Psychiatric Disorders

AFFECTIVE PSYCHOSIS–DEPRESSION, MANIA, MDP / BPAD (Mood Disorders)

Mood Disorders: Clinical Features

Terminology

Mood disorders are characterized by pervasive dysregulation of mood and psychomotor activity and by related biorhythmic and cognitive disturbances. The rubric of "affective disorder," which in some European classifications also subsumes morbid anxiety states, is increasingly being replaced by the nosologically more delimited concept of "mood disorder." Thus mood disorder is now the preferred term in both the World Health Organization's (WHO's) 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the American Psychiatric Association's (APA's) fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Official mood disorder categories in current use include bipolar disorders (with manic or hypomanic, depressive, or mixed episodes) and major depressive disorders and their respective attenuated variants known as cyclothymic and dysthymic disorders. Conditions that in earlier editions of these manuals were categorized as "endogenous depression," "involutional melancholia," and "psychotic depressive reaction" have been incorporated into major depressive disorder, whereas "depressive neurosis" has been largely absorbed by dysthymic disorder.

AFFECTS, MOODS, TEMPERAMENTS, AND MORBID MOOD STATES

Ethological Considerations

Affects and moods refer to different aspects of emotion. Affect is communicated through facial expression, vocal inflection, gestures, and posture.

Mood Disturbances Mood change, usually considered the sine qua non of morbid depression, appears in a variety of disturbances, including (1) painful arousal, (2) hypersensitivity to unpleasant events, (3) insensitivity to pleasant events, (4) insensitivity to unpleasant events, (5) reduced anticipatory pleasure, (6) anhedonia or reduced consummatory pleasure, (7) affective blunting, and (8) apathy....