1. IN THE NAME OF GOD MOOD DISORDERS MOHAMAD NADI M.D PSYCHIATRIST

2. MOOD DISORDERS Historical perspective black bile and melancholia Endogenous vs. reactive depression Neurotic vs. psychotic depression

3. MOOD DISORDERS DSM-IV-TR 5 mood disorders: Major depressive disorder Dysthymic disorder Bipolar disorder Cyclothymic disorder mood disorder NOS (Not Otherwise specified )

4. MOOD DISORDERS Diagnostic issues – Types of symptoms mood and emotion cognitions behaviour and motivation physical

5. MOOD DISORDERS Major depression symptoms include feelings of sadness, loss of interest or inability to experience pleasure, unexplained weight loss, difficulty sleeping, fatigue, difficulty concentrating, feelings of worthlessness or guilt, suicidal thoughts, agitation or slowing down And functional impairment

6. MOOD DISORDERS Major depression estimates suggest about 5-10% of people suffer from depression twice as common in women – biological differences, expression of symptoms, social acceptability, role strain and stress 50% recurrence rate

7. MOOD DISORDERS Major depression Problem of underdiagnosis no obvious marker for depression stigma associated with diagnosis of depression

8. MOOD DISORDERS Major depression Etiology of Depression Biologic Theories – Genetic – Biochemical Cognitive Theories _ Object loss _ aggression turned inward

9. Risk Factors for Depression Chronic Illness Female Gender Bereavement Perfectionistic Situational stressors Previous History Family History Social Isolation

10. MOOD DISORDERS Dysthymia many of the same symptoms as major depressive disorder, but less severe dysthymia persists for at least 2 years with only brief times mood returns to normal chronic sadness

11. Treatment of major depression Selective Serotonin Reuptake Inhibitors Tricyclic Antidepressants (TCA’s) Monoamine Oxidase Inhibitors ECT Psychoterapy

12. BIPOLAR DISORDERS Mania A.A distinct period of elevated or irritable mood, lasting at least 1 week. B. During the period of mood disturbance 3 or 4 of the following have persisted and have been present to a significant degree:

13. – 1. Inflated self-esteem or grandiosity – 2. Decreased need for sleep – 3. More talkative than usual – 4. Flight of ideas – 5. Distractibility – 6. Increase in goal-directed activity – 7. Excessive involvement in pleasurable activities Mania BIPOLAR DISORDERS

14. Hypomania less severe episodes of mania less severe episodes of mania less functional impairment less functional impairment less duration less duration BIPOLAR DISORDERS

15. Bipolar disorders Bipolar I and II Bipolar I – at least one or more manic episodes with or without one or more depressive episodes Bipolar II – at least one hypomanic episode with one or more episodes of major depression

16. Bipolar disorders Cyclothymia Alternating mood episodes: fluctuation between mild depression and hypomania Duration at least 2 years

17. Treatment of bipolar disorders Mood stabilizers – Lithium Anticonvulsants– Valproat sodiom Antipsychotics – Risperidon Psychoterapy – CBT ECT