A formal psychiatric evaluation must include an itemized description of the mental status exam (MSE). For purposes of documentation, the MSE is considered, by most practitioners, the “objective” portion of the psychiatric assessment, in contrast with history data, which comprise the “subjective” part of the examination. The present chapter provides a succinct description on the MSE and of the main psychopathological concepts of interest for its proper description.

This book aims at providing the reader with an introduction to psychiatry and to the study of mental disorders. While still addressing basic theoretical concepts of importance for the understanding of psychiatry as a specific field of knowledge, its main focus is not an extensive discussion or a comprehensive review of research findings. Instead, whenever possible, the different topics are addressed from a practical point of view, allowing the reader not only to expand their base knowledge but, most importantly, to obtain a good picture of how patients experiencing these conditions usually present themselves in clinical contexts. Moreover, the treatment of mental disorders is addressed in an objective, straightforward way, based on the respective authors’ own clinical experience in the management of a high number of patients, in different settings.

The diagnostic process is a crucial aspect of medical practice. Psychiatric diagnosis involves information gathering, mental state assessment, hypothesis integration with laboratory or imaging when needed, and data interpretation. Clinical reasoning operates through two systems: System 1, characterized by intuitive pattern recognition; and System 2, which employs meticulous critical thinking. These systems complement each other, with System 1 being faster but riskier while System 2 offers a more planned approach. Today, the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) are the two primary diagnostic manuals. Despite their imperfections and reliance on symptom descriptions, the DSM and ICD remain indispensable tools in psychiatry for communication, research, and clinical decision-making.

Bipolar disorder (BD) is one of the most important and potentially incapacitating mental disorders, typically characterized by the alternation of depressive symptoms with periods of elevated mood, called manic or hypomanic episodes. The present chapter provides an overview of the main aspect of this psychiatric condition, including its clinical presentation, diagnosis, pathophysiology, and therapeutic aspects. While the diagnosis and management of BD can be challenging, ongoing research has led to considerable advances in its understanding. It is expected that those advances will bring about improvements in the identification and treatment of this mental illness.

Over the past few decades, the role of inflammation in the pathophysiology of depressive disorder and bipolar disorder has been the focus of considerable attention. In this chapter, we provide an update on the association between inflammatory processes and mood disorders, in light of available evidence. The pathophysiological and clinical implications of this association are critically discussed, as well as the interaction between inflammation, metabolic abnormalities, and medical comorbidities, which have important prognostic consequences for patients with mood disorders.

Mood disorders are among the most prevalent and potentially severe mental disorders. These conditions are associated with important psychological morbidity and functional impact, as well as elevated rates of suicide. While the past several decades have produced valuable contributions to the understanding of the pathophysiology of mood disorders, currently available treatments at times fail to produce full remission and restore patient’s premorbid level of function. Nevertheless, promising new agents and novel therapeutic targets are currently under investigation. The twenty-first century is looking at an individualized approach for the management of mood disorders, with the proper integration of evidence-based, effective biological and psychosocial therapeutic modalities.