Mood Disorders (Affective Disorder) Date: Tuesday, November 22 @ 00:19:46 IST Topic: Psychiatry Print this page Mood – Internal Emotional State of an Individual Mood Disorder – Excessive swing of Mood Normal – Mild Elation to Mild Depression depending on many factors. -------------------- Classification -------------------- 1. Manic Depressive Psychosis - Bipolar Affective Disorders 2. Endogenus Depression - Major Depression 3. Neurotic Depression - Dysthymic Disorder Depression It is the common cold of Psychiatric Illness, Commonly people says – Sad – Depressed – Down, Mood out, Dull, Lost of Interest & isolated. ======================================== Depression ======================================== – reaction to an event such as death of a loved one or Change in financial situation or it may come without any obvious external cause -------------------- Epidemiology -------------------- -Wide Spread Problem -Young and Old -Rich and Poor -Men & Women India – 1-6 % population 5 – 20 % Psychiatric Out Patient Age  30 – 50 Yrs. > 60 Yrs.  13 – 22 % Depression Female > Male -------------------- Major Depression -------------------- Presence of a. Depressed Mood b. Loss of Interest and Pleasure c. 4 or more of following symptoms Feelings of worthlessness or guilt Impaired Concentration Loss of Energy and Fatigue Thoughts Suicide Loss or increase of Appetite & Weight Insomnia or Excessive sleep Retardation or Agitation - Symptoms for atleast 2 weeks, Major Depression - Major Depression may present with or without psychotic symptoms. - Delusions, Hallucination & Bizaree Behaviour -------------------- Dysthymic Disorder -------------------- Depressed Mood – 2 Years Other Symptoms Or Sleep Or Appetite, Energy Self Esteem Poor Concentration & Hopelessness -------------------- Masked Depression -------------------- -------------------- Seasonal Depression – Winter -------------------- -------------------- Aetiology for Depression -------------------- Biological Factors Genetic Factors - Higher among the relatives of Individual Biochemical - Reduced Norepinephrine, Serotonin & Dopamine - Transposition of Sodium and Potassium Psychological Factors - Low Self-Esteem - Guilt - Lack of Support System - Lack of Clear Goals - Feelings of Failure - Inability to fulfill expectations - Separation or Object Loss Cognitive - Narrow negative attitude about self, environment & future, bad or inadequate judgement Behavioural - Hopelessness, Loss of positive reinforcement Socio Cultural Factors - Social Situations - Minority Group - Women in a male-dominant Occupation - Role Loss (Empty nest syndrome) Adverse Events - Injustice - Poverty - Unemployment Alcohol & Depression - Alcohol, Drug Abuse -------------------- Complications -------------------- Recover spontaneously after sometime some patient may so far His work & day to day activity suffer Loss in productivity & financial status Alcoholism or Drug Abuse Suicide -------------------- Management -------------------- Hospitalisation Indiacation: Severe Depression, Suicidal Tendencies Drug Therapy: Anti-Depressant Electro-Convulsive Therapy Psychotherapy - Problem Oriented, Positive Reinforcement, Family Therapy, Group Therapy & Cognitive Therapy Nursing Care in Depression Promote food intake & Sleep & Monitoring Food Intake & Drugs Take safety measures – In suicidal tendency Diminish feeling of loneliness Interaction focus on present & not the past – Reassurance Provide non-intellectual activities (Cleaning & Exercise) Strict record of Sleeping – Discourse sleep during daytime Health Education Family Education ======================================== Bipolar Disorders ======================================== - Mood swings from profound depression to extreme euphoria (Mania) with intervening period of normalcy. Mixed Manic Depressed ======================================== MANIA ======================================== It is mood disorder Patient excessively Happy & Energetic Usually occur as a part of Bipolar Very rarely mania alone occur (recurrently) Primary Mania  Affective or Mood Disorder Secondary Mania  Due to Organic Disorder -------------------- Aetiology -------------------- Biological Factors - Genetic Factors: Among the relative of Bipolar Disorders - Biochemical: Excessive Serotonin & Norepinephrine Psychological Factors - Faulty dynamics in the family system and disturbed ego development gives way to a strong id. -------------------- Clinical Features -------------------- Persistently Elevated, Expansive or Irritable Mood Inflated Self Esteem or Grandiosity Hyperactivity or Psychomotor Agitation Sleep Disturbance Pressure of Speech, More Talkative Flight of Ideas Distracted – Poor attention Span Pleasurable Activity – Spending, - Sexual Activity Dress in Bright Colour, Excessive Make Up & Jewellery Impaired Occupational Functioning Psychotic Symptoms Delusions, Hallucinations -------------------- Hypomonia -------------------- Euphoric, Elated, Dressing Colourfully, Cracking Jokes, Excessive Talk, Overactivity Manic Excitement Irritable, Excited, Violent -------------------- Management -------------------- Hospitalisation - Excited Drug Treatment - Anti-Psychotics - Anti-Manic - ECT Nursing Care Manic Patient Special attention to patient diet Drugs for restlessness & overactivity Emotional Needs _________________ ©2005 DR.M.RAJARAM This article comes from RxPG http://www.rxpgonline.com The Largest Community Website for Medical Students and Doctors The URL for this story is: http://www.rxpgonline.com/article1569.html