What Is an Affective Disorder?

The clinical manifestations of affective disorder are mainly emotional ups and downs, accompanied by thoughtfulness or slowness, psychomotor excitement or depression, and the patient's mood is high in a manic state, which is disproportionate to the situation and can be elated and irritable Annoyance, agitation, anger, anxiety, and severe cases can cause mental symptoms such as delusions, hallucinations that are coordinated or uncoordinated with the mood. In a depressed state, the patient is in a bad mood, distressed, sad to pessimistic, desperate, unable to get up, loses interest, has low self-evaluation, and has severe suicidal ideas and behaviors, and his condition changes gradually from day to night.

Affective disorder

The clinical manifestations of affective disorder are

One unknown cause is:

(I) Physical factors:

1. The results of epidemiological investigation of genetic factors show that genetic factors are one of the important factors in the pathogenesis of this disease. The same disease rate in the family of the pre-sexer is 30 times that of the general population, and the expected incidence of first-degree relatives is 7.2-16%. The closer the blood relationship is, the higher the incidence is.

1. History and symptoms:

(A) clinical manifestations

(B) the characteristics of the course of disease

Most have recurrent episodes, intermittent mental states are generally normal, and often have a high positive family history.

2. Physical examination findings

Physical, nervous system, and laboratory tests are generally not positive.

The diagnosis is clinically based: symptoms, course, and family history, sometimes with reference

Physical Examination and Nervous System Examination

Perform physical examinations as required for physical and neurological examinations.

Mental Condition Examination

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Differential diagnosis:

A schizophrenia: When adolescents are sick and have emotional speech or behavioral excitement or suppression, they are easily misdiagnosed as bipolar disorder. In the former case, emotions, thinking and behaviors are uncoordinated, and they are mainly divorced from reality; the latter are coordinated without deviating from reality. In addition, the onset of the disease, the stage of the disease, the presence or absence of residual symptoms after previous attacks, family history, and treatment response all help to identify.

two

Suicide risk

Suicide is

Course and

1. Western medicine treatment

(1) Unipolar mental disorder

Antidepressants: Amitriptyline, 50-300mg / day; Bentriptyline, 50-150mg / day; Imipramine, 50-300mg / day; Medication for 2-4 weeks. If necessary, supplement with antipsychotic drugs, such as methylthiopyridine 300mg / day, orally or two or three times a day, or thioxanthine or intramuscular injection of 30mg / day, two or three times daily.

Psychotherapy: For cases that have been relieved in the acute depression period, the use of short-term individual psychotherapy can help improve the coping skills of patients. Couple therapy can help resolve conflicts between the two parties. Long-range psychotherapy does not seem appropriate unless there is a significant personality disorder.

(2) Manic mental disorder: Manic mental disorder is often an emergency situation and it is best to be hospitalized; mild mania can be treated out-patient.

Oral lithium carbonate 300mg, started 2-3 times a day, and increased to a blood lithium concentration of 0.8-1. 5mg / L within 7-10 days. Sometimes intramuscular injection of haloperidol 5-10mg (up to 60mg / day) or other antipsychotic drugs is necessary until the manic symptoms are controlled.

For the mixed state of manic depression, use antipsychotic drugs and lithium salts in combination, and stop using antipsychotic drugs

Another treatment method for severe psychotic excitement and mixed state is: carbamazepine 1200mg / day, the treatment of a single manic episode should last at least 6 months.

Frequent recurrent bipolar disorder is best maintained by lithium for an indefinite period of time, and the blood concentration is maintained at 0.4-0.8 mg / L, usually 600-1500 mg / day.

Mild mania fluctuation or mixed state, 50-300mg / day of chlorpromazine or methiopyrazine can be used together, once a few days or several weeks.

It is better to use lithium salt for the treatment of bipolar depression. Anti-depressants should be avoided for mild episodes and anti-depressants for moderate episodes.