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13Clinical Disorders11 min read

Treatment of Affective Disorders

1. Overview & Epidemiology

  • Affective (mood) disorders = unipolar depression (MDD, dysthymia) and bipolar disorder. Treatment splits along this axis: antidepressants drive unipolar therapy; mood stabilizers anchor bipolar therapy.
  • MDD: lifetime prevalence ~10–15%; women > men ~2:1. ~60–70% respond to an adequate first antidepressant trial.
  • Bipolar I: ~1% lifetime, sexes roughly equal. Requires a mood stabilizer ± antipsychotic — never antidepressant monotherapy (switch risk).
  • Suicide is the central treatment-relevant complication. Gajdos: depressed patients are at increased risk as they begin to improve and regain energy to act (**paradoxical suic

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