MOOD (AFFECTIVE) DISORDERS
1. Depressive disorders (unipolar depression)
Very often, rank 4 as a cause of disability worldwide projected to rank second to 2020. Although effective treatments available are, depression often goes undetected and untreated, often by patients and their doctors considered to be understandable.
Mild depression has a significant morbidity and mortality. Suicide is the leading cause of death in person 20-35 years old; a depression is high percentage (up to 50%).
Depression contributes disruption also to higher morbidity and mortality in other physical disorders (such as MI) associated and its successful diagnosis and treatment has been shown to improve the medical and surgical results.
It is a congenital aversion to pharmacological treatments for emotional problems, despite overwhelming evidence for the effectiveness to check. Also has great concern, the drugs improve the mood addictive, despite evidence to the contrary.
Non-compliance remains the main reason for treatment failure and often underestimated (up to 40% of treatment failure non-compliance).
Low difference between the ICD-10 and DSM-IV, but the core symptoms are almost identical:
- Present for at least 2 weeks
- Depressed mood present almost throughout the day, nearly every day with little variety and often lack of responsiveness may change. There may be diurnal variation in mood with bad mood in the morning.
- Anhedonia marked decreased interest or pleasure in all or almost all activities most of the day.
- Change associated with reduced weight loss weight or gain (5% in a month), or increased appetite.
- Disturbed sleep insomnia (with early morning hours earlier than usual wake up 2-3) or Hypersomia (atypical depression).
- Psychomotor retardation or agitation subjective and objective
- Fatigue or loss of energy.
- Decreased libido
- Deforestation of worthlessness or excessive or inappropriate guilt (delusional can be).
- Diminished ability to think or concentrate, or indecisiveness.
- Recurrent thoughts of suicide or death, which may or may not have already acted.
Somatic symptoms, “also known as”biological”, healthy” or “vital”
- Loss of emotional reactivity
- Diurnal mood variation.
- Wear away in the early morning
- Psychomotor agitation or retardation
- Loss of appetite and weight
- Loss of libido
- Delusions such as poverty, personal inadequacy, guilt, other nihilistic delusions.
- Hallucinations such as deformity or accusatory voices, cries for help or yell. bad smell, demons, Devils, corpses.
- Catatonic as depressive stupor.
Level of difficulty:
Mild, moderate or
? Melancholic or with somatic symptoms
? With psychotic symptoms
? Under ‘other depressive episodes’:
- Atypical depression (mood but reactive depressive, Hypersomnia, hyperplasia, leaden paralysis, hypersensitivity to perceived rejection, initial insomnia, inverted diurnal variation, lack of sense of guilt.) In the early 1920s.
- Postnatal depression
- Seasonal affective disorder
- Premenstrual dysphoric disorder
- Insomnia or other somatic complaints (E.g. headache, GI upset)
- Person from a different cultural background presented with cultural-specific symptoms.
- Physical fault masking the depressive characteristics.
Prevalence of 2-5%
Lifetime rate 10-20%
Sex ratio M: F 1:2
(Bio-psycho-social approach / precipitation predisposing 3Ps, and perpetuate)
1 Biological and genetic factors:
Lack of Monoamines (serotonin, norepinephrine and dopamine, may)
Abroad an antidepressant to the increase of the above. SSRI (serotonin reuptake inhibitors such as Prozac, Cipralex.) TCA (old