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Classification
Unipolar Bipolar
A. Depressed mood
Loss of interest and enjoyment
Reduced energy
and decreased activity
B Reduced concentration
Reduced self-esteem and confidence
Ideas of guilt and unworthiness
Pessimistic thoughts
Ideas of self-harm
Disturbed sleep
Diminished appetite
- Normal Sadness
- Anxiety Disorder
- Schizophrenia
- Organic Brain Syndrome
Course & Prognosis
The age of onset of unipolar disorders varies widely; it is generally
agreed to be later than for bipolar cases.
The average length of a depressive episode is about 6 months.
About 80% of patients with major depression will experience further
episodes.
As with bipolar patients, the interval between episodes becomes
progressively shorter.
About one third of depressed patients do not achieve complete symptom
remission between episodes.
The longer-term prognosis of depression may be a little better in some
ways than that of bipolar disorder but is still modest.
The assessment of depressive disorder
The steps in assessment are:
To decide whether the diagnosis is depressive disorder.
To judge the severity of the disorder, including the risk
of suicide.
To form an opinion about the causes.
To assess the patient's social resources.
To gauge the effect of the disorder on other people
Management
In- patient Vs Out-patient:
- depends on severity
* Mood:-
- Elevated
- Irritable
* Appearance + Behaviour
- Clothes brightly coloured
- Untidy and disheveled
- Over active
- Food intake
- Sexual desire + activity
- Disinhibition
- Sleep reduced
* Perceptual Disturbances :-
- Anxiety
- Schizophrenia
- Drug induced Psychosis
- Physical Condition
. Thyrotoxicosis
- Organic Brain Syndrome
Course & Prognosis
b) Mood Stabilizers
- Lithium
- Sodium Valproate
- Carbamazepine
c) Benzodiazepines