El trastorno del estado de ánimo , también conocido como trastornos afectivos del estado de ánimo , es un grupo de afecciones en las que una alteración del estado de ánimo de la persona es la principal característica subyacente. [1] La clasificación se encuentra en el Manual diagnóstico y estadístico de trastornos mentales (DSM) y en la Clasificación internacional de enfermedades (CIE).
Desorden de ánimo | |
---|---|
Otros nombres | Trastorno afectivo |
Un hombre depresivo de pie junto a un estanque campestre bajo la lluvia torrencial | |
Especialidad | Psiquiatría |
Tipos | Trastorno bipolar , ciclotimia , trastorno por desregulación disruptiva del estado de ánimo , distimia , trastorno depresivo mayor , trastorno disfórico premenstrual , trastorno afectivo estacional |
Medicamento | Antidepresivos, estabilizadores del estado de ánimo. |
Los trastornos del estado de ánimo se incluyen en los grupos básicos de estado de ánimo elevado, como la manía o la hipomanía ; estado de ánimo deprimido, de los cuales el más conocido y más investigado es el trastorno depresivo mayor (TDM) (conocido alternativamente como depresión clínica, depresión unipolar o depresión mayor); y estados de ánimo que alternan entre la manía y la depresión, conocido como trastorno bipolar (BD) (anteriormente conocido como depresión maníaca). Hay varios subtipos de trastornos depresivos o síndromes psiquiátricos que presentan síntomas menos graves, como el trastorno distímico (similar pero más leve que el TDM) y el trastorno ciclotímico (similar pero más leve que el TB). [2] [ página necesaria ] Los trastornos del estado de ánimo también pueden ser inducidos por sustancias o ocurrir en respuesta a una afección médica .
El psiquiatra inglés Henry Maudsley propuso una categoría general de trastorno afectivo . [3] El término fue reemplazado por trastorno del estado de ánimo , ya que el último término se refiere al estado emocional subyacente o longitudinal, [4] mientras que el primero se refiere a la expresión externa observada por otros. [1]
Clasificación
Trastornos depresivos
- Trastorno depresivo mayor (TDM), comúnmente llamado depresión mayor, depresión unipolar o depresión clínica, en el que una persona tiene uno o más episodios depresivos mayores . Después de un solo episodio, se diagnosticaría un trastorno depresivo mayor (un solo episodio). Después de más de un episodio, el diagnóstico se convierte en trastorno depresivo mayor (recurrente). La depresión sin períodos de manía a veces se denomina depresión unipolar porque el estado de ánimo permanece en el "polo" inferior y no sube al "polo" maníaco más alto, como en el trastorno bipolar. [5]
- Las personas con un episodio depresivo mayor o un trastorno depresivo mayor tienen un mayor riesgo de suicidio . Buscar ayuda y tratamiento de un profesional de la salud reduce drásticamente el riesgo de suicidio del individuo. Los estudios han demostrado que preguntar si un amigo o familiar deprimido ha pensado en suicidarse es una forma eficaz de identificar a los que están en riesgo y no "planta" la idea ni aumenta el riesgo de suicidio de una persona. [6] Los estudios epidemiológicos llevados a cabo en Europa sugieren que, en este momento, aproximadamente el 8,5 por ciento de la población mundial tiene un trastorno depresivo. Ningún grupo de edad parece estar exento de depresión, y los estudios han encontrado que la depresión aparece en bebés de tan solo 6 meses de edad que han sido separados de sus madres. [7]
- El trastorno depresivo es frecuente en la atención primaria y la práctica hospitalaria general, pero a menudo no se detecta. El trastorno depresivo no reconocido puede retrasar la recuperación y empeorar el pronóstico de la enfermedad física, por lo que es importante que todos los médicos puedan reconocer la afección, tratar los casos menos graves e identificar aquellos que requieran atención especializada. [8]
- Los diagnosticadores reconocen varios subtipos o especificadores de cursos:
- La depresión atípica ( EA ) se caracteriza por reactividad del estado de ánimo (anhedonia paradójica) y positividad, [ aclaración necesaria ] aumento de peso significativoo aumento del apetito ("comer reconfortante"), sueño excesivo o somnolencia ( hipersomnia ), una sensación de pesadez en las extremidades conocida como parálisis plomiza y deterioro social significativo como consecuencia de la hipersensibilidad al rechazo interpersonal percibido. [9] Las dificultades para medir este subtipo han llevado a cuestionar su validez y prevalencia. [10]
- La depresión melancólica se caracteriza por una pérdida de placer ( anhedonia ) en la mayoría o en todas las actividades, una falta de reactividad a los estímulos placenteros, una calidad del estado de ánimo depresivo más pronunciada que la del dolor o la pérdida, un empeoramiento de los síntomas en las horas de la mañana, temprano - despertar por la mañana, retraso psicomotor , pérdida de peso excesiva (no confundir con anorexia nerviosa ) o culpa excesiva. [11]
- La depresión mayor psicótica ( PMD ), o simplemente depresión psicótica, es el término para un episodio depresivo mayor, en particular de naturaleza melancólica, en el que el paciente experimenta síntomas psicóticos tales como delirios o, con menor frecuencia, alucinaciones . Estos son más comúnmente congruentes con el estado de ánimo (contenido coincidente con temas depresivos). [12]
- La depresión catatónica es una forma rara y grave de depresión mayor que implica alteraciones del comportamiento motor y otros síntomas. Aquí, la persona es muda y casi estuporosa, y está inmóvil o exhibe movimientos sin propósito o incluso extraños. Los síntomas catatónicos también pueden ocurrir en la esquizofrenia o en un episodio maníaco , o pueden deberse a un síndrome neuroléptico maligno . [13]
- La depresión posparto ( PPD ) figura como un especificador de curso en el DSM-IV-TR; se refiere a la depresión intensa, sostenida y en ocasiones incapacitante que experimentan las mujeres después de dar a luz. La depresión posparto, que afecta a entre el 10 y el 15% de las mujeres, suele aparecer dentro de los tres meses posteriores al trabajo de parto y dura hasta tres meses. [14] Es bastante común que las mujeres experimenten una sensación de cansancio y tristeza a corto plazo en las primeras semanas después del parto; sin embargo, la depresión posparto es diferente porque puede causar dificultades importantes y un funcionamiento deficiente en el hogar, el trabajo o la escuela, así como, posiblemente, dificultades en las relaciones con miembros de la familia, cónyuges o amigos, o incluso problemas para establecer vínculos con el recién nacido. [15] En el tratamiento de los trastornos depresivos mayores posparto y otras depresiones unipolares en mujeres que están amamantando, la nortriptilina , la paroxetina (Paxil) y la sertralina (Zoloft) se consideran en general los medicamentos preferidos. [16] Las mujeres con antecedentes personales o familiares de trastornos del estado de ánimo tienen un riesgo particularmente alto de desarrollar depresión posparto. [17]
- El trastorno disfórico premenstrual ( TDPM ) es una forma grave e incapacitante de síndrome premenstrual que afecta a 3 a 8% de las mujeres que menstrúan. [18] El trastorno consiste en un "grupo de síntomas afectivos, conductuales y somáticos" que se repiten mensualmente durante la fase lútea del ciclo menstrual . [18] El TDPM se agregó a la lista de trastornos depresivos en el Manual diagnóstico y estadístico de los trastornos mentales en 2013. La patogenia exacta del trastorno aún no está clara y es un tema de investigación activo. El tratamiento del PMDD se basa en gran medida en antidepresivos que modulan los niveles de serotonina en el cerebro a través de inhibidores de la recaptación de serotonina, así como la supresión de la ovulación mediante el uso de anticonceptivos. [18] [19]
- El trastorno afectivo estacional ( TAE ), también conocido como "depresión invernal" o "tristeza invernal", es un especificador. Algunas personas tienen un patrón estacional, con episodios depresivos que aparecen en otoño o invierno y se resuelven en primavera. El diagnóstico se realiza si han ocurrido al menos dos episodios en los meses más fríos y ninguno en otros momentos durante un período de dos años o más. [20] Se suele plantear la hipótesis de que las personas que viven en latitudes más altas tienden a tener menos exposición a la luz solar en el invierno y, por lo tanto, experimentan tasas más altas de TAE, pero el apoyo epidemiológico para esta propuesta no es fuerte (y la latitud no es el único determinante de la cantidad de luz solar que llega a los ojos en invierno). Se dice que este trastorno puede tratarse con fototerapia . [21] El TAE también es más frecuente en personas más jóvenes y, por lo general, afecta a más mujeres que hombres. [22]
- La distimia es una condición relacionada con la depresión unipolar, donde los mismos problemas físicos y cognitivos son evidentes, pero no son tan severos y tienden a durar más (generalmente al menos 2 años). [23] El tratamiento de la distimia es en gran medida el mismo que el de la depresión mayor, incluidos los medicamentos antidepresivos y la psicoterapia. [24]
- La depresión doble se puede definir como un estado de ánimo bastante deprimido (distimia) que dura al menos dos años y está marcado por períodos de depresión mayor. [23]
- El trastorno depresivo no especificado de otra manera (DD-NOS) está designado por el código 311 para los trastornos depresivos que son perjudiciales pero que no se ajustan a ninguno de los diagnósticos especificados oficialmente. Según el DSM-IV, DD-NOS abarca "cualquier trastorno depresivo que no cumpla con los criterios para un trastorno específico". Incluye los diagnósticos de investigación de depresión breve recurrente y trastorno depresivo menor que se enumeran a continuación.
- El trastorno de personalidad depresiva (DPD) es un diagnóstico psiquiátrico controvertido que denota un trastorno de personalidad con características depresivas. Originalmente incluido en el DSM-II, el trastorno depresivo de la personalidad se eliminó del DSM-III y del DSM-III-R. [25] Recientemente, se ha reconsiderado su reinstalación como diagnóstico. El trastorno depresivo de la personalidad se describe actualmente en el Apéndice B del DSM-IV-TR como digno de estudio adicional.
- Depresión breve recurrente ( RBD ), que se distingue del trastorno depresivo mayor principalmente por diferencias en la duración. Las personas con RBD tienen episodios depresivos aproximadamente una vez al mes, con episodios individuales que duran menos de dos semanas y, por lo general, menos de 2 a 3 días. El diagnóstico de RBD requiere que los episodios ocurran en el lapso de al menos un año y, en pacientes femeninas, independientemente del ciclo menstrual . [26] Las personas con depresión clínica pueden desarrollar RBD y viceversa, y ambas enfermedades tienen riesgos similares. [27] [ aclaración necesaria ]
- Minor depressive disorder, or simply minor depression, which refers to a depression that does not meet full criteria for major depression but in which at least two symptoms are present for two weeks.[28]
Bipolar disorders
- Bipolar disorder (BD) (also called "manic depression" or "manic-depressive disorder"), an unstable emotional condition characterized by cycles of abnormal, persistent high mood (mania) and low mood (depression),[29] which was formerly known as "manic depression" (and in some cases rapid cycling, mixed states, and psychotic symptoms).[30] Subtypes include:
- Bipolar I is distinguished by the presence or history of one or more manic episodes or mixed episodes with or without major depressive episodes. A depressive episode is not required for the diagnosis of Bipolar I Disorder, but depressive episodes are usually part of the course of the illness.
- Bipolar II consisting of recurrent intermittent hypomanic and depressive episodes or mixed episodes.
- Cyclothymia is a form of bipolar disorder, consisting of recurrent hypomanic and dysthymic episodes, but no full manic episodes or full major depressive episodes.
- Bipolar disorder not otherwise specified (BD-NOS), sometimes called "sub-threshold" bipolar, indicates that the patient has some symptoms in the bipolar spectrum (e.g., manic and depressive symptoms) but does not fully qualify for any of the three formal bipolar DSM-IV diagnoses mentioned above.
- It is estimated that roughly 1% of the adult population has bipolar I, a further 1% has bipolar II or cyclothymia, and somewhere between 2% and 5% percent have "sub-threshold" forms of bipolar disorder. Furthermore, the possibility of getting bipolar disorder when one parent is diagnosed with it is 15–30%. Risk, when both parents have it, is 50–75%. Also, while with bipolar siblings the risk is 15–25%, with identical twins it is about 70%. [31]
A minority of people with bipolar disorder have high creativity, artistry or a particular gifted talent. Before the mania phase becomes too extreme, its energy, ambition, enthusiasm and grandiosity often bring people with this type of mood disorder life's masterpieces.[29]
Substance-induced
A mood disorder can be classified as substance-induced if its etiology can be traced to the direct physiologic effects of a psychoactive drug or other chemical substance, or if the development of the mood disorder occurred contemporaneously with substance intoxication or withdrawal. Also, an individual may have a mood disorder coexisting with a substance abuse disorder. Substance-induced mood disorders can have features of a manic, hypomanic, mixed, or depressive episode. Most substances can induce a variety of mood disorders. For example, stimulants such as amphetamine, methamphetamine, and cocaine can cause manic, hypomanic, mixed, and depressive episodes.[32]
Alcohol-induced
High rates of major depressive disorder occur in heavy drinkers and those with alcoholism. Controversy has previously surrounded whether those who abused alcohol and developed depression were self-medicating their pre-existing depression. But recent research has concluded that, while this may be true in some cases, alcohol misuse directly causes the development of depression in a significant number of heavy drinkers. Participants studied were also assessed during stressful events in their lives and measured on a Feeling Bad Scale. Likewise, they were also assessed on their affiliation with deviant peers, unemployment, and their partner's substance use and criminal offending.[33][34][35] High rates of suicide also occur in those who have alcohol-related problems.[36] It is usually possible to differentiate between alcohol-related depression and depression that is not related to alcohol intake by taking a careful history of the patient.[35][37][38] Depression and other mental health problems associated with alcohol misuse may be due to distortion of brain chemistry, as they tend to improve on their own after a period of abstinence.[39]
Benzodiazepine-induced
Benzodiazepines, such as alprazolam, clonazepam, lorazepam and diazepam, can cause both depression and mania.[40]
Benzodiazepines are a class of medication commonly used to treat anxiety, panic attacks and insomnia, and are also commonly misused and abused. Those with anxiety, panic and sleep problems commonly have negative emotions and thoughts, depression, suicidal ideations, and often have comorbid depressive disorders. While the anxiolytic and hypnotic effects of benzodiazepines disappear as tolerance develops, depression and impulsivity with high suicidal risk commonly persist.[41] These symptoms are "often interpreted as an exacerbation or as a natural evolution of previous disorders and the chronic use of sedatives is overlooked".[41] Benzodiazepines do not prevent the development of depression, can exacerbate preexisting depression, can cause depression in those with no history of it, and can lead to suicide attempts.[41][42][43][44][45] Risk factors for attempted and completed suicide while using benzodiazepines include high dose prescriptions (even in those not misusing the medications), benzodiazepine intoxication, and underlying depression.[40][46][47]
The long-term use of benzodiazepines may have a similar effect on the brain as alcohol, and are also implicated in depression.[48] As with alcohol, the effects of benzodiazepine on neurochemistry, such as decreased levels of serotonin and norepinephrine, are believed to be responsible for the increased depression.[49][50][51][52][53][54] Additionally, benzodiazepines can indirectly worsen mood by worsening sleep (i.e., benzodiazepine-induced sleep disorder). Like alcohol, benzodiazepines can put people to sleep but, while asleep, they disrupt sleep architecture: decreasing sleep time, delaying time to REM sleep, and decreasing deep sleep (the most restorative part of sleep for both energy and mood).[55][56][57] Just as some antidepressants can cause or worsen anxiety in some patients due to being activating, benzodiazepines can cause or worsen depression due to being a central nervous system depressant—worsening thinking, concentration and problem solving (i.e., benzodiazepine-induced neurocognitive disorder).[40] However, unlike antidepressants, in which the activating effects usually improve with continued treatment, benzodiazepine-induced depression is unlikely to improve until after stopping the medication.
In a long-term follow-up study of patients dependent on benzodiazepines, it was found that 10 people (20%) had taken drug overdoses while on chronic benzodiazepine medication despite only two people ever having had any pre-existing depressive disorder. A year after a gradual withdrawal program, no patients had taken any further overdoses.[58]
Just as with intoxication and chronic use, benzodiazepine withdrawal can also cause depression.[59][60][61] While benzodiazepine-induced depressive disorder may be exacerbated immediately after discontinuation of benzodiazepines, evidence suggests that mood significantly improves after the acute withdrawal period to levels better than during use.[41] Depression resulting from withdrawal from benzodiazepines usually subsides after a few months but in some cases may persist for 6–12 months.[62][63]
Due to another medical condition
"Mood disorder due to a general medical condition" is used to describe manic or depressive episodes which occur secondary to a medical condition.[64] There are many medical conditions that can trigger mood episodes, including neurological disorders (e.g. dementias), metabolic disorders (e.g. electrolyte disturbances), gastrointestinal diseases (e.g. cirrhosis), endocrine disease (e.g. thyroid abnormalities), cardiovascular disease (e.g. heart attack), pulmonary disease (e.g. chronic obstructive pulmonary disease), cancer, and autoimmune diseases (e.g. multiple sclerosis ) .[64]
Not otherwise specified
Mood disorder not otherwise specified (MD-NOS) is a mood disorder that is impairing but does not fit in with any of the other officially specified diagnoses. In the DSM-IV MD-NOS is described as "any mood disorder that does not meet the criteria for a specific disorder."[65] MD-NOS is not used as a clinical description but as a statistical concept for filing purposes.[66]
Most cases of MD-NOS represent hybrids between mood and anxiety disorders, such as mixed anxiety-depressive disorder or atypical depression.[66] An example of an instance of MD-NOS is being in minor depression frequently during various intervals, such as once every month or once in three days.[65] There is a risk for MD-NOS not to get noticed, and for that reason not to get treated.[67]
Causas
Meta-analyses show that high scores on the personality domain neuroticism are a strong predictor for the development of mood disorders.[68] A number of authors have also suggested that mood disorders are an evolutionary adaptation (see also evolutionary psychiatry).[69] A low or depressed mood can increase an individual's ability to cope with situations in which the effort to pursue a major goal could result in danger, loss, or wasted effort.[70] In such situations, low motivation may give an advantage by inhibiting certain actions. This theory helps to explain why negative life incidents precede depression in around 80 percent of cases,[71][72] and why they so often strike people during their peak reproductive years. These characteristics would be difficult to understand if depression were a dysfunction.[70]
A depressed mood is a predictable response to certain types of life occurrences, such as loss of status, divorce, or death of a child or spouse. These are events that signal a loss of reproductive ability or potential, or that did so in humans' ancestral environment. A depressed mood can be seen as an adaptive response, in the sense that it causes an individual to turn away from the earlier (and reproductively unsuccessful) modes of behavior.
A depressed mood is common during illnesses, such as influenza. It has been argued that this is an evolved mechanism that assists the individual in recovering by limiting his/her physical activity.[73] The occurrence of low-level depression during the winter months, or seasonal affective disorder, may have been adaptive in the past, by limiting physical activity at times when food was scarce.[73] It is argued that humans have retained the instinct to experience low mood during the winter months, even if the availability of food is no longer determined by the weather.[73]
Much of what is known about the genetic influence of clinical depression is based upon research that has been done with identical twins. Identical twins have exactly the same genetic code. It has been found that when one identical twin becomes depressed the other will also develop clinical depression approximately 76% of the time. When identical twins are raised apart from each other, they will both become depressed about 67% of the time. Because both twins become depressed at such a high rate, the implication is that there is a strong genetic influence. If it happened that when one twin becomes clinically depressed the other always develops depression, then clinical depression would likely be entirely genetic.[74]
Bipolar disorder is also considered a mood disorder and it is hypothesized that it might be caused by mitochondrial dysfunction.[75][76][77]
Sex Differences Mood disorders, specifically stress-related mood disorders such as anxiety and depression, have been shown to have differing rates of diagnosis based on sex. In the United States, women are two times more likely than men to be diagnosed with a stress-related mood disorder.[78][79] Underlying these sex differences, studies have shown a dysregulation of stress-responsive neuroendocrine function causing an increase in the likelihood of developing these affective disorders.[80] Overactivation of the hypothalamic-pituitary-adrenal (HPA) axis could provide potential insight into how these sex differences arise. Neuropeptide corticotropin-releasing factor (CRF) is released from the paraventricular nucleus (PVN) of the hypothalamus, stimulating adrenocorticotropic hormone (ACTH) release into the blood stream. From here ACTH triggers the release of glucocorticoids such as cortisol from the adrenal cortex. Cortisol, known as the main stress hormone, creates a negative feedback loop back to the hypothalamus to deactivate the stress response.[81] When a constant stressor is present, the HPA axis remains overactivated and cortisol is constantly produced. This chronic stress is associated with sustained CRF release, resulting in the increased production of anxiety- and depressive-like behaviors and serving as a potential mechanism for differences in prevalence between men and women.[82]
Diagnóstico
DSM-5
The DSM-5, released in May 2013, separates the mood disorder chapter from the DSM-TR-IV into two sections: Depressive and related disorders and bipolar and related disorders. Bipolar disorders falls in between depressive disorders and schizophrenia spectrum and related disorders "in recognition of their place as a bridge between the two diagnostic classes in terms of symptomatology, family history and genetics" (Ref. 1, p 123).[83] Bipolar disorders underwent a few changes in the DSM-5, most notably the addition of more specific symptomology related to hypomanic and mixed manic states. Depressive disorders underwent the most changes, the addition of three new disorders: disruptive mood dysregulation disorder, persistent depressive disorder (previously dysthymia), and premenstrual dysphoric disorder (previously in appendix B, the section for disorders needing further research). Disruptive mood dysregulation disorder is meant as a diagnosis for children and adolescents who would normally be diagnosed with bipolar disorder as a way to limit the bipolar diagnosis in this age cohort. Major depressive disorder (MDD) also underwent a notable change, in that the bereavement clause has been removed. Those previously exempt from a diagnosis of MDD due to bereavement are now candidates for the MDD diagnosis.[84]
Tratamiento
There are different types of treatments available for mood disorders, such as therapy and medications. Behaviour therapy, cognitive behaviour therapy and interpersonal therapy have all shown to be potentially beneficial in depression.[85][86] Major depressive disorder medications usually include antidepressants; a combination of antidepressants and cognitive behavioral therapy has shown to be more effective than one treatment alone.[87] Bipolar disorder medications can consist of antipsychotics, mood stabilizers, anticonvulsants[88] and/or lithium. Lithium specifically has been proven to reduce suicide and all causes of mortality in people with mood disorders.[89] If mitochondrial dysfunction or mitochondrial diseases are the cause of mood disorders like bipolar disorder,[75] then it has been hypothesized that N-acetyl-cysteine (NAC), acetyl-L-carnitine (ALCAR), S-adenosylmethionine (SAMe), coenzyme Q10 (CoQ10), alpha-lipoic acid (ALA), creatine monohydrate (CM), and melatonin could be potential treatment options.[90] In determining treatment, there are many types of depression scales that are used. One of the depression scales is a self-report scale called Beck Depression Inventory (BDI). Another scale is the Hamilton Depression Rating Scale (HAMD). HAMD is a clinical rating scale in which the patient is rated based on clinician observation.[91] The Center for Epidemiologic Studies Depression Scale (CES-D) is a scale for depression symptoms that applies to the general population. This scale is typically used in research and not for self-reports. The PHQ-9 which stands for Patient-Health Questionnaire-9 questions, is a self-report as well. Finally, the Mood Disorder Questionnaire (MDQ) evaluates bipolar disorder.[92]
Epidemiología
According to a substantial number of epidemiology studies conducted, women are twice as likely to develop certain mood disorders, such as major depression. Although there is an equal number of men and women diagnosed with bipolar II disorder, women have a slightly higher frequency of the disorder.[93]
The prevalence of depressive symptoms has increased over the years with recent generations reporting a 6% increase in symptoms of depression compared to individuals from older generations.[94]
In 2011, mood disorders were the most common reason for hospitalization among children aged 1–17 years in the United States, with approximately 112,000 stays.[95] Mood disorders were top principal diagnosis for Medicaid super-utilizers in the United States in 2012.[96] Further, a study of 18 States found that mood disorders accounted for the highest number of hospital readmissions among Medicaid patients and the uninsured, with 41,600 Medicaid patients and 12,200 uninsured patients being readmitted within 30 days of their index stay—a readmission rate of 19.8 per 100 admissions and 12.7 per 100 admissions, respectively.[97] In 2012, mood and other behavioral health disorders were the most common diagnoses for Medicaid-covered and uninsured hospital stays in the United States (6.1% of Medicaid stays and 5.2% of uninsured stays).[98]
A study conducted in 1988 to 1994 amongst young American adults involved a selection of demographic and health characteristics. A population-based sample of 8,602 men and women ages 17–39 years participated. Lifetime prevalence were estimated based on six mood measures:
- major depressive episode (MDE) 8.6%,
- major depressive disorder with severity (MDE-s) 7.7%,
- dysthymia 6.2%,
- MDE-s with dysthymia 3.4%,
- any bipolar disorder 1.6%, and
- any mood disorder 11.5%.[99]
Investigar
Kay Redfield Jamison and others have explored the possible links between mood disorders – especially bipolar disorder – and creativity. It has been proposed that a "ruminating personality type may contribute to both [mood disorders] and art."[100]
Jane Collingwood notes an Oregon State University study that
- "looked at the occupational status of a large group of typical patients and found that 'those with bipolar illness appear to be disproportionately concentrated in the most creative occupational category.' They also found that the likelihood of 'engaging in creative activities on the job' is significantly higher for bipolar than nonbipolar workers". [101]
In Liz Paterek's article "Bipolar Disorder and the Creative Mind"[102] she wrote
- "Memory and creativity are related to mania. Clinical studies have shown that those in a manic state will rhyme, find synonyms, and use alliteration more than controls. This mental fluidity could contribute to an increase in creativity. Moreover, mania creates increases in productivity and energy. Those in a manic state are more emotionally sensitive and show less inhibition about attitudes, which could create greater expression. Studies performed at Harvard looked into the amount of original thinking in solving creative tasks. Bipolar individuals, whose disorder was not severe, tended to show greater degrees of creativity".
The relationship between depression and creativity appears to be especially strong among poets.[103][104]
Ver también
- Personality disorder
Referencias
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- Cited texts
- American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders, Fourth Edition, Text Revision: DSM-IV-TR. Washington, DC: American Psychiatric Publishing, Inc. p. 943. ISBN 978-0-89042-025-6.
- Parker, Gordon; Dusan Hadzi-Pavlovic; Kerrie Eyers (1996). Melancholia: A disorder of movement and mood: a phenomenological and neurobiological review. Cambridge: Cambridge University Press. ISBN 978-0-521-47275-3.
- Sadock, Benjamin J.; Sadock, Virginia A. (2002). Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry (9th ed.). Lippincott Williams & Wilkins. ISBN 978-0-7817-3183-6.
- Carlson, Neil R.; C. Donald Heth (2007). Psychology the science of behaviour (4th ed.). Pearson Education Inc. ISBN 978-0-205-64524-4.
enlaces externos
- Media related to Mood disorders at Wikimedia Commons
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