHORIA - Increased sense of psychological

wellbeing and happiness. y ELATION Moderate elevation of mood with increased psychomotor activity. y EXALTATION Intense elevation of mood with delusions of grandeur. y ECSTASY = Severe elevation of mood with intense sense of blissfulness.

DIAGNOSIS
yPsychological Test

(Young Mania Rating Scale) yICD 10 Diagnostic criteria yBased on MSE

TREATMENT
yPharmacotherapy yElectroconvulsive

Therapy yPsychosocial Treatment

NURSING MANAGEMENT
y High Risk for injury related to extreme hyperactivity and

impulsive behavior, evidenced by lack of control over purposeless and potentially injurious movements.
y High Risk for violence, self directed or directed at others

related to manic excitement, delusional thinking and paranoid hallucinations.

y Impaired social interaction related to egocentric

and narcissistic behavior as evidenced by inability to develop satisfying relationship.

y Self Esteem disturbance related to unmet

dependency needs