Affective disorder
| Classification according to ICD-10 | |
|---|---|
| F30-F39 | Affective disorders |
| ICD-10 online (WHO version 2019) | |
The affective disorders or affective disorders ( English affective disorders ) are a group of mental disorders . What they all have in common is a clinically significant change in mood.
The emotions ( affects ) can be pushed towards depression or increased towards mania . In this context the term affect is used in the sense of basic mood . This change in mood can set in quickly ( acute ), develop slowly ( chronic ) or only occur in phases ( episodic ).
Formal and substantive thought disorders , cognitive impairments and occasionally psychotic experiences can also occur at the same time . Various aspects are considered for the diagnosis, e.g. B. Drive , spontaneity , need for sleep, appetite, sexual interest and the social life of the person concerned.
term
The term affective disorder is defined in the 10th edition of the International Classification of Diseases (ICD-10) in section F30-F39 . However, this term has been criticized because it would be better suited to describe anxiety disorders , but does not currently include them.
Strictly speaking, the illnesses discussed here are not at all disturbances of affects (i.e. flurry of feelings), but rather disturbances of mood. In the English-speaking world, the term "Mood Disorders" is usually used. In the past, this group of diseases was referred to as affective psychoses or, less often, as mental illnesses .
Disorders
The classification of mood disorders has undergone many changes over time. The following illustration is based on the classification in the ICD-10 , which differs from the classification in the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5 ).
mania
Mania is characterized by excessive excitement that is inappropriate for the situation, or irritability when the level of activity is excessive. It can appear with or without psychotic symptoms. A weaker form of mania is known as hypomania .
depression
An overly depressed mood with a lack of energy is characteristic of depression. It can be mild, moderate or severe. Severe forms can occur without or with psychotic symptoms.
Bipolar disorder
States of mania and depression can alternate more or less regularly, one then speaks of a bipolar disorder (also known as “affective bipolar disorder”). In the past, bipolar disorder was also known as "manic-depressive illness" or "cyclothymia". A bipolar affective disorder is specified in the diagnosis by its current episode. Mixed episodes are also taken into account here.
Bipolar disorders are often divided into Bipolar I and Bipolar II. Bipolar I is a manic episode followed by at least one depressive episode. Bipolar II includes one depressive episode followed by at least one hypomania (milder form of mania). In contrast to the DSM-IV, this structure is not found in the ICD-10. Bipolar II, however, is expressly classified under “Other bipolar affective disorders”.
Recurrent depressive disorder
When depressive episodes occur repeatedly, it is referred to as a recurrent depressive disorder. The ICD-10 rules out a history of manic episodes. These fall into the realm of bipolar disorder. Recurrent depressive disorders are also specified in the diagnosis according to the appearance of the current episode. The current depressive episode can be mild, moderate, severe with no psychotic symptoms, severe with psychotic symptoms, or in remission (ie, without any depressive symptoms in the last few months). The seasonal depressive disorder is classified here.
Persistent mood disorders
A chronically depressed mood (over several years) with slight fluctuations, but which does not reach the extent of an actual depression, is called dysthymia . The Cyclothymia (not to be confused with the above cyclothymia) refers to a chronic instability of mood with periods of mild depression and hypomania. None of the criteria for a full picture of depression or bipolar disorder are met at any time.
Demarcation
An organic cause is usually not detectable in mood disorders, so therefore it is diseases of internal ( endogenous ) or unknown ( idiopathic n ) causes.
Reactive depression and organic brain impairment of affect are also to be distinguished from endogenous affective disorders. The same applies to pure flattening of affect, such as can occur in schizophrenia or certain forms of dementia . The ICD-10, however, no longer distinguishes between reactive and endogenous depression and summarizes both under mood disorders.
literature
- Martin Hautzinger : Affective disorders . In: Kurt Hahlweg , Anke Ehlers (Hrsg.): Mental disorders and their treatments (= encyclopedia of psychology ). Volume D.II.2. Hogrefe, Göttingen 1997, ISBN 978-3-8017-0544-2 , pp. 155-239 .
- Matthias R. Lemke (Ed.): Affective disorders . Thieme, Stuttgart 2004, ISBN 978-3-13-128241-5 .
