9C. An Introduction to Mood Disorders

• What do mood disorders affect?

  Feelings and emotional responses
• How do feelings in mood disorders differ from normal feelings?

  They are not congruent with daily events
• What is the range of mood disorders?

  From severe depression to severe mania
• What factors affect mood disorders?

  • Biological factors: Genetics, neurochemistry, stress response
  • Psychological factors: Explanatory style, learned helplessness, gender differences
  • Socio-cultural factors: Negative/traumatic events, cultural expectations
• What is the prevalence of Major Depressive Disorder?

  15%
• What is the incidence of Major Depressive Disorder?

  1%
• When does Major Depressive Disorder typically onset?

  Early adulthood
• What percentage of individuals with Major Depressive Disorder attempt suicide?

  15%
• What percentage of individuals with Major Depressive Disorder die by suicide?

  10%
• In which gender is Major Depressive Disorder more prevalent after age 13?

  Females
• How can Major Depressive Disorder manifest over time?

  Continuously or in episodes
• What is the prevalence of Bipolar Disorder?

  1-1.5%
• What is the incidence of Bipolar Disorder?

  4%
• When does Bipolar Disorder typically onset?

  Late adolescence
• What percentage of individuals with Bipolar Disorder attempt suicide?

  30%
• What percentage of individuals with Bipolar Disorder die by suicide?

  15%
• How prevalent is Bipolar Disorder among genders?

  Equally prevalent in males and females
• What are the emotional symptoms of Major Depressive Disorder?

  • Sadness
  • Anxiety
  • Guilt
  • Anger
  • Helplessness
  • Hopelessness
  • Irritability
• What are the cognitive symptoms of Major Depressive Disorder?

  • Self-critical thoughts
  • Impaired memory
  • Impaired concentration
  • Indecisiveness
  • Suicidal thoughts
• What are the physical symptoms of Major Depressive Disorder?

  • Chronic fatigue
  • Lack of energy
  • Change in weight
  • Loss of motivation
  • Aches and pains
  • Altered sleep pattern
• What are the behavioral symptoms of Major Depressive Disorder?

  • Crying
  • Social withdrawal
  • Altered appearance
  • Agitation
  • Slow movement
  • Neglecting responsibilities
• What are the manic mood and behavior symptoms of Bipolar Disorder?

  • Diminished need for sleep
  • Euphoria
  • Grandiosity
  • Pressured speech
  • Impulsivity
  • Excessive libido
  • Recklessness
• What are the dysphoric mood and behavior symptoms of Bipolar Disorder?

  • Depression
  • Anxiety
  • Irritability
  • Hostility
  • Violence
  • Suicide
• What are the psychotic symptoms of Bipolar Disorder?

  • Delusions
  • Hallucinations
• What are the cognitive symptoms of Bipolar Disorder?

  • Distractibility
  • Racing thoughts
  • Disorganisation
  • Inattentiveness
• What genetic factors are associated with Major Depressive Disorder?

  • Family, twin, and adoption studies indicate genetic components
  • Heritability ranges from ~17-78%
  • Genes implicated include:
  • APoE
  • PCLO
  • TOMM40
  • GNB3
  • MTHFR
  • SLC6A4
• What environmental factors are linked to Major Depressive Disorder?

  • In-utero factors: infection, nutrient lack, maternal stress
  • Social disadvantage
  • Urban upbringing
  • Ethnic minority status
  • Childhood maltreatment
  • Bullying
  • Traumatic events
  • Cannabis use
  • Exposure to stress
• How do genetic and environmental factors interact in Major Depressive Disorder?

  • Not everyone with stressors develops depression
  • Interaction between genetics and environmental factors is significant
  • Example: 5-HTT gene variations affect depression risk
• What genetic factors are associated with Bipolar Disorder?

  • Family, twin, and adoption studies indicate genetic components
  • MZ concordance rate of 43%
  • Heritability estimated at 58%
  • Genes implicated include:
  • WFS1
  • FKBP5
  • CRH
• What environmental factors are linked to Bipolar Disorder?

  • Asthma
  • Irritable bowel syndrome
  • Obesity
  • Perinatal pathogen
  • Childhood adversity
  • Head injury
  • Obstetric complications
• How do genetic and environmental factors interact in Bipolar Disorder?

  • Not everyone with stressors develops bipolar disorder
  • Interaction between genetics and environmental factors is significant
  • Example: COMT Val158Met polymorphism increases risk with stressors
• What are the most commonly reported stressful life events in Bipolar Disorder?

  1. Personal illness, injury, or assault
  2. Marital separation or breakup
  3. Serious problem with a close friend or relative