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Psychiatry – Depressed Mood: By Javeed Sukhera M.D.

medskl.com is a global, free open access medical education (FOAMEd) project covering the fundamentals of clinical medicine with animations, lectures and concise summaries. medskl.com is working with over 170 award-winning medical school professors to provide content in 200+ clinical presentations for use in the classroom and for physician CME. Psychiatry – Depressed Mood Whiteboard Animation Transcript with Javeed Sukhera, MD https://medskl.com/module/index/depre... Depression is a concept that can be both a symptom and an illness. A depressed mood is a common presenting symptom. The term ‘depressed mood’ may include feeling of sadness, hopelessness, or discouragement. A depressed mood is a key symptom in the diagnosis of a major depressive episode (MDE). According to the DSM-5, in addition to having a depressed mood, patients must have at least 5 of the symptoms famously remembered by the SIGECAPS mnemonic. This stands for: Sleep disturbances Loss of Interest (anhedonia – which is a pervasive lack of pleasure) Increased Guilt (or persistent worthlessness) Low Energy (or high in cases of atypical depression) Loss of Concentration Appetite changes (increase or decrease) Psychomotor disturbances, and Suicidal ideation In order to meet criteria for an MDE, One of the symptoms must either be a depressed mood or anhedonia. Symptoms must be present for the same 2 week period, represent a change from previous functioning, cause clinically significant distress or impairment and must not be attributable to a medical condition or direct physiological effects of a substance. A person can be diagnosed with major depressive disorder in the presence of a MDE that is not better accounted for by schizoaffective disorder or superimposed on schizophrenia, delusional disorder or unspecified psychotic disorder. In other words, other disorders may produce symptoms of an MDE. Commonly, MDE symptoms can occur in response to a major stressor which would fall into the category of an “adjustment disorder with depressed mood”. Also the patient must not have had previous manic or hypomanic episodes. MDE in the presence of previous manic or hypomanic episode points to a diagnosis of bipolar affective disorder, Type I or Type II respectively. A depressed mood is also a criteria in the diagnosis of persistent depressive disorder (previously referred to in the DSM-IV as dysthymia). Here, the depressed mood must be present for most of the day, most days than not for a period of ≥2years. Individuals with persistent depression have a more chronic clinical picture lasting years instead of weeks. Other depressive disorders to be aware of include premenstrual dysphoric disorder, postpartum depression. Although a depressed mood is a key symptom of these psychiatric mood disorders, it is important to recognize that it can occur as a result of normal grief, substance use, or a general medical illness like hypothyroidism, Cushing’s syndrome, Parkinson's disease, stroke, or vitamin B12 deficiency.