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The fundamentals of psychiatry
Published in Ben Green, Problem-based Psychiatry, 2018
Also record again any biological features of mood disturbance: sleep abnormalities (initial insomnia, waking and early morning wakening), poor appetite, weight loss (exactly how much?), diurnal mood variation, altered sexual drive and constipation.
Major Depressive Disorder and Bipolar Disorder
Published in Dr. Ather Muneer, Mood Disorders, 2018
An important subtype of the disorder is MDD with melancholic features. In this condition there is a distinct flavor to the depressed mood, characterized by anhedonia or loss of pleasure in day-to-day activities. There is marked diurnal variation as the patient feels worse during the morning with varying degrees of improvement towards the latter afternoon and evening. There is severe insomnia, markedly reduced sleep duration and early morning wakening. Anorexia can be extreme with significant weight loss over a short period of time. Patients experience severe guilt which is often delusional in intensity, worthlessness, helplessness, hopelessness and suicidal ideation. Behavior is characterized by restlessness and psychomotor agitation. It can be construed that MDD with melancholic features is a particularly severe form of the disorder and is accompanied with discernible impairment in daily functioning. An interesting subtype is MDD with atypical features which is exemplified by reversed vegetative signs, that is, increased sleep and appetite with weight gain. While the mood is low, depression is usually mild to moderate, there is no diurnal mood variation or anhedonia. Patients have psychomotor retardation, and experience heaviness in the body, sometimes described as “leaden paralysis”. Depression with atypical features may be comorbid with eating disorders such as bulimia nervosa and binge eating disorder, sleep disorders like obstructive sleep apnea and substance use disorders, particularly alcohol abuse.19
Psychiatry
Published in David McCollum, The Easy Guide to Focused History Taking for OSCEs, 2017
Typical symptoms – sleep disturbance, early morning waking (>2 h earlier than usual), decreased appetite, weight loss (>10%), decreased libido, diurnal mood variation, feelings of worthlessness, guilt and hopelessness, decreased concentration and attention, recurrent thoughts of death/suicide
Self-perceived rhythmicity in affective and cognitive functions is related to psychiatric symptoms in adolescents
Published in Chronobiology International, 2023
Ana Paula Francisco, Andre Comiran Tonon, Guilherme Rodriguez Amando, Maria Paz Hidalgo
Current diagnostic criteria suggest that major depressive disorder is a unitary construct (Gordijn et al. 1994; Reinink et al. 1990; Riemann et al. 1991). Quite possibly, the set of symptoms currently homogeneously labeled as “depression” actually constitutes a heterogeneous group of different subtypes of depression with differing pathophysiology and, therefore, with varying risk factors, different phenotypic expressions, and diverse responses to treatments. Recognizing these subtypes may be relevant to determining severity and planning individual treatments. Previous studies in adults comparing depressed patients with and without diurnal mood variation showed that those with variation had better response to the sleep deprivation strategy (Gordijn et al. 1994; Reinink et al. 1990; Riemann et al. 1991). Could this also be the case with self-perceived rhythmicity in affective, somatic, and cognitive factors? Further studies are needed to clarify whether these self-perceived rhythmicity alterations are consistent across different samples. If this proves to be the case, could the presence or absence of self-perceived mood rhythmicity in affective, somatic, and cognitive factors have important implications for treatment and outcomes of depression?
When Do People Seek Internet Counseling? Exploring the Temporal Patterns of Initial Submissions to Online Counseling Services
Published in Journal of Technology in Human Services, 2020
Maili Tirel, Dmitri Rozgonjuk, Merle Purre, Jon D. Elhai
Diurnal mood variation (DMV) with early morning worsening is considered a classic symptom of melancholic features of major depressive disorder (Courtet & Olie, 2012). However, Morris and colleagues (2007) found that of the patients who experienced DMV, only 31.9% reported morning worsening, while 19.5% and 48.6% reported afternoon and evening worsening. Data from Twitter has been used to study mood variation during the day. Golder and Macy (2011) found that negative affect was the lowest in the morning and increased throughout the day. Lampos, Lansdall-Welfare, Araya, and Cristianini (2013) found that joy peaks midmorning and decreases during the day. Anger and sadness showed a midmorning peak as well, but stayed relatively stable throughout the day, whereas, fear was stable during the day and increased in the evening. These findings are supported by Dzogang, Lightman, and Cristianini (2017), who found similar patterns of good mood in the morning which decreases during the day.
Mood rhythmicity is associated with depressive symptoms and caffeinated drinks consumption in South American young adults
Published in Chronobiology International, 2019
Angela J. Pereira-Morales, Leandro P. Casiraghi, Ana Adan, Andrés Camargo
These results are especially relevant since overall synchronicity of physiology and behavior represents an important subject of study in health research. Recent studies have found that depressive patients show an improvement of mood state and an increase in activity during the afternoon and the evening (Salgado-Delgado et al. 2011; Wulff et al. 2010). Interestingly, this pattern is inverted in bipolar disorders individuals (Wulff et al. 2010). In addition, profiles of diurnal mood variation have been associated with a greater risk of depression severity and are proposed as predictor of treatment response (Courtet and Olie 2012). Furthermore, patients with depressive symptomatology show constant hypercortisolemia, which is associated with anhedonic behavior (a cardinal symptom in depressive disorder) and it has been suggested that disruption of the circadian rhythm of cortisol may trigger depressive symptomatology (Hsiao et al. 2010; Salgado-Delgado et al. 2011).