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Block 3 Unit 3 Other Mood Disorders: Mood Disorder Due to General Medical Condition

1. Explain the nature of mood disorder due to general medical condition.

• A mood disorder due to a general medical condition is characterised by a prominent and persistent disturbance in mood that is judged to be a direct physiological consequence of a general medical condition.
• This means that the mood disturbance (depressed, elevated or irritable mood) is a result of a medical condition and not due to a separate psychological disorder.
• The symptoms of this disorder can include depressed mood, loss of interest or pleasure, or elevated, expansive or irritable mood, similar to other mood disorders.
• It is essential to distinguish this disorder from primary mood disorders because it is caused by a medical condition and failure to identify this underlying medical cause can be potentially dangerous.

2. Discuss the diagnostic criteria for mood disorder due to a general medical condition.

• According to the DSM-IV-TR, the diagnostic criteria are:
  • The presence of either a depressed mood or diminished interest or pleasure, or an elevated, expansive, or irritable mood.
  • Evidence from the history, physical examination, or lab findings that the disturbance is a direct physiological consequence of a general medical condition.
  • The mood disturbance is not better accounted for by another mental disorder (e.g., an adjustment disorder) and does not occur only during a delirium.
  • The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• The diagnostic criteria are less rigorous than those for primarily psychiatric mood disorders.

3. Differentiate between mood disorder due to general medical condition and major depressive disorder.

• Mood disorder due to a general medical condition is directly caused by a medical illness, substance abuse, or medications used to treat another condition, and is diagnosed when:
  • The mood disturbance is judged to be a direct physiological consequence of the medical condition.
  • There is a temporal association between the onset or worsening of the medical condition and the mood disturbance.
• There is some evidence that the features are atypical of a primary mood disorder.
• The symptoms must not be better accounted for by a primary mood disorder or other mental disorder.
• There must be evidence from the history, physical examination, or laboratory findings that the disturbance is a direct physiological consequence of a general medical condition.
• Major depressive disorder is a primary psychiatric disorder where the mood disturbance is not directly linked to an identifiable medical condition.
  • Major depressive disorder is characterised by a combination of persistent low mood, loss of interest or pleasure, and a number of related symptoms such as fatigue, changes in appetite and sleep, and feelings of worthlessness.
• The key difference lies in the causation: if the mood disturbance is a direct result of a medical condition, it is diagnosed as a mood disorder due to a general medical condition, otherwise, it would be a primary mood disorder such as major depressive disorder.

4. Explain the etiology of bipolar disorder.

• The sources indicate that bipolar disorder is likely influenced by both biological and psychological factors.
• Biological Factors: There is a strong genetic component with family and twin studies indicating a high heritability.
• Psychological Factors: Recent life events and interpersonal relationships contribute to the likelihood of onset and recurrence of bipolar mood episodes. Individual psychosocial factors may also interact with genetic predispositions. Early experiences of adversity or conflict may increase the risk of developing bipolar disorder.
• It is important to note that bipolar disorder is a separate diagnosis from mood disorder due to a general medical condition, and that medical conditions do not cause bipolar disorder.

5. Discuss any three of the major medical conditions which may cause mood disorder.

Several medical conditions can induce mood disorders, these include:

• Parkinson's disease: A neurological condition that can lead to severe depression in approximately 27–57% of patients.
• Heart disease: Coronary artery disease is associated with depressive symptoms in approximately 19% of patients. Depression after a heart attack can delay recovery.
• Thyroid disorders: Conditions like hypothyroidism (underactive thyroid) are linked to higher rates of depression, as high as 40%. Excess thyroid hormone (hyperthyroidism) may also cause mood disturbance.
• HIV/AIDS: This illness progressively destroys the body's ability to fight infection and can lead to several mental health complications.
• Cancer: Cancer patients may experience depression which can be related to physical and emotional challenges of the disease and treatment.
• Diabetes: This medical condition can cause depression in some patients.
• Stroke: Stroke may cause mood disorders in some patients.