Mood Disorders (Affective Disorder)
Date: Tuesday, November 22 @ 00:19:46 IST
Topic: Psychiatry


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Mood Internal Emotional State of an Individual

Mood Disorder Excessive swing of Mood

Normal Mild Elation to Mild Depression depending on many factors.

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Classification
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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.

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Depression
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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

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Epidemiology
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-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

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Major Depression
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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

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Dysthymic Disorder
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Depressed Mood 2 Years
Other Symptoms
Or Sleep
Or Appetite, Energy
Self Esteem
Poor Concentration & Hopelessness

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Masked Depression
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Seasonal Depression Winter
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Aetiology for Depression
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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

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Complications
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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

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Management
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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

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Bipolar Disorders
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- Mood swings from profound depression to extreme euphoria (Mania) with intervening period of normalcy.

Mixed
Manic
Depressed

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MANIA
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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

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Aetiology
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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.

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Clinical Features
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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

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Hypomonia
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Euphoric, Elated, Dressing Colourfully, Cracking Jokes, Excessive Talk, Overactivity

Manic Excitement
Irritable, Excited, Violent

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Management
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Hospitalisation - Excited
Drug Treatment
- Anti-Psychotics
- Anti-Manic
- ECT

Nursing Care Manic Patient
Special attention to patient diet
Drugs for restlessness & overactivity
Emotional Needs
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2005 DR.M.RAJARAM




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