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Introduction to Mood Disorders & Affective Disorders


Bipolar Affective Disorder(BAD) = it is characterized by repeated (ie at least two) episodes in which the patient’s mood and activity levels are significantly disturbed so there may be alternate episodes of mania & depression.
Male: Female = 1:1 (means age of onset 30 years), this disorder tends to occur in episodes lasting usually 3-4 months
Hypomania = is lesser degree of mania where the function of the person is relatively intact

Criteria for a Manic Episode

  1. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary)

Mood Disorder & Affective Disorder

  1. During the period of mood disturbance, three (or more) of the following symptoms have persisisted (four if the mood is only irritable) and have been present to a significant degree:
    1. Inflated self-esteem or grandiosity
    2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
    3. More talkative than usual or pressure to keep talking
    4. Flight of ideas or subjective experience that thoughts are racing
    5. Distractibility (e.g., attention too easily drawn to unimportant or irrelevant external stimulti)
    6. Increase in goal-directed activated (either socially, at work or school, or sexually) or psychomotor agitation
    7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying spree, sexual indiscreation, or foolish business investments)
  2. The symptoms do not meet criteria for a mixed episode.
  3. The mood disturbance is sufficiently serve to cause marked impairment in occupational functioning or in usual social activities or relationships with other, or to necessitate hospitalization to prevent harm to self or other, to harm self or others, or there are psychotic features.
  4. The symptoms are not due to the direct physiologic effect of a substance (e.g. a drug of abuse, a medication, or other treatment) or a general medical condition (e.g. hyperthyroidism)

Note : Symptoms lasting for 7 days. Manic- like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis or bipolar I disorder.
Usual course of Manic episode: 3-6 Months
Rapid Cycling Bipolar Affective Disorder –
Occurrence of 4 or more episodes per year is called as rapid cycling.
Drug of choice: of Rapid Cycling is Sodium Valproate.

  1. BAD, currently manic state = mood stabilizer ± An tipsychotic ± Benzodiazepine
  2. BAD, currently depression = mood stabilizer ± antidepressant
  3. Rapid cycling BAD(4 episodes in past 12 months) = Sodium Valproate
Extra Edge : Drug of choice for prophylaxis of Mania lithium carbonate
                     Drug of choice for acute mania  - Atypical antipsychotic / sodium valproate

                     Drug of choice in pregnant lady with bipolar disorder is lithium.

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