Chapter 17 - Affective disorders

Abstract

Affective disorders are mood disorders that affect thoughts and feelings. The most common examples are depressive disorders and bipolar disorder. They are called “affective” because they mostly affect the emotions. Major depressive disorder results in cognitive and psychomotor dysfunction, fatigue, poor concentration, loss of interest or pleasure, loss of sexual desire, and sleep disturbances. Persistent depressive disorder (dysthymia) is very similar, but with longer-lasting symptoms. Bipolar I disorder is characterized by one or more manic episodes, with or without mixed or psychotic features. The individual has a hypomanic stage before progressing to full mania. Bipolar II disorder is characterized by one or more episodes of hypomania and one or more episodes of major depression. There is no full manic episode. Cyclothymic disorder involves many periods of depression along with hypomania. Affective disorders are implicated in suicides and homicides. Suicides may be the result of a traumatic brain injury (TBI), PTSD, chronic pain and/or opioid use, or alcohol use. Suicide attempts are the strongest predictors of actual suicide. Assisted suicide is also known as euthanasia. The most common mental disorders linked to homicide include schizophrenia, substance-induced psychosis, TBI, temporal lobe dysfunction, dementia, and antisocial personality disorder.