Mood Disorders: What Is Mood Disorder?

Mood Disorders What is mood
Part 1 disorder?
Rainier B. Umali, M.D.
Mood Disorder Mood

is a group of conditions where a is a pervasive and sustained feeling
disturbance in the person's mood or tone that is experienced internally and
feeling is the main underlying feature that influences a person's behavior and
perception of the world
Affect Definition of Terms

is observed feeling tone of the 1. Manic
individual showing wild and apparently
deranged excitement and energy
2. Flight of ideas
refers to a thought disorder, wherein
there are abrupt, rapid shifts in the
conversation topics
Definition of Terms Definition of Terms

3. Thought racing 5. Tangential
A series of uncontrollable thoughts that train of thought of the speaker wanders
switch rapidly between ideas and shows a lack of focus, never
4. Pressure of speech returning to the initial topic of the
tendency to speak rapidly and frenziedly, as conversation
if motivated by an urgency not apparent to
the listener 6. Circumstantial
they re difficult to interrupt occurs when the focus of a
speech may be too fast, erratic, irrelevant, or conversation drifts, but often comes
too tangential for the listener to understand back to the point
Definition of Terms Bipolar and Related Disorders
7. Lability of mood are separated from the depressive disorders
sign or symptom typified by in DSM-5 and placed between the chapters
exaggerated changes in mood or affect on schizophrenia spectrum and other
in quick succession psychotic disorders and depressive
disorders in recognition of their place as a
bridge between the two diagnostic classes in
terms of symptomatology, family history,
and genetics.
Bipolar and Related Disorders Bipolar and Related Disorders

The diagnoses included in this chapter The diagnoses included in this chapter
are: are:
1. bipolar I disorder 4. substance/medication-induced
2. bipolar II disorder bipolar and related disorder
3. cyclothymic disorder 5. bipolar and related disorder due to
another medical condition
For a diagnosis of bipolar I disorder,

Bipolar I Disorder it is necessary to meet the following
criteria for a manic episode.
(ICD 10-F31.0) The manic episode may have been
preceded by and may be followed by
hypomanic or major depressive
episodes.
I. Manic Episode
A.A distinct period of abnormally and
Bipolar I Disorder persistently:
I. Manic Episode elevated
expansive or irritable mood
Diagnostic Criteria
I. Manic Episode I. Manic Episode
A.A distinct period of abnormally and B. During the period of mood disturbance
persistently: and increased energy or activity, three (or
more) of the following symptoms are
increased goal-directed activity or
present to a significant degree and
energy, lasting at least 1 week represent a noticeable change from usual
present most of the day, nearly behavior:
every day (or any duration if 1. Inflated self-esteem or grandiosity.
hospitalization is necessary)

B. During the period of mood disturbance B. During the period of mood disturbance
and increased energy or activity, three (or and increased energy or activity, three (or
more) of the following symptoms are more) of the following symptoms are
present to a significant degree and present to a significant degree and
represent a noticeable change from usual represent a noticeable change from usual
behavior: behavior:
2. Decreased need for sleep (e.g., feels 3. More talkative than usual or pressure
rested after only 3 hours of sleep) to keep talking (pressure of speech)

behavior: behavior:
4. Flight of ideas or subjective experience 5. Distractibility (i.e., attention too easily
that thoughts are racing. drawn to unimportant or irrelevant
external stimuli), as reported or
observed.

behavior: behavior:
6. Increase in goal-directed activity (either 7. Excessive involvement in activities that have
socially, at work or school, or sexually) a high potential for painful consequences
or psychomotor agitation (i.e., (e.g., engaging in unrestrained buying
purposeless non-goal-directed activity). sprees, sexual indiscretions, or foolish
business investments).
C.The mood disturbance is sufficiently D.The episode is not attributable to the
severe to cause marked impairment physiological effects of a substance
in social or occupational functioning (e.g., a drug of abuse, a medication,
or to necessitate hospitalization to other treatment) or to another
prevent harm to self or others, or medical condition.
there are psychotic features.
I. Manic Episode
NOTE: Criteria A-D constitute a manic
episode. At least one lifetime manic Bipolar I Disorder
episode is required for the diagnosis of
bipolar I disorder.
II. Hypomanic Episode
Diagnostic Criteria
II. Hypomanic Episode II. Hypomanic Episode

A. A distinct period of abnormally and B. During the period of mood disturbance
persistently: and increased energy and activity, three
(or more) of the following symptoms
elevated
have persisted and represent a noticeable
expansive, or irritable mood change from usual behavior, and have
abnormally and persistently increased been present to a significant degree:
activity or energy, lasting at least 4
consecutive days NOTE: Criteria for 1-7 of Hypomanic
Episode is the same with Manic Episode
present most of the day, nearly every
day

C. The episode is associated with an D. The disturbance in mood and the
unequivocal change in functioning change in functioning are observable
that is uncharacteristic of the by others.
individual when not symptomatic.
E. The episode is NOT severe enough F. The episode is not attributable to the
to cause marked impairment in physiological effects of a substance
social or occupational functioning or (e.g., a drug of abuse, a medication,
to necessitate hospitalization. other treatment).
II. Hypomanic Episode

NOTE: Criteria A-F constitute a
hypomanic episode. Hypomanic
Bipolar I Disorder
episodes are common in bipolar I III. Major Depressive
disorder but are not required for the Episode
diagnosis of bipolar I disorder.
Diagnostic Criteria
III. Major Depressive Episode III. Major Depressive Episode

A. Five (or more) of the following symptoms have A. Five (or more) of the following symptoms have
been present during the same 2-WEEK PERIOD been present during the same 2-WEEK PERIOD
and represent a change from previous and represent a change from previous
functioning; at least one of the symptoms is functioning; at least one of the symptoms is
either (1) depressed mood or (2) loss of interest either (1) depressed mood or (2) loss of interest
or pleasure. or pleasure.
1. Depressed mood most of the day, nearly every 2. Markedly diminished interest or pleasure in
day, as indicated by either subjective report all, or almost all, activities most of the day,
(e.g., feels sad, empty, or hopeless) or nearly every day (as indicated by either
observation made by others (e.g., appears subjective account or observation).
tearful). (Note: In children and adolescents, can
be irritable mood.)

3. Significant weight loss when not dieting or
weight gain (e.g., a change of more than 5% of 4. Insomnia or hypersomnia nearly every day.
body weight in a month), or decrease or increase
in appetite nearly every day. (Note: In children,
consider failure to make expected weight gain.)
5. Psychomotor agitation or retardation nearly
every day (observable by others; not merely 6. Fatigue or loss of energy nearly every day.
subjective feelings of restlessness or being
slowed down).

7. Feelings of worthlessness or excessive or 8. Diminished ability to think or concentrate, or
inappropriate guilt (which may be indecisiveness, nearly every day (either by
delusional) nearly every day (not merely self- subjective account or as observed by others).
reproach or guilt about being sick).

A. Five (or more) of the following symptoms have B. The symptoms cause clinically significant
been present during the same 2-WEEK PERIOD distress or impairment in social,
and represent a change from previous occupational, or other important areas of
functioning; at least one of the symptoms is
either (1) depressed mood or (2) loss of interest
functioning.
or pleasure.
9. Recurrent thoughts of death (not just fear of
dying), recurrent suicidal ideation without a
specific plan, or a suicide attempt or a
specific plan for committing suicide.
III. Major Depressive Episode

C. The episode is not attributable to the NOTE:
physiological effects of a substance or A.Criteria have been met for at least
another medical condition.
one MANIC EPISODE.
NOTE:
B. The occurrence of the manic and major
Bipolar I Disorder
depressive episode(s) is not better
Associated Features for
explained by schizoaffective disorder,
schizophrenia, schizophreniform Bipolar I Disorder:
disorder, delusional disorder, or other Manic Episode
specified or unspecified schizophrenia
spectrum and other psychotic disorder.
Associated Features for Bipolar I Associated Features for Bipolar I

Disorder: Manic Episode Disorder: Manic Episode
During a manic episode, individuals often Mood may shift very rapidly to anger
do not perceive that they are ill or in need or depression (lability of mood)
of treatment and vehemently resist efforts
to be treated. Individuals may change
their dress, makeup, or personal
appearance to a more sexually suggestive
or flamboyant style. Some perceive a
sharper sense of smell, hearing, or vision.
Prevalence
The lifetime male-to-female
prevalence ratio is approximately
Bipolar I Disorder 1.1:1.
Prevalence
Course and Development

Mean age at onset of the first manic,
hypomanic, or major depressive
Bipolar I Disorder episode is approximately 18 years for
bipolar I disorder.
More than 90% of individuals who
have a single manic episode go on to
have recurrent mood episodes. Bipolar I Disorder
Risk and Prognostic
Factors
Risk and Prognostic Factors Risk and Prognostic Factors

Environmental: Genetic and Physiological:
Bipolar disorder is more common in A family history of bipolar disorder is
high-income than in low-income one of the strongest and most consistent
countries (1.4 vs. 0.7%). Separated, risk factors for bipolar disorders. There
divorced, or widowed individuals have is an average 10-fold increased risk
higher rates of bipolar I disorder than among adult relatives of individuals
do individuals who are married or have with bipolar I and bipolar II disorders.
never been married Magnitude of risk increases with degree
of kinship.
Gender-Related Diagnostic
Issues
Females are more likely to experience
rapid cycling and mixed states, and to
Bipolar I Disorder have patterns of comorbidity that
differ from those of males
Issues
Suicide Risk
The lifetime risk of suicide in
individuals with bipolar disorder is
Bipolar I Disorder estimated to be at least 15 times that
of the general population.
Suicide Risk Bipolar disorder may account for one-
quarter of all completed suicides.
For a diagnosis of bipolar II disorder, it is
Bipolar II Disorder necessary to meet the following criteria for
a current or past hypomanic episode and
(ICD 10-F31.81) the following criteria for a current or past
major depressive episode:
I. Hypomanic Episode
NOTE: Criteria A-F is the same as the
Bipolar II Disorder Hypomanic Episode in Bipolar I
Disorder
I. Hypomanic Episode
Diagnostic Criteria
I. Major Depressive Episode

NOTE: Criteria A-C is the same as the
Bipolar II Disorder Major Depressive Episode in Bipolar I
I. Major Depressive Disorder
Episode
Diagnostic Criteria
NOTE: NOTE:
A. Criteria have been met for at least B. THERE HAS NEVER BEEN A
one HYPOMANIC EPISODE MANIC EPISODE.
(Criteria A-F under HYPOMANIC
EPISODE above) and at least one
major depressive episode (Criteria
A-C under Major Depressive
Episode above).
NOTE: NOTE:
C. The occurrence of the hypomanic D. The symptoms of depression and
episode(s) and major depressive hypomania causes clinically
episode(s) is not better explained by significant distress or impairment
schizoaffective disorder, in social, occupational, or other
schizophrenia, schizophreniform
important areas of functioning.
disorder, delusional disorder, or other
specified or unspecified schizophrenia
spectrum and other psychotic disorder.
Associated Features
Impulsivity may contribute to suicide
attempts and substance use disorders
Bipolar II Disorder Heightened creativity may contribute to
ambivalence about seeking treatment
Associated Features
Prevalence
0.3% to 0.8% of the general population
Bipolar II Disorder
Prevalence

Average onset mid-20s
Starts later than bipolar I disorder but
Bipolar II Disorder earlier than major depressive disorder

Risk and Prognostic Factors
Genetic and Physiological
Bipolar II Disorder risk of bipolar II disorder tends to

be highest among relatives of
individuals with bipolar II disorder,
Risk and Prognostic
as opposed to individuals with
Factors bipolar I disorder or major
depressive disorder.
Issues
Little to no evidence of bipolar
gender differences
Bipolar II Disorder
Issues
Suicide Risk
Suicide risk is high in bipolar II
disorder.
Bipolar II Disorder Approximately one-third of
individuals with bipolar II disorder
Suicide Risk
report a lifetime history of suicide
attempt.
Prevalence rate 32.4% to 36.3%
Diagnostic Criteria
A. For at least 2 YEARS (at least 1 year in
Cyclothymic Disorder children and adolescents).
(ICD 10-F34.0) There have been numerous periods

with hypomanic symptoms that do
Diagnostic Criteria not meet criteria for a hypomanic
episode and numerous periods with
depressive symptoms that do not
meet criteria for a major depressive
episode.
Diagnostic Criteria Diagnostic Criteria
B. During the above 2-year period (1 C. Criteria for a major depressive,
year in children and adolescents), manic, or hypomanic episode have
the hypomanic and depressive never been met.
periods have been present for at
least half the time and the
individual has not been without the
symptoms for more than 2 months
at a time.

D. The symptoms in Criterion A are E. The symptoms are not attributable
not better explained by to the physiological effects of a
schizoaffective disorder, substance (e.g., a drug of abuse, a
schizophrenia, schizophreniform medication) or another medical
disorder, delusional disorder, or condition (e.g., hyperthyroidism).
other specified or unspecified
schizophrenia spectrum and other
psychotic disorder.
Diagnostic Criteria
F. The symptoms cause clinically
significant distress or impairment
in social, occupational, or other Cyclothymic Disorder
important areas of functioning.
Prevalence
Prevalence
Lifetime prevalence of cyclothymic
disorder is approximately 0.4%-l%.
Cyclothymic Disorder
Begins in adolescence or early adult
life
Has an insidious onset and a Cyclothymic Disorder
persistent course
Risk and Prognostic
Factors
Risk and Prognostic Factors Risk and Prognostic Factors

Genetic and Physiological Genetic and Physiological
Common among first-degree There may also be an increased
biological relatives of individuals familial risk of substance-related
with cyclothymic disorder than in disorders.
the general population
Diagnostic Criteria
Substance/Medication A. A prominent and persistent
-Induced disturbance in mood characterized
by elevated, expansive, or irritable
Bipolar and Related mood, with or without depressed
Disorder mood, or markedly diminished
interest or pleasure in all, or almost
Diagnostic Criteria
all, activities.

B. There is evidence from the history, B. There is evidence from the history,
physical examination, or laboratory physical examination, or laboratory
findings of both (1)and (2): findings of both (1)and (2):
1. The symptoms in Criterion A 2. The involved
developed during or soon after substance/medication is capable of
substance intoxication or producing the symptoms in
withdrawal or after exposure to a Criterion A.
medication.
C. The disturbance is not better D. The disturbance does not occur
explained by a bipolar or related exclusively during the course of a
disorder that is NOT delirium.
substance/medication-induced.
Diagnostic Criteria
E. The disturbance causes clinically Substance/Medication
significant distress or impairment in -Induced
social, occupational, or other
important areas of functioning. Bipolar and Related
Disorder
Prevalence
Prevalence
There are no epidemiological studies Substance/Medication
of substance/medication-induced -Induced
mania or bipolar disorder
Bipolar and Related
Disorder
Course and Development Course and Development

In stimulant-induced manic or The episode is very brief and
hypomanic states, the response is in typically resolves over 1-2 days
minutes to 1 hour after one or several
ingestions or injections
Diagnostic Criteria
Bipolar and Related A. A prominent and persistent period
Disorder of abnormally elevated, expansive,
or irritable mood and abnormally
Due to Another increased activity or energy that
Medical Condition predominates in the clinical picture.
Diagnostic Criteria

B. There is evidence from the history, C. The disturbance is not better
physical examination, or laboratory explained by another mental
findings that the disturbance is the disorder.
direct pathophysiological
consequence of another medical
condition.

D. The disturbance does not occur E. The disturbance causes clinically
exclusively during the course of a significant distress or impairment
delirium. in social, occupational, or other
important areas of functioning, or
necessitates hospitalization to
prevent harm to self or others, or
there are psychotic features.
Associated Features
Bipolar and Related Among the best known of the
Disorder medical conditions that can cause a
bipolar manic or hypomanic
Due to Another condition are Cushing's disease and
Medical Condition multiple sclerosis, as well as stroke
and traumatic brain injuries.
Associated Features
Bipolar and Related Has its onset acutely or subacutely
Disorder within the first weeks or month of the
onset
Due to Another
Medical Condition
Issues
Bipolar and Related Female systemic lupus
Disorder erythematosus (SLE)
Due to Another Male stroke
Medical Condition
Issues
MOOD DISORDERS DEPRESSIVE
PART 2 DISORDERS
Depressive disorders include: Depressive disorders include:

1. disruptive mood dysregulation disorder 3. persistent depressive disorder
2. major depressive disorder (including (dysthymia)
major depressive episode) 4. premenstrual dysphoric disorder
Depressive disorders include: DISRUPTIVE MOOD

5. substance/medication-induced DYSREGULATION
depressive disorder DISORDER
6. depressive disorder due to another
medical condition
DIAGNOSTIC CRITERIA DIAGNOSTIC CRITERIA
A. Severe recurrent temper outbursts B. The temper outbursts are inconsistent

manifested verbally (e.g., verbal rages) with developmental level.
and/or behaviorally (e.g., physical aggression
toward people or property) that are grossly
out of proportion in intensity or duration
to the situation or provocation.
C. The temper outbursts occur, on D. The mood between temper outbursts

average, three or more times per is persistently irritable or angry most
week. of the day, nearly every day, and is
observable by others (e.g., parents,
teachers, peers).
E. Criteria A-D have been present for 12 F. Criteria A and D are present in at least
or more months. Throughout that time, two of three settings
the individual has not had a period Home
lasting 3 or more consecutive months. School
Peers
G. The diagnosis should be made between H. By history or observation, the age at

age 6 years and 18 below. onset of Criteria A-E is before 10
years.
I. There has never been a distinct period J. The behaviors do not occur exclusively during an
lasting more than 1 day. episode of major depressive disorder and are not
better explained by another mental disorder (e.g.,
autism spectrum disorder, posttraumatic stress
disorder, separation anxiety disorder, persistent
depressive disorder [dysthymia]).
DIAGNOSTIC CRITERIA PREVALENCE
K. The symptoms are not attributable to

Children 2-5%
the physiological effects of a substance
Adolescent 1-2%
or to another medical or neurological
Disruptive Mood Dysregulation Disorder is
condition.
more common than bipolar disorder prior to
adolescence
GENDER-RELATED DIAGNOSTIC
RISK AND PROGNOSTIC FACTORS
ISSUES
Temperamental Predominantly male children

chronic irritability
ADHD
DIAGNOSTIC CRITERIA
MAJOR DEPRESSIVE NOTE: Criteria A-C is the same as in

DISORDER Major Depressive Episode
D. The occurrence of the major depressive E. There has NEVER been a manic
episode is not better explained by episode or a hypomanic episode.
schizoaffective disorder, schizophrenia,
schizophreniform disorder, delusional
disorder, or other specified and unspecified
schizophrenia spectrum and other psychotic
disorders.
ASSOCIATED FEATURES PREVALENCE
Associated with high mortality, much of Female 1.5-3x higher than males
which is accounted for by suicide
COURSE AND DEVELOPMENT COURSE AND DEVELOPMENT
Appears at any age but increases markedly in The risk of recurrence becomes progressively lower
puberty over time as the duration of remission increases.
Course is variable some rarely experience Despite consistent differences between genders in
remission while others many years with few prevalence rates there appear to be no clear
or no symptoms between episodes differences by gender for treatment response
RISK AND PROGNOSTIC FACTORS RISK AND PROGNOSTIC FACTORS
Temperamental Genetic and Physiological

Neuroticism (negative affectivity) is a First-degree family members of individuals
well-established risk factor for the with major depressive disorder have a risk
for major depressive disorder two- to
onset of major depressive disorder
fourfold higher than that of the general
population.
RISK AND PROGNOSTIC FACTORS SUICIDE RISK
Environmental The possibility of suicidal behavior exists

Stressful life events at all times during major depressive
episodes.
The most consistently described risk
factor is a past history of suicide
attempts.
DIAGNOSTIC CRITERIA
PERSISTENT DEPRESSIVE A. Depressed mood for most of the day, for more
DISORDER (DYSTHYMIA) days than not, as indicated by either subjective
account or observation by others, for at least 2
YEARS.
NOTE: Children 1 YEAR
B. Presence, while depressed, of two (or more) of the B. Presence, while depressed, of two (or more) of the
following: following:
1. Poor appetite or overeating. 4. Low self-esteem.
2. Insomnia or hypersomnia. 5. Poor concentration or difficulty making decisions.
3. Low energy or fatigue. 6.Feelings of hopelessness/ helplessness / worthlessness
C. During the 2-year period of the D. Criteria for a major depressive

disturbance, the individual is NOT disorder may be continuously present
symptom-free of Criteria A and B for for 2 years.
more than 2 months at a time.
E. There has never been a manic episode F. The disturbance is not better explained
or a hypomanic episode. by a persistent schizoaffective disorder,
schizophrenia, delusional disorder, or
other specified or unspecified
schizophrenia spectrum and other
psychotic disorder.
G. The symptoms are not attributable to H. The symptoms cause clinically

the physiological effects of a substance significant distress or impairment in
(e.g., a drug of abuse, a medication) or social, occupational, or other important
another medical condition (e.g. areas of functioning.
hypothyroidism).
PREVALENCE COURSE AND DEVELOPMENT
In the U.S. 0.5% It follows an early and insidious onset
Worldwide 4.6% Early onset is associated with a higher

likelihood of comorbid personality
disorders and substance use disorders.
Temperamental Environmental
Factors predictive of poorer long-term Loss or separation of parents
outcome include higher levels of
neuroticism (negative affectivity)
Greater severity of symptoms
Poor GAF
Genetic and Physiological PREMENSTRUAL

No clear differences in illness DYSPHORIC DISORDER
development, course, or family history
A. In the majority of menstrual cycles, at B. One (or more) of the following

least five symptoms must be present in symptoms must be present:
the final week before the onset of 1. Marked affective lability
menses, start to improve within a few mood swings:
days after the onset of menses, and
feeling suddenly sad or tearful
become minimal or absent in the week
increased sensitivity to rejection
postmenses.
B. One (or more) of the following B. One (or more) of the following
symptoms must be present: symptoms must be present:
2. Marked irritability or anger or 3. Marked depressed mood, feelings of
increased interpersonal conflicts. hopelessness, or self-deprecating
thoughts.
B. One (or more) of the following C. One (or more) of the following
symptoms must be present: symptoms must be present.
4. Marked anxiety or tension 1. Decreased interest in usual activities
(e.g., work, school, friends, hobbies).
C. One (or more) of the following C. One (or more) of the following
symptoms must be present. symptoms must be present.
2. Subjective difficulty in concentration. 3. Lethargy, easy fatigability, or marked
lack of energy.
4. Marked change in appetite; 5. Hypersomnia or insomnia.
overeating; or specific food cravings.
6. A sense of being overwhelmed or 7. Physical symptoms such as breast
out of control. tenderness or swelling, joint or
muscle pain, a sensation of bloating,
or weight gain.
D. The symptoms are associated with

D. The symptoms are associated with
clinically significant distress or
clinically significant distress or
interference with:
interference with:
Work
Social activities
School
Relationships with others
DIAGNOSTIC CRITERIA PREVALENCE
E. The symptoms are not attributable to 5.8% of menstruating women

the physiological effects of a substance
(e.g., a drug of abuse, a medication,
other treatment) or another medical
condition (e.g., hyperthyroidism).
COURSE AND DEVELOPMENT RISK AND PROGNOSTIC FACTORS
Occurs at any point after menarche Environmental

Stress
Interpersonal trauma
Seasonal changes
Sociocultural aspects of female sexual
behavior
SUBSTANCE/MEDICATION
Genetic and Physiological -INDUCED
Unknown DEPRESSIVE DISORDER
A. A prominent and persistent NOTE: Criteria B-E is the same as

disturbance in mood that Substance/Medication-Induced Bipolar and
predominates in the clinical picture and Related Disorder
is characterized by depressed mood or
markedly diminished interest or
pleasure in all, or almost all, activities.
PREVALENCE COURSE AND DEVELOPMENT
0.26% of adult population Onset while taking the substance or

during withdrawal
Once the substance is discontinued, the
depressive symptoms usually remit within
days to several weeks
Temperamental Environmental
history of major depressive disorder Treatment using anti hepatitis C drugs
history of drug-induced depression Corticosteroids
psychosocial stressors Estrogen
SUICIDE RISK
DEPRESSIVE DISORDER
Marked change in thoughts and behavior
DUE TO ANOTHER
from the person s baseline
MEDICAL CONDITION
A. A prominent and persistent period of B. There is evidence from the history,

depressed mood or markedly physical examination, or laboratory
diminished interest or pleasure in all, findings that the disturbance is the
or almost all, activities that direct pathophysiological consequence
predominates in the clinical picture. of another medical condition.
C. The disturbance is not better D. The disturbance does not occur

explained by another mental disorder exclusively during the course of a
(e.g., adjustment disorder, with delirium.
depressed mood, in which the stressor
is a serious medical condition).
DIAGNOSTIC CRITERIA COURSE DEVELOPMENT
E. The disturbance causes clinically Stroke most common

significant distress or impairment in Cancer
social, occupational, or other important Huntington s Disease
areas of functioning.
GENDER-RELATED DIAGNOSTIC
ISSUES
Frontal lobe lesion Female SLE

Cerebro Vascular Accident (CVA) Male stroke
SUICIDE RISK
THANK YOU
No epidemiological studies that provide AND
evidence to differentiate the risk of GOOD DAY!
suicide from a major depressive episode

Mood Disorders: What Is Mood Disorder?

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Mood Disorders What is mood

Mood Disorder Mood

Affect Definition of Terms

Definition of Terms Definition of Terms

Bipolar and Related Disorders Bipolar and Related Disorders

For a diagnosis of bipolar I disorder,

I. Manic Episode I. Manic Episode

I. Manic Episode I. Manic Episode

I. Manic Episode I. Manic Episode

II. Hypomanic Episode II. Hypomanic Episode

II. Hypomanic Episode II. Hypomanic Episode

II. Hypomanic Episode

III. Major Depressive Episode III. Major Depressive Episode

III. Major Depressive Episode III. Major Depressive Episode

III. Major Depressive Episode III. Major Depressive Episode

III. Major Depressive Episode III. Major Depressive Episode

III. Major Depressive Episode

Associated Features for Bipolar I Associated Features for Bipolar I

Course and Development

Risk and Prognostic Factors Risk and Prognostic Factors

I. Major Depressive Episode

Course and Development

Course and Development

Bipolar II Disorder risk of bipolar II disorder tends to

(ICD 10-F34.0) There have been numerous periods

Diagnostic Criteria Diagnostic Criteria

Risk and Prognostic Factors Risk and Prognostic Factors

Diagnostic Criteria Diagnostic Criteria

Course and Development Course and Development

Diagnostic Criteria Diagnostic Criteria

Diagnostic Criteria Diagnostic Criteria

Due to Another Male stroke

Depressive disorders include: Depressive disorders include:

Depressive disorders include: DISRUPTIVE MOOD

DIAGNOSTIC CRITERIA DIAGNOSTIC CRITERIA

A. Severe recurrent temper outbursts B. The temper outbursts are inconsistent

C. The temper outbursts occur, on D. The mood between temper outbursts

DIAGNOSTIC CRITERIA DIAGNOSTIC CRITERIA

DIAGNOSTIC CRITERIA DIAGNOSTIC CRITERIA

G. The diagnosis should be made between H. By history or observation, the age at

DIAGNOSTIC CRITERIA DIAGNOSTIC CRITERIA

K. The symptoms are not attributable to

Temperamental Predominantly male children

MAJOR DEPRESSIVE NOTE: Criteria A-C is the same as in

DIAGNOSTIC CRITERIA DIAGNOSTIC CRITERIA

COURSE AND DEVELOPMENT COURSE AND DEVELOPMENT

RISK AND PROGNOSTIC FACTORS RISK AND PROGNOSTIC FACTORS

Temperamental Genetic and Physiological

RISK AND PROGNOSTIC FACTORS SUICIDE RISK

Environmental The possibility of suicidal behavior exists

NOTE: Children 1 YEAR

DIAGNOSTIC CRITERIA DIAGNOSTIC CRITERIA

DIAGNOSTIC CRITERIA DIAGNOSTIC CRITERIA

C. During the 2-year period of the D. Criteria for a major depressive

DIAGNOSTIC CRITERIA DIAGNOSTIC CRITERIA

G. The symptoms are not attributable to H. The symptoms cause clinically

PREVALENCE COURSE AND DEVELOPMENT

In the U.S. 0.5% It follows an early and insidious onset

Worldwide 4.6% Early onset is associated with a higher

RISK AND PROGNOSTIC FACTORS RISK AND PROGNOSTIC FACTORS

RISK AND PROGNOSTIC FACTORS

Genetic and Physiological PREMENSTRUAL