Important Questions for IGNOU PGDCFT MSCCFT MCFT002 Exam with Main Points for Answer - Unit 8

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Unit 8 Mood Disorders

1. What does one mean by the term ‘mood’? How is it different from affect?

Mood is a sustained feeling state that is experienced internally and that influences a person’s behaviour and awareness of the world. Mood can be normal, cheerful or elevated, depressed, anxious etc. Affect is a related term which is external expression of mood usually interpreted based on the facial expression. Mood is considered based on longitudinal course of feeling state while affect is cross sectional assessment of feeling state.

2. How will you identify depression?

Diagnosis of depressive disorder is based on the characteristic symptoms and signs. ICD-10 is used for diagnosing clinical depression.

At least 2 out of first 3 key symptoms must be present for a minimum of 2 weeks to call it a depressive episode. The symptoms are given below:

i) Sustained depressed mood to a degree that is definitely abnormal for the individual, present for most of the day and almost every day, largely uninfluenced by circumstances,

ii) Loss of interest or pleasure in activities that are normally pleasurable,

iii) Decreased energy or increased fatiguability,

iv) Loss of confidence and self-esteem,

v) Unreasonable feelings of self-reproach or excessive and inappropriate guilt,

vi) Recurrent thoughts of death or suicide, or any suicidal behaviour,

vii) Complaints or evidence of diminished ability to think or concentrate, such as indecisiveness or vacillation,

viii) Change in psychomotor activity, with agitation or retardation (either subjective or objective),

ix) Sleep disturbance of any type, and

x) Change in appetite (decrease or increase) with corresponding weight change).

3. How will you identify mania?

Diagnosis of mania is based on symptoms and signs. ICD-10 is used for diagnosing clinical manic episode.

At least 4 symptoms besides first symptom must be present for a minimum period of one week. The symptoms are as follows:

i) A mood which is predominantly elevated, expansive or irritable and definitely abnormal for the individual concerned and is sustained for at least a week (unless it is severe enough to require hospital admission),

ii) Increased activity or physical restlessness,

iii) Increased talkativeness (‘pressure of speech’),

iv) Flight of ideas or the subjective experience of thoughts racing,

v) Loss of normal social inhibitions resulting in behaviour which is inappropriate to the circumstances,

vi) Decreased need for sleep,

vii) Inflated self-esteem or grandiosity,

viii) Distractibility or constant changes in activity or plans,

ix) Behaviour which is foolhardy or reckless and whose risks the subject does not recognize for example spending sprees, foolish enterprises, reckless driving, and

x) Marked sexual energy or sexual indiscretions.

The episode is not attributable to psychoactive substance use or any organic mental disorder.

4. What are the options available for treatment of mood disorders?

Main treatment options available for mood disorders can be listed as below:

• Pharmacological treatment: These include antidepressant drugs, antipsychotics and mood stabilizers. During manic episodes there can be need for sedative drugs also.

• Psychosocial treatment: These include psychoeducation, cognitive behaviour therapy, physical exercise and counselling, interpersonal psychotherapy, and supportive psychotherapy.

• Electro convulsive treatment (ECT).

5. How long should one continue treatment in a patient with mood disorders?

In the treatment of mood disorders two commonly used terms are therapeutic and prophylactic treatment. Therapeutic treatment is for the current ongoing episode and it aims at reducing the duration of the episode and continued sometime after remission of the current episode and stopped. While prophylactic treatment is aimed at preventing further episodes and it is continued for longer period.

For single episode of depression drugs should be continued for a period of minimum 6 -9 months or more after the symptoms of depression have disappeared. If one stops them too soon the depression may quickly return.

If there is no recurrence, the drugs should be gradually decreased and stopped over a period of weeks. In patients with multiple episodes and incomplete improvement, the drugs need to be continued for long periods.

In cases of single manic episode drugs should be continued for a minimum of 4-6 months after the symptoms of mania have disappeared.

In case of bipolar disorder or recurrent depressive disorder treatment should be continued at least for 5 years of episode free period. Treatment needs to be longer in cases where there is likelihood of further episodes considering past or family history of mood disorders.

6. Name the different episodes that a person with mood disorders can have?

Depressive Episode
Manic Episode
Mixed Episode

7. How is mania different from depression?

The primary distinction lies in the individual's mood and energy levels.

Mania is characterised by a persistently elevated, expansive, or irritable mood, often accompanied by increased energy, activity, and a decreased need for sleep. This can manifest as excessive talkativeness, racing thoughts, inflated self-esteem, and impulsive behaviours.

Depression, in contrast, features a persistently low or sad mood, coupled with diminished energy, loss of interest in activities, and increased fatigue. This may lead to social withdrawal, difficulty concentrating, changes in sleep and appetite, and feelings of hopelessness or worthlessness.

8. How can a person with depressive disorder become well?

Treatment of Depressive Disorders

Pharmacological Treatment
Psychosocial Treatment
Electro Convulsive Treatment

9. What happens if treatment is stopped for mania immediately after becoming symptom free?

Mania has a high chance of recurrence, and abruptly halting medication increases the risk of relapse. Each subsequent episode may be more severe and more difficult to treat.

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