Module 4
Major Depressive Episode
● Five or more symptoms clustered together within the 2-week period that represent a
change in functioning.
● 1 of 5 has to be depressed mood or anhedonia (loss of pleasure/interest).
● Nearly every day throughout the day for two weeks.
● Symptoms cause significant distress or impairment.
Other Features:
● Disturbance of appetite.
● Recurring thoughts of death or suicide
● Difficulties in thinking
● Feelings of worthlessness and guilt
● Loss of energy
● Psychomotor agitation or retardation
● Sleep disturbances
Manic Episode:
● Elevated, expansive, or irritable mood - hallmark of mania.
● Abnormally and persistently increased goal-directed activity or energy.
● Lasts at least 1 week or any duration if hospitalization is necessary.
● 3 or more additional symptoms.
○ 4 or more if only an irritable mood is present.
Other Features:
● Inflated self-esteem
● Reckless behavior
● Hyperactivity
● Distractibility
● Flight of ideas
● Talkativeness
● sleeplessness
Hypomanic Episode
, ● Briefer and less severe than a manic episode.
● Similar symptoms to a manic episode.
● Does not require impairment.
● It requires a change in functioning and must be observable by others.
Other Forms of Mood Disorders
● Bipolar spectrum: Mood episode, bipolar two disorder, rapid cycling, cyclothymia.
● Unipolar spectrum: Dysthymia, double depression, DMDD, premenstrual dysphoric
disorder.
Major Depressive Disorder (MDD)
● The leading cause of disability and premature death worldwide.
● Causes more doctor visits than any other medical problem except hypertension.
● Causes greater impairment than chronic medical conditions such as diabetes or heart
disease.
● Although there are effective treatments for depression, most people do not receive
adequate treatment.
Risk for Depression
● Hispanics have higher rates than White or African Americans.
○ Especially female youth.
● Never married or formerly married.
● The most substantial risk factor is female gender.
○ Emerges during adolescence.
Sex Differences
● Really important in understanding depression.
● Possible factors:
○ More likely to have an interpersonal orientation.
○ Greater need for social support and reassurance seeking.
○ More likely to ruminate.
○ Women experience higher levels of sexual and physical abuse than men.
● Controlling for psychosocial factors reduces the gender effect.
Difference over Time
● Increased rates after WWII