Appropriate laboratory tests including pulmonary function studies should also be performed to exclude any suspected medical disorders that may be the cause of the patient's insomnia or hypersomnia
DSM-IV Criteria for Major Depressive Disorder with Postpartum Onset (PPD) and Those Criteria Identified by Fathers in the Study DSM-IV criteria for Major Depressive Disorder * Father identified criteria Depressed mood** X Anhedonia (loss of interest or pleasure)** X Significant weight loss or weight gain Insomnia or hypersomnia
Psychomotor agitation or retardation X Fatigue or loss of energy X Feelings of worthlessness or excessive guilt X Diminished ability to think or concentrate Recurrent thoughts of death, suicidal ideation, or a suicide attempt * Five (or more) of the above symptoms must have been present during the same 2-week period and represent a change from previous functioning and significant distress or impairment.
Once the level of care is determined and the patient is placed accordingly, a plan of care is formulated to target each identified problem and how the depression is manifested (psychomotor retardation or psychomotor agitation, insomnia or hypersomnia
, and poor appetite or excessive appetite).
Dysthymia is the prototype of a less than major depression, and requires that at least three of the following symptoms must cluster with depressed mood and must have been present for most of the days within the last 2 years: changes in appetite, insomnia or hypersomnia
, low energy or fatigue, low self-esteem, poor concentration or difficulties in making decisions, and feelings of hopelessness.
Overall, one in 10 persons reported insomnia and about one in 35 reported excessive sleepiness (hypersomnia
) at the first interview.
G, age 14, presents to the emergency department (ED) for acute-onset hypersomnia
that has gradually worsened over the course of a few days.
Physical symptoms of depression include weight gain or loss, an increase or decrease in appetite, insomnia or hypersomnia
(excessive sleeping), physical agitation, or speaking or moving more slowly.
Q I've been told that my daytime sleepiness and constant fatigue are signs of hypersomnia
. What are hypersomnia
The KLS attacks are characterized by hypersomnia
(15-21 hour/day), cognitive impairment (apathy, confusion, slowness, amnesia), derealization (dreamy state, altered perception) and more infrequently hypersexuality and depressive mood (3).
The Diagnostic and Statistical Manual of the American Psychiatric Association, Fourth Edition (DSM-IV) defined the atypical features (ATFs) of BD and related disorders as showing the main feature of 'mood reactivity' and four adjunct features including 'significant weight gain or increase in appetite', 'hypersomnia
', 'leaden paralysis' and 'a long-standing pattern of interpersonal rejection sensitivity'.
As shown in Table 4, the majority of participants treated with Hijamah for back pain (97.9%), headache (96.6%), joint pain (91.7), hypersomnia
(88.9%), and fatigue (84.3%) showed improvement compared to 68.2% among those performed Hijamah to treat other conditions (fever, bronchial asthma, dizziness, hyperlipidemia, and irritable bowel syndrome).
In a translational analogy, hyperactivity of this circuit may cause insomnia, while its hypo-activity could be responsible for hypersomnia
, making it a new therapeutical target for sleep disorders.