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Though I am often in the depths of misery, there is still calmness, pure harmony and music inside me. I see paintings or drawings in the poorest cottages and the dirtiest corners. And my mind is driven towards these things with an irresistible momentum.
VINCENT VAN GOGH, BIPOLAR SUFFERER (1853–1890)
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A mood disorder, also referred to as an affective disorder, is an emotional condition that significantly impacts on a person’s mood and related functions. The combination of involved symptoms leads to a predominant mood state that is abnormal in quality, duration or both.
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Classification:
A classification of the types of mood disorders is presented in TABLE 68.1. There are two basic groups ranging from the very low mood of depression to the elevated mood of mania.
The DSM-5 classification1 divides depressive disorders into major depressive disorder (MDD), disruptive mood dysregulation disorder, persistent depressive disorder (PDD) and premenstrual dysphoric disorder. Other ‘specified’ and ‘unspecified’ disorder categories allow for diagnosis of those patients who fall short of the various diagnostic criteria.2 Refer to CHAPTER 10 on depression.3
MDD is subclassified with coded course or severity specifiers. These include mild, moderate or severe (see TABLE 68.2)—with psychotic features, in partial remission and in full remission.
Non-coded specifiers can also be used, including ‘with anxious distress’, ‘with mixed features’, ‘with melancholic features’, ‘with atypical features’, ‘with mood-congruent psychotic features’, ‘with catatonia’, ‘with peripartum onset’ and ‘with seasonal pattern’.
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