PS5.1-2,PS6.1 | Mood Disorders — Glossary

Lack of recognition by the patient that they are experiencing a psychiatric illness; a key MSE finding in mania that impairs voluntary treatment engagement and informed consent.

The objective, observable expression of emotional state as perceived by the examiner; in depression typically described as constricted, blunted, or flat.

Markedly diminished interest or pleasure in activities that were previously enjoyed; one of the two anchor symptoms of a major depressive episode.

The precipitation of a manic, hypomanic, or mixed episode by antidepressant monotherapy in a patient with bipolar disorder; a major prescribing risk in unrecognised bipolar depression.

A neurotrophin involved in neuronal survival, plasticity, and synaptic remodelling; its upregulation is implicated in the mechanism of antidepressant response beyond monoamine reuptake inhibition.

A structured psychological intervention for depression that involves scheduling pleasurable or purposeful activities to counteract avoidance and withdrawal, rooted in the behavioural model of depression.

An integrated framework for understanding illness causation that incorporates biological (genetic, neurochemical, medical), psychological (cognitive, personality, trauma), and social (environmental, economic, relational) determinants.

A mood disorder characterised by recurrent episodes of both depression and mania (or hypomania); a critical differential for unipolar MDD because treatment with antidepressant monotherapy risks precipitating mania.

A mood disorder defined by the occurrence of at least one full manic episode; depressive episodes are common but not required for the diagnosis.

A mood disorder defined by recurrent hypomanic episodes alternating with major depressive episodes, with no history of a full manic episode.

Rhythmic, involuntary muscular contractions triggered by sustained muscle stretch; a hallmark of hyperreflexia and a key differentiating feature of serotonin syndrome.

Mnemonic for the associated symptoms of a manic episode: Distractibility, Irritability/inflated self-esteem, Grandiosity, Flight of ideas, Activity increase, Sleep reduced, Talkativeness (pressured speech).

The phenomenon in bipolar disorder whereby successive mood episodes lower the threshold for triggering the next episode, potentially leading to more frequent cycling over time; a rationale for prophylactic mood stabiliser therapy.

A measure of the emotional tone of family members toward a patient with psychiatric illness, encompassing criticism, hostility, and emotional over-involvement; high expressed emotion is associated with higher relapse rates in bipolar disorder and schizophrenia.

Rapid, loosely connected transitions between topics in speech, driven by phonemic or semantic associations; a characteristic thought-form abnormality in mania, distinct from loosening of associations.

Inflated self-esteem or an unrealistic belief in one's special powers, abilities, importance, or divine mission; may reach delusional intensity in severe mania.

A milder, time-limited period of elevated or irritable mood with the same qualitative features as mania but lasting ≥4 days without marked functional impairment, psychotic features, or hospitalisation.

The phenomenon whereby successive depressive episodes require progressively less psychosocial stress to trigger, and may eventually become autonomous; one rationale for long-term maintenance antidepressant therapy.

A monovalent cation used as a mood stabiliser in bipolar disorder; has a narrow therapeutic index (therapeutic range 0.6–1.2 mEq/L; toxicity >1.5 mEq/L) and requires regular monitoring of serum levels, renal function, and thyroid function.

A mood disorder characterised by one or more major depressive episodes — periods of ≥2 weeks with depressed mood and/or anhedonia plus associated neurovegetative and cognitive symptoms, causing significant impairment.

A distinct period of abnormally and persistently elevated, expansive, or irritable mood and increased energy lasting ≥1 week (or any duration if hospitalised), with ≥3 additional DIG FAST symptoms, causing marked functional impairment or requiring hospitalisation.

A clinical presentation of depression in which somatic symptoms (pain, fatigue, GI disturbance) predominate and the affective component is minimised or absent from the patient's chief complaint; common in primary-care India.

Indian legislation that replaced the Mental Health Act 1987; key provisions include decriminalisation of suicide attempts, the right to make advance directives, and the right to access mental health care.

The subjective, internally experienced emotional state as reported by the patient; in depression characteristically described as low, sad, empty, or hopeless.

A class of medications that reduce the frequency and severity of mood episodes in bipolar disorder, including both manic and depressive phases; lithium, valproate, carbamazepine, and lamotrigine are the primary agents.

A property of drugs for which the difference between the effective dose and the toxic dose is small, requiring careful dose titration and regular monitoring; lithium is a classic example.

A life-threatening idiosyncratic reaction to antidopaminergic agents (typically antipsychotics), presenting with hyperthermia, lead-pipe rigidity, bradyreflexia, autonomic instability, and elevated creatine kinase, with slower onset over days.

Patient Health Questionnaire-9; a validated 9-item self-report tool that screens for and monitors the severity of major depression in primary-care settings, scored 0–27.

Rapid, loud, voluminous speech that is difficult or impossible to interrupt; a cardinal feature of the manic mental status examination reflecting the internal pressure of racing thoughts.

Visible slowing of physical movements and speech, observable to others, occurring in severe depression; a key mental status finding.

The use of parenteral (or oral) medication — typically a first-generation antipsychotic (haloperidol) or a benzodiazepine — to safely and rapidly reduce agitation in an acutely disturbed patient who poses a risk to themselves or others.

A class of antidepressants that selectively block the reuptake of serotonin at the presynaptic terminal, increasing synaptic serotonin availability; first-line pharmacotherapy for depression and anxiety disorders.

A life-threatening drug-induced state caused by excess serotonergic activity, presenting with the triad of altered mental status, autonomic instability, and neuromuscular abnormalities (hyperreflexia and clonus), with rapid onset.

Failure to achieve an adequate response to at least two antidepressant trials of adequate dose and duration (≥6–8 weeks each) from different pharmacological classes.

An anticonvulsant used as a mood stabiliser in bipolar disorder; highly effective for acute mania and prophylaxis; teratogenic — contraindicated in women of childbearing potential without adequate contraception.