Mood Disorders Depression Dysthymic Disorder Bipolar Disorder

Mood Disorders
Major depressive episode
Major depressive disorder
Dysthymic Disorder
Bipolar Disorder
– Both mania and depressive episodes at some
point in life
Mood Disorders
Depression as symptom, syndrome, disorder
Symptom = feeling sad, down, blue
Syndrome = group of symptoms that occur
Affective changes
Vegetative or psychomotor disturbances
Cognitive changes (depressive triad)
Disorder = syndrome defined by DSM criteria
DSM criteria for Major Depressive
Need 5 symptoms present for at least 2 weeks
– Must include depressed mood or loss of interest/pleasure:
persistent feelings of sadness (can be irritability in children)
– restlessness, reduced activity, slowed speech, excessive crying
– Feelings of worthlessness and low self-esteem
– Changes in appetite or weight
– Fatigue or loss of energy
– Sleep disturbances
– Difficulty thinking or concentrating
– Thoughts of death and suicide
See case study
Additional information about
Prevalence: 2 – 8% of children ages 4 –
Rare among preschool-aged children,
prevalence increases with age
70% comorbidity
First episode age of onset 13 – 15 years
Myths about depression in children
A. Depression doesn’t exist
B. “masked” depression: bedwetting, sleep
problems, hyperactivity, etc.
C. Childhood depression is same/different
than adult depression
Childhood depression as different
than adult depression
Different gender ratio
Missing some major symptoms (vegetative
symptoms, suicide) in childhood
Antidepressants don’t work as well
More irritability
High rates of comorbidity
Much lower base rates
Associated characteristics in
Intellectual and academic problems
Cognitive disturbances – depressive triad
Low self-esteem and unstable self-esteem
Social withdrawal
More on age differences
Depressive feelings
Suicide rare
Why these age differences?
Sex hormones
Family less operative
Cognitive changes
Causes of depression in children
1. Genetic and family risk
2. Neurobiological influences
3. Family influences
4. Stressful life events
5. Emotion regulation
Treatment of depression
1. Psychosocial interventions
A. Cognitive techniques
B. Behavioral techniques
C. Affective education
D. Family context
2. Medications
3. prevention
Bipolar Disorder
Expansive, elevated or irritable mood with
one or more depressive episodes
Several subtypes
Less common until adolesc.
Onset and course
Treatment of bipolar
1. Education
2. Medication
3. Symptom management and relapse
Suicidal thoughts – common
Suicidal intent – involves specific plan and
motivation to carry it out
“suicidal gestures” = instrumental behavior
Suicide attempts
– Low lethality
– High lethality