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{{Merge from |Types of psychological depression |date=May 2010}}
{{Infobox Disease
{{Infobox Disease
| Name = Mood disorder
| Name = Mood disorder
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=== Depressive disorders ===
=== Depressive disorders ===


* '''[[Major depressive disorder]]''' ('''MDD'''), commonly called major depression, unipolar depression, or clinical depression, where a person has two or more [[major depressive episode]]s. Depression without periods of mania is sometimes referred to as ''unipolar depression'' because the mood remains at one emotional state or "pole".<ref>{{Harvnb |Parker|1996| p=173}}</ref> Diagnosticians recognize several subtypes or course specifiers:
* '''[[Major depressive disorder]]''' ('''MDD'''), commonly called major depression, unipolar depression, or clinical depression, where a person has two or more [[major depressive episode]]s. Depression without periods of mania is sometimes referred to as ''unipolar depression'' because the mood remains at one emotional state or "pole".<ref>{{Harvnb |Parker|1996| p=173}}</ref>

:Individuals with a major depressive episode or major depressive disorder are at increased risk for suicide. Seeking help and treatment from a health professional dramatically reduces the individual's risk for suicide. Studies have demonstrated that asking if a depressed friend or family member has thought of committing suicide is an effective way of identifying those at risk, and it does not "plant" the idea or increase an individual's risk for suicide in any way.<ref>The ICD-10 Classification of Mental and Behavioural Disorders. World Health Organisation. 1993.</ref>

:Diagnosticians recognize several subtypes or course specifiers:


:* ''[[Atypical depression]]'' (''AD'') is characterized by mood reactivity (paradoxical anhedonia) and positivity, significant [[weight gain]] or increased appetite ("comfort eating"), excessive sleep or somnolence ([[hypersomnia]]), a sensation of heaviness in limbs known as leaden paralysis, and significant social impairment as a consequence of hypersensitivity to perceived [[social rejection|interpersonal rejection]].<ref>{{Harvnb |American Psychiatric Association|2000| p=421–22}}</ref> Difficulties in measuring this subtype have led to questions of its validity and prevalence.<ref>{{Harvnb |Sadock|2002| p=548}}</ref>
:* ''[[Atypical depression]]'' (''AD'') is characterized by mood reactivity (paradoxical anhedonia) and positivity, significant [[weight gain]] or increased appetite ("comfort eating"), excessive sleep or somnolence ([[hypersomnia]]), a sensation of heaviness in limbs known as leaden paralysis, and significant social impairment as a consequence of hypersensitivity to perceived [[social rejection|interpersonal rejection]].<ref>{{Harvnb |American Psychiatric Association|2000| p=421–22}}</ref> Difficulties in measuring this subtype have led to questions of its validity and prevalence.<ref>{{Harvnb |Sadock|2002| p=548}}</ref>
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:* ''[[Catatonia|Catatonic depression]]'' is a rare and severe form of major depression involving disturbances of motor behavior and other symptoms. Here the person is mute and almost stuporose, and either immobile or exhibits purposeless or even bizarre movements. Catatonic symptoms also occur in [[schizophrenia]], a [[manic episode]], or be due to [[neuroleptic malignant syndrome]].<ref>{{Harvnb |American Psychiatric Association|2000| p=417–18}}</ref>
:* ''[[Catatonia|Catatonic depression]]'' is a rare and severe form of major depression involving disturbances of motor behavior and other symptoms. Here the person is mute and almost stuporose, and either immobile or exhibits purposeless or even bizarre movements. Catatonic symptoms also occur in [[schizophrenia]], a [[manic episode]], or be due to [[neuroleptic malignant syndrome]].<ref>{{Harvnb |American Psychiatric Association|2000| p=417–18}}</ref>


:* ''[[Postpartum depression]]'' (''PPD'') is listed as a course specifier in DSM-IV-TR; it refers to the intense, sustained and sometimes disabling depression experienced by women after giving birth. Postpartum depression, which has incidence rate of 10–15%, typically sets in within three months of [[childbirth|labor]], and lasts as long as three months.<ref>Ruta M Nonacs. [http://www.emedicine.com/med/topic3408.htm eMedicine - Postpartum Depression]</ref>
:* ''[[Postpartum depression]]'' (''PPD'') is listed as a course specifier in DSM-IV-TR; it refers to the intense, sustained and sometimes disabling depression experienced by women after giving birth. Postpartum depression, which has incidence rate of 10–15%, typically sets in within three months of [[childbirth|labor]], and lasts as long as three months.<ref>Ruta M Nonacs. [http://www.emedicine.com/med/topic3408.htm eMedicine - Postpartum Depression]</ref> It is quite common for women to experience a short term feeling of tiredness and sadness in the first few weeks after giving birth; however, postpartum depression is different because it can cause significant hardship and impaired functioning at home, work, or school as well as possibly difficulty in relationships with family members, spouses, friends, or even problems bonding with the newborn.<ref>O'Hara, Michael W. "Postpartum Depression: Causes and consequences." 1995.</ref> In the treatment of postpartum major depressive disorders and other unipolar depressions in women who are breastfeeding, [[nortriptyline]], [[paroxetine]] (Paxil), and [[sertraline]] (Zoloft) are generally considered to be the preferred medications.<ref>[http://ajp.psychiatryonline.org/cgi/content/abstract/161/6/1066 Weissman, A.M., et al. "Pooled Analysis of Antidepressant Levels in Lactating Mothers, Breast Milk, and Nursing Infants." ''American Journal of Psychiatry'', 161:1066-1078, June 2004.]</ref>


:* ''[[Seasonal affective disorder]]'' (''SAD''), also known as "winter depression" or "winter blues", is a specifier. Some people have a seasonal pattern, with depressive episodes coming on in the autumn or winter, and resolving in spring. The diagnosis is made if at least two episodes have occurred in colder months with none at other times over a two-year period or longer.<ref>{{Harvnb |American Psychiatric Association|2000| p=425}}</ref>
:* ''[[Seasonal affective disorder]]'' (''SAD''), also known as "winter depression" or "winter blues", is a specifier. Some people have a seasonal pattern, with depressive episodes coming on in the autumn or winter, and resolving in spring. The diagnosis is made if at least two episodes have occurred in colder months with none at other times over a two-year period or longer.<ref>{{Harvnb |American Psychiatric Association|2000| p=425}}</ref> People who live at higher latitudes tend to have less sunlight exposure in the winter and therefore experience higher rates of SAD. SAD is also more prevalent in people who are younger and typically affects more females than males.<ref>Lam, Raymond W. and Robert D. Levitan. "Pathophysiology of seasonal affective disorder: A review". ''Journal of Psychiatry and Neuroscience'', 25, 469-480. 2000.</ref>


* '''[[Dysthymia]]''', which is a chronic, different mood disturbance where a person reports a low mood almost daily over a span of at least two years. The symptoms are not as severe as those for major depression, although people with dysthymia are vulnerable to secondary episodes of major depression (sometimes referred to as ''double depression'').<ref>{{Harvnb |Sadock|2002| p=552}}</ref>
* '''[[Dysthymia]]''', which is a chronic, different mood disturbance where a person reports a low mood almost daily over a span of at least two years. The symptoms are not as severe as those for major depression, although people with dysthymia are vulnerable to secondary episodes of major depression (sometimes referred to as ''double depression'').<ref>{{Harvnb |Sadock|2002| p=552}}</ref> The treatment of dysthymia is largely the same as for major depression, including antidepressant medications and psychotherapy.<ref>The ICD-10 Classification of Mental and Behavioural Disorders World Health Organisation 1993</ref>


*'''[[Depressive Disorder Not Otherwise Specified]]''' ('''DD-NOS''') is designated by the [[DSM-IV Codes|code]] ''311'' for depressive disorders that are impairing but do not fit any of the officially specified diagnoses. According to the DSM-IV, DD-NOS encompasses ''"any depressive disorder that does not meet the criteria for a specific disorder."'' It includes the research diagnoses of ''recurrent brief depression'', and ''minor depressive disorder'' listed below.
*'''[[Depressive Disorder Not Otherwise Specified]]''' ('''DD-NOS''') is designated by the [[DSM-IV Codes|code]] ''311'' for depressive disorders that are impairing but do not fit any of the officially specified diagnoses. According to the DSM-IV, DD-NOS encompasses ''"any depressive disorder that does not meet the criteria for a specific disorder."'' It includes the research diagnoses of ''recurrent brief depression'', and ''minor depressive disorder'' listed below.
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[[Category:Mood disorders| ]]
[[Category:Mood disorders| ]]
[[Category:Abnormal psychology]]
[[Category:Abnormal psychology]]
[[Category:History of medicine]]
[[Category:Bipolar spectrum| ]]


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[[tr:Duygudurum bozukluğu]]
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[[zh:情感障礙]]
[[zh:抑郁性障碍]]

Revision as of 18:42, 3 July 2010

Mood disorder
SpecialtyPsychiatry, clinical psychology Edit this on Wikidata

A mood disorder is the term given for a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV TR) classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature.[1] The classification is known as mood (affective) disorders in ICD 10.

English psychiatrist Henry Maudsley proposed an overarching category of affective disorder.[2] The term was then replaced by mood disorder, as the latter term refers to the underlying or longitudinal emotional state,[3] whereas the former refers to the external expression observed by others.[1]

Two groups of mood disorders are broadly recognized; the division is based on whether the person has ever had a manic or hypomanic episode. Thus, there are depressive disorders, of which the best known and most researched is major depressive disorder (MDD) commonly called clinical depression or major depression, and bipolar disorder (BD), formerly known as "manic depression" and described by intermittent periods of manic and depressed episodes.

Classification

Depressive disorders

  • Major depressive disorder (MDD), commonly called major depression, unipolar depression, or clinical depression, where a person has two or more major depressive episodes. Depression without periods of mania is sometimes referred to as unipolar depression because the mood remains at one emotional state or "pole".[4]
Individuals with a major depressive episode or major depressive disorder are at increased risk for suicide. Seeking help and treatment from a health professional dramatically reduces the individual's risk for suicide. Studies have demonstrated that asking if a depressed friend or family member has thought of committing suicide is an effective way of identifying those at risk, and it does not "plant" the idea or increase an individual's risk for suicide in any way.[5]
Diagnosticians recognize several subtypes or course specifiers:
  • Atypical depression (AD) is characterized by mood reactivity (paradoxical anhedonia) and positivity, significant weight gain or increased appetite ("comfort eating"), excessive sleep or somnolence (hypersomnia), a sensation of heaviness in limbs known as leaden paralysis, and significant social impairment as a consequence of hypersensitivity to perceived interpersonal rejection.[6] Difficulties in measuring this subtype have led to questions of its validity and prevalence.[7]
  • Psychotic major depression (PMD), or simply psychotic depression, is the term for a major depressive episode, particularly of melancholic nature, where the patient experiences psychotic symptoms such as delusions or, less commonly, hallucinations. These are most commonly mood-congruent (content coincident with depressive themes).[9]
  • Postpartum depression (PPD) is listed as a course specifier in DSM-IV-TR; it refers to the intense, sustained and sometimes disabling depression experienced by women after giving birth. Postpartum depression, which has incidence rate of 10–15%, typically sets in within three months of labor, and lasts as long as three months.[11] It is quite common for women to experience a short term feeling of tiredness and sadness in the first few weeks after giving birth; however, postpartum depression is different because it can cause significant hardship and impaired functioning at home, work, or school as well as possibly difficulty in relationships with family members, spouses, friends, or even problems bonding with the newborn.[12] In the treatment of postpartum major depressive disorders and other unipolar depressions in women who are breastfeeding, nortriptyline, paroxetine (Paxil), and sertraline (Zoloft) are generally considered to be the preferred medications.[13]
  • Seasonal affective disorder (SAD), also known as "winter depression" or "winter blues", is a specifier. Some people have a seasonal pattern, with depressive episodes coming on in the autumn or winter, and resolving in spring. The diagnosis is made if at least two episodes have occurred in colder months with none at other times over a two-year period or longer.[14] People who live at higher latitudes tend to have less sunlight exposure in the winter and therefore experience higher rates of SAD. SAD is also more prevalent in people who are younger and typically affects more females than males.[15]
  • Dysthymia, which is a chronic, different mood disturbance where a person reports a low mood almost daily over a span of at least two years. The symptoms are not as severe as those for major depression, although people with dysthymia are vulnerable to secondary episodes of major depression (sometimes referred to as double depression).[16] The treatment of dysthymia is largely the same as for major depression, including antidepressant medications and psychotherapy.[17]
  • Depressive Disorder Not Otherwise Specified (DD-NOS) is designated by the code 311 for depressive disorders that are impairing but do not fit any of the officially specified diagnoses. According to the DSM-IV, DD-NOS encompasses "any depressive disorder that does not meet the criteria for a specific disorder." It includes the research diagnoses of recurrent brief depression, and minor depressive disorder listed below.
  • Recurrent brief depression (RBD), distinguished from major depressive disorder primarily by differences in duration. People with RBD have depressive episodes about once per month, with individual episodes lasting less than two weeks and typically less than 2–3 days. Diagnosis of RBD requires that the episodes occur over the span of at least one year and, in female patients, independently of the menstrual cycle.[18] People with clinical depression can develop RBD, and vice versa, and both illnesses have similar risks.[19]
  • 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.[20]

Bipolar disorders

  • Bipolar disorder (BD), a mood disorder formerly known as "manic depression" and described by alternating periods of mania and depression (and in some cases rapid cycling, mixed states, and psychotic symptoms). 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 often part of the course of the illness.
  • Bipolar II consisting of recurrent intermittent hypomanic and depressive episodes.
  • Cyclothymia is a different 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 suffers from 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 one percent of the adult population suffers from bipolar I, roughly one percent of the adult population suffers from bipolar II or cyclothymia, and somewhere between two and five percent suffer from "sub-threshold" forms of bipolar disorder.

Substance-induced mood disorders

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. Alternately, 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 (Adderall, Dexedrine; "Speed"), methamphetamine (Desoxyn; "Meth", "Crank", "Crystal", etc.), and cocaine ("Coke", "Crack", etc.) can cause manic, hypomanic, mixed, and depressive episodes.

Alcohol-induced mood disorders

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.[21][22][23] High rates of suicide also occur in those who have alcohol-related problems.[24] It is usually possible to differentiate between alcohol-related depression and depression which is not related to alcohol intake by taking a careful history of the patient.[23][25][26] 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.[27]

Benzodiazepine-induced mood disorders

Long term use of benzodiazepines which have a similar effect on the brain as alcohol and are also associated with depression.[28] Major depressive disorder can also develop as a result of chronic use of benzodiazepines or as part of a protracted withdrawal syndrome. Benzodiazepines are a class of medication which are commonly used to treat insomnia, anxiety and muscular spasms. 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.[29][30][31][32] Major depressive disorder may also occur as part of the benzodiazepine withdrawal syndrome.[33][34][35] 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.[36] Depression resulting from withdrawal from benzodiazepines usually subsides after a few months but in some cases may persist for 6–12 months.[37][38]

Sociocultural aspects

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."[39] The relationship between depression and creativity appears to be especially strong among poets.[40][41]

See also

References

Notes

  1. ^ a b Sadock 2002, p. 534
  2. ^ Lewis, AJ (1934). "Melancholia: A Historical Review". Journal of Mental Science. 80: 1–42. doi:10.1192/bjp.80.328.1. {{cite journal}}: Invalid |ref=harv (help)
  3. ^ Berrios G E (1985) The Psychopathology of Affectivity: Conceptual and Historical Aspects. Psychological Medicine 15: 745-758
  4. ^ Parker 1996, p. 173
  5. ^ The ICD-10 Classification of Mental and Behavioural Disorders. World Health Organisation. 1993.
  6. ^ American Psychiatric Association 2000, p. 421–22
  7. ^ Sadock 2002, p. 548
  8. ^ American Psychiatric Association 2000, p. 419–20
  9. ^ American Psychiatric Association 2000, p. 412
  10. ^ American Psychiatric Association 2000, p. 417–18
  11. ^ Ruta M Nonacs. eMedicine - Postpartum Depression
  12. ^ O'Hara, Michael W. "Postpartum Depression: Causes and consequences." 1995.
  13. ^ Weissman, A.M., et al. "Pooled Analysis of Antidepressant Levels in Lactating Mothers, Breast Milk, and Nursing Infants." American Journal of Psychiatry, 161:1066-1078, June 2004.
  14. ^ American Psychiatric Association 2000, p. 425
  15. ^ Lam, Raymond W. and Robert D. Levitan. "Pathophysiology of seasonal affective disorder: A review". Journal of Psychiatry and Neuroscience, 25, 469-480. 2000.
  16. ^ Sadock 2002, p. 552
  17. ^ The ICD-10 Classification of Mental and Behavioural Disorders World Health Organisation 1993
  18. ^ American Psychiatric Association 2000, p. 778
  19. ^ Carta, Mauro Giovanni; Altamura, Alberto Carlo; Hardoy, Maria Carolina; et al. (2003). "Is recurrent brief depression an expression of mood spectrum disorders in young people?". European Archives of Psychiatry and Clinical Neuroscience. 253 (3): 149–53. doi:10.1007/s00406-003-0418-5. PMID 12904979. {{cite journal}}: Explicit use of et al. in: |author= (help); Invalid |ref=harv (help)CS1 maint: multiple names: authors list (link)
  20. ^ Rapaport MH, Judd LL, Schettler PJ, Yonkers KA, Thase ME, Kupfer DJ, Frank E, Plewes JM, Tollefson GD, Rush AJ (2002). "A descriptive analysis of minor depression". American Journal of Psychiatry. 159 (4): 637–43. doi:10.1176/appi.ajp.159.4.637. PMID 11925303. {{cite journal}}: Invalid |ref=harv (help)CS1 maint: multiple names: authors list (link)
  21. ^ Fergusson DM, Boden JM, Horwood LJ (2009). "Tests of causal links between alcohol abuse or dependence and major depression". Arch. Gen. Psychiatry. 66 (3): 260–6. doi:10.1001/archgenpsychiatry.2008.543. PMID 19255375. {{cite journal}}: Invalid |ref=harv (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  22. ^ Falk DE, Yi HY, Hilton ME (2008). "Age of onset and temporal sequencing of lifetime DSM-IV alcohol use disorders relative to comorbid mood and anxiety disorders". Drug Alcohol Depend. 94 (1–3): 234–45. doi:10.1016/j.drugalcdep.2007.11.022. PMC 2386955. PMID 18215474. {{cite journal}}: Invalid |ref=harv (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  23. ^ a b Schuckit MA, Smith TL, Danko GP; et al. (2007). "A comparison of factors associated with substance-induced versus independent depressions". J Stud Alcohol Drugs. 68 (6): 805–12. PMID 17960298. {{cite journal}}: Explicit use of et al. in: |author= (help); Invalid |ref=harv (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  24. ^ Chignon JM, Cortes MJ, Martin P, Chabannes JP (1998). "[Attempted suicide and alcohol dependence: results of an epidemiologic survey]". Encephale (in French). 24 (4): 347–54. PMID 9809240. {{cite journal}}: Invalid |ref=harv (help)CS1 maint: multiple names: authors list (link)
  25. ^ Schuckit MA, Tipp JE, Bergman M, Reich W, Hesselbrock VM, Smith TL (1997). "Comparison of induced and independent major depressive disorders in 2,945 alcoholics". Am J Psychiatry. 154 (7): 948–57. PMID 9210745. {{cite journal}}: Invalid |ref=harv (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  26. ^ Schuckit MA, Tipp JE, Bucholz KK; et al. (1997). "The life-time rates of three major mood disorders and four major anxiety disorders in alcoholics and controls". Addiction. 92 (10): 1289–304. doi:10.1111/j.1360-0443.1997.tb02848.x. PMID 9489046. {{cite journal}}: Explicit use of et al. in: |author= (help); Invalid |ref=harv (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  27. ^ Wetterling T (2000). "Psychopathology of alcoholics during withdrawal and early abstinence". Eur Psychiatry. 15 (8): 483–8. doi:10.1016/S0924-9338(00)00519-8. PMID 11175926. {{cite journal}}: Invalid |ref=harv (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  28. ^ Semple, David (2007) [2005]. "13". Oxford Handbook of Psychiatry. United Kingdom: Oxford University Press. p. 540. ISBN 0198527837. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  29. ^ Collier, Judith; Longmore, Murray (2003). "4". In Scally, Peter (ed.). Oxford Handbook of Clinical Specialties (6 ed.). Oxford University Press. p. 366. ISBN 978-0198525189.
  30. ^ Professor Heather Ashton (2002). "Benzodiazepines: How They Work and How to Withdraw".
  31. ^ Lydiard RB, Laraia MT, Ballenger JC, Howell EF (1987). "Emergence of depressive symptoms in patients receiving alprazolam for panic disorder". Am J Psychiatry. 144 (5): 664–5. PMID 3578580. {{cite journal}}: Invalid |ref=harv (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  32. ^ Nathan RG (1 January 1985). "Long-term benzodiazepine use and depression". Am J Psychiatry. 142 (1). American Journal of Psychiatry: 144–5. PMID 2857068. {{cite journal}}: Invalid |ref=harv (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  33. ^ Fyer AJ (1987). "Discontinuation of Alprazolam Treatment in Panic Patients". Am J Psychiatry. 144 (3). benzo.org.uk: 303–8. PMID 3826428. Retrieved 10 December 2008. {{cite journal}}: Invalid |ref=harv (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  34. ^ Modell JG (1997). "Protracted benzodiazepine withdrawal syndrome mimicking psychotic depression" (PDF). Psychosomatics. 38 (2). Psychiatry Online: 160–1. PMID 9063050. {{cite journal}}: Invalid |ref=harv (help); Unknown parameter |month= ignored (help)
  35. ^ Lader M (1994). "Anxiety or depression during withdrawal of hypnotic treatments". J Psychosom Res. 38 Suppl 1: 113–23, discussion 118–23. doi:10.1016/0022-3999(94)90142-2. PMID 7799243. {{cite journal}}: Invalid |ref=harv (help)
  36. ^ Professor C Heather Ashton (1987). "Benzodiazepine Withdrawal: Outcome in 50 Patients". British Journal of Addiction. 82: 655–671. {{cite journal}}: Invalid |ref=harv (help)
  37. ^ Ashton CH (1995). "Protracted Withdrawal From Benzodiazepines: The Post-Withdrawal Syndrome". Psychiatric Annals. 25 (3). benzo.org.uk: 174–179. {{cite journal}}: Invalid |ref=harv (help); Unknown parameter |month= ignored (help)
  38. ^ Professor Heather Ashton (2004). "Protracted Withdrawal Symptoms From Benzodiazepines". Comprehensive Handbook of Drug & Alcohol Addiction.
  39. ^ "Experts ponder link between creativity, mood disorders - CNN.com". CNN. 2 April 2009. Retrieved 13 May 2010.
  40. ^ Kaufman, JC (2001). "The Sylvia Plath effect: Mental illness in eminent creative writers". Journal of Creative Behavior. 35 (1): 37–50. {{cite journal}}: Invalid |ref=harv (help)
  41. ^ Bailey, DS (2003). "Considering Creativity: The 'Sylvia Plath' effect". Journal of Creative Behavior. 34 (10): 42. {{cite journal}}: Invalid |ref=harv (help)

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 0890420254. {{cite book}}: Invalid |ref=harv (help)
  • Parker, Gordon (1996). Melancholia: A disorder of movement and mood: a phenomenological and neurobiological review. Cambridge: Cambridge University Press. ISBN 052147275X. {{cite book}}: Invalid |ref=harv (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  • Sadock, Benjamin J. (2002). Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry (9th ed.). Lippincott Williams & Wilkins. ISBN 0781731836. {{cite book}}: Invalid |ref=harv (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
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