Depressed mood

Central nervous system—mental depression, mood swings, insomnia, psychosis, euphoria, nervousness, and headaches ... 

Psychological Depressed mood Anhedonia Low self-esteem Guilt... 

Uncomplicated, with delirium, with delusions, and with depressed mood Dementia due to HIV disease Dementia due to head trauma Dementia due to Parkinson s disease Dementia due to Huntington s disease Dementia due to Pick s disease Dementia due to Creutzfeldt-Jakob disease Dementia due to a specific general medical condition (specify) Dementia that is substance-induced Dementia due to multiple etiologies Dementia not otherwise specified... 

At least five of the following symptoms are present markedly depressed mood, marked anxiety, marked affective lability,... 

One of the symptoms must be marked depressed mood, anxiety, irritability, or affective lability. 

Androgens are important for general sexual function and libido, but testosterone supplementation is only effective in patients with documented low serum testosterone levels. In patients with hypogonadism, testosterone replacement is the initial treatment of choice, as it corrects decreased libido, fatigue, muscle loss, sleep disturbances, and depressed mood. Improvements in ED may occur, but they should not be expected to occur in all patients.23 The initial trial should be for 3 months. At that time, re-evaluation and the addition of another ED therapy is warranted. Routes of administration include oral, intramuscular, topical patches or gel, and a buccal tablet. 

Cacciatore, R., Helbing, A., Jost, C., and Bess, B., Episodic headache, diminished performance and depressive mood. Schweiz Rundsch Med Prax, 85(22), 727-729, 1996. 

Wu LT and Anthony JC (1999). Tobacco smoking and depressed mood in late childhood and early adolescence. American Journal of Public Health, 89, 1837-1840. 

Abnormal depressed mood most of the day, nearly every day, for at least 2 weeks. 

Abnormal depressed mood (or irritable mood if a child or adolescent) [as defined in criterion A]. 

Yes >2-Week period of either depressed mood or loss of interest or pleasure... 

The essential feature of major depressive disorder is a clinical course that is characterized by one or more major depressive episodes without a history of manic, mixed, or hypomanic episodes. Dysthymic disorder is a chronic disturbance of mood involving depressed mood and at least two other symptoms, and it is generally less severe than major depressive disorder. This chapter focuses exclusively on the diagnosis and treatment of major depressive disorder. 

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. 

Among other parameters, LCA calculates conditional probabilities. A conditional probability is the proportion of members of a given class that scored a certain value on the indicator. Assume that in the depression example we have an indicator of severity of depression that reads How much does your depressed mood interfere with your life Assume further that three latent classes have the following conditional probabilities (see Table 3.3). Notice that the numbers in the columns add up to one, but the rows do not. 

Lithium is the simplest therapeutic agent for the treatment of depression and has been used for over 100 years—lithium carbonate and citrate were described in the British Pharmacopoeia of 1885. Lithium therapy went through periods when it was in common use, and periods when it was discouraged. Finally, in 1949, J.J.F. Cade reported that lithium carbonate could reverse the symptoms of patients with bipolar disorder (manic-depression), a chronic disorder that affects between 1% and 2% of the population. The disease is characterized by episodic periods of elevated or depressed mood, severely reduces the patients quality of life and dramatically increases their likelihood of committing suicide. Today, it is the standard treatment, often combined with other drugs, for bipolar disorder and is prescribed in over 50% of bipolar disorder patients. It has clearly been shown to reduce the risk of suicide in mood disorder patients, and its socioeconomic impact is considerable—it is estimated to have saved around 9 billion in the USA alone in 1881. 

Lerman C, Audrain J, Orleans CT, Boyd R, Gold K, Main D, Caporaso N. (1996). Investigation of mechanisms linking depressed mood to nicotine dependence. Addict Behav. 21(1) 9-19. 

The unipolar mood disorders consist solely of episodes of depression. On the other hand, the bipolar mood disorders consist of episodes of both depressed and elevated mood. The periods of elevated mood are characterized by either euphoria or irritability and are called mania or hypomania depending on the level of severity. A schematic of the mood disorders is shown in Figure 3.1. Substance-induced mood disorders and mood disorders due to general medical conditions usually manifest depressed mood however, manic episodes are occasionally seen as well. 

Depressed mood is the hallmark symptom of MDD, but it is neither required nor sufficient for the diagnosis of major depression. In addition to depressed mood, the key symptoms of a major depressive episode include anhedonia, changes in sleep or appetite, psychomotor retardation or agitation, poor concentration or indecisiveness, and recurrent thoughts of death or suicide. The DSM-IV definition of major depression requires that five or more of these symptoms be present for at least 2 weeks in the absence of an identifiable cause such as medication, medical illness, or the death of a loved one. Refer to Table 3.2 for the DSM-IV criteria for MDD. 

A. At least five of the following symptoms are present most of the day nearly every day for 2 weeks and are different from the patient s usual mood. One of the five symptoms must be either depressed mood or anhedonia. 

Depressed mood acknowledged by the patient or witnessed by others... 

Patients with depression usually do not present initially to mental health professionals. Most visit their primary care physicians, complaining not of depressed mood but of other symptoms of depression. Fatigue, insomnia, loss of appetite, loss of interest in sex, muscle tension, body aches, and poor concentration are all commonly reported. These so-called masked presentations of depression may in part explain the documented failure of primary care physicians to diagnose depression reliably. This underscores the importance of considering depression in the differential diagnosis of physical complaints that appear vague or exaggerated. 

The differential diagnosis of depression is organized along both symptomatic and causative lines. Symptomatically, major depression is differentiated from other disorders by its clinical presentation or its long-term history. This is, of course, the primary means of distinguishing psychiatric disorders in DSM-1V. The symptomatic differential of major depression includes other mood disorders such as dysthymic disorder and bipolar disorder, other disorders that frequently manifest depressed mood including schizoaffective disorder, schizophrenia, dementia, adjustment disorder, and post-traumatic stress disorder, and, finally, other nonpsychiatric conditions that resemble depression such as bereavement and medical illnesses like cancer or AIDS. 

Dysthymic disorder, also called dysthymia, is by definition a chronic illness that lasts two or more years. It consists of persistently depressed mood that is not as severe as major depression. However, double depression can occur in which a major depressive episode is superimposed on a preexisting dysthymia. It is unclear whether double depression is actually two illnesses or a single illness that varies in severity over time. Please refer to Table 3.12 for diagnostic criteria of dysthymic disorder. 

Dysthymic patients are less likely to complain of depressed mood than those with major depression. They experience vague feelings of apathy, inadequacy, ruminative... 

A. Depressed mood most of the day at least half of the time for 2 years. 

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