Bipolar and Depressive Disorders Flashcards
Bipolar Disorder 1 Criteria
Manic Episode
A. a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and presistently increased goal directed activity or energy LASTING AT LEAST A WEEK and present most days nearly everyday
B. during the period of mood disturbance and increased energy or activity, three or more of the following symptoms FOUR if the mood is irritable:
1.inflated self esteem or grandiosity
2. decreased need for sleep
3. More talkative than usual or pressure to keep talking
4. flight of ideas or subjective experience that thoughts are racing
5. distractability
6. increase in goal directed activity or psychomatic agitation
7. excessive involvement in activities that have a high potention for painful consequences ( buying sprees, sexual indescretions)
C. The mood disturbance is severe enough to impair social functioning or need hospitalization
D. not attributable to substance or another condition
Hypomanic Episode
A. A distinct period of abnormally or presistantly elevated, expansive or irritable mood. increase in activity or energy last at least 4 days
B. during the period of mood disturbance and increased energy or activity, three or more of the following symptoms FOUR if the mood is irritable:
1.inflated self esteem or grandiosity
2. decreased need for sleep
3. More talkative than usual or pressure to keep talking
4. flight of ideas or subjective experience that thoughts are racing
5. distractability
6. increase in goal directed activity or psychomatic agitation
7. excessive involvement in activities that have a high potention for painful consequences ( buying sprees, sexual indescretions)
C. episode with an unequivocal change in functioning that is uncharacteristic of the individual
D. The disturbance in mood and the change in functioning are observable by others
E. The episode is not severe enough to cause marked impairment in social
F. Cant be chalked up to substance
Major Depressive Episode
A. 5 or more of the following symptoms have been present during the same 2 week period and represent a change from previous functioning, at least one symptom is 1 depressed mood or 2 loss of interest or pleasure
1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (eg feels sad, empty, or hopeless) in kids or adolecents can be mood
2. Markedly diminished interest or pleasure in all or almost all activities most of the day or nearly every day
3. significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day
4. Insomnia or hypersomnia nearly every day
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness)
6. fatigue or loss of energy nearly every day
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day
8. Diminished ability to think or concentrate or indecisiveness
9. Recurrent thoughts of death, suicidal ideation, or a suicide attempt with plan.
B. The symptoms cause clinically significant distress or impairment in social, occuplation, or other functioning
C. Not attributable to substance
HAVE HAD AT LEAST ONE MANIC EPISODE
Bipolar II Disorder Criteria
Hypomanic Episode
A. A distinct period of abnormally and persistenty elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days of present mood of the day nearly ebery day
B. During the period of miid disturbance and increased energy and activity, three (or more) of the following symptoms have persisted (four if the mood is irritable) represent a noticible change from usual behavior, and have been present to a significant degree:
1. inflated self-esteem or grandiosity
2. Decreased need for sleep
3. More talkative than usual or pressure to keep talking
4.flight of ideas or subjective experince thta thoughts are racing
5. Distractibility
6. Increase in goal directed activity or phsychomoter agitation
7. excesive involvement in activities that have a high potential for painful consequences
C. The episdoe has unequivocal change in funtioning that isnt characteristic
D. The disturbance in mood and the change in function can be noticed by others
E. NOT SEVER enough to cause marked impairment in social or occupational functioning
F. Not attributable to substance
Major Depressive Episode
A. five or more sumptoms DURING THE SAME 2 WEEK PERIOD and are a change, at least one is depressed mood or loss of interest/pleasure
1. depressed mood most of the day either by their report or someone else
2. Markedly diminished interest or pleasure
3. Significant weight loss when not dieting or wieght gain , decrease or increase in appetite
4. Insomnia or hypersomnia nearly every day
5. Psychomoter agitation or retardation nearly everyday
6. Fatigue or loss of energy
7. Feelings of worthlessness, excessive or inappropriate guilt (which may be delusional)
8. Diminished ability to think or concentrate, indecisiveness
9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, suicide attempt
B. Symptoms cause clinincally significant distress or impairment in functioning
C. Not attributable to substance
HAVE MET CRITERIA FOR AT LEAST ONE HYPOMANIC EPISODE AND ONE DEPRESSIVE EPISODE, NO MANIC EPISODE
Bipolar 1 and 2 severity levels
mild moderate severe
Cyclothymic Disorder Criteria
A.For at least 2 years (at least 1 year in kids and adolescents) there have been numerous periods of hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous episdoes by depressive symptoms that dont meet criteria for depressive episode
B. During the above 2 year period (1 yr in kids), the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than TWO MONTHS
C. Criteria for major depressive, manic, or hypomanic episode have been met
D. Not better explained by schizoaffective
E. Not attributable to the physiological effects of a substance
F. The symptoms cause clinically significant distress or impairment n social functioning
Disruptive mood dysregulation disorder criteria
A. Severe recurrent temper outbursts manifested verbally and/or behaviourally (physical agression toward people or property that are grossly out of proportion or intensity or duration to the situation
B. The temper outbursts are inconsistent with developmental level
C. The temper outbursts occur on average 3 or more times a week
D. The mood between the temper outbursts ins persistently irritable or angry most of the day and is observable by others
E. Criteria A-D have been present for 12 OE MOEW MONTHS, has not had a period lasting more than 3 months without all the symptoms
F. A-D are present in at least two of three settings (home, school peers) and are severe in at least one of these
G. the diagnosis should not be BEFORE 6 OR AFTE 18
H. By history or observation the age at onset of a-e before 10 years
I. Theres never been a distinct period lasting more than 1 day during which the full symptom criteria, except duration, meet manic or hypomanic
J. Dont occur exclusively during an episode of major depressive disorder and harent explained by anuthing else
K. Not due to to substance
Major Depressive Disorder Criteria
A. Five or more of the following symptoms have been present during the same 2-week period and represent a change from previous functioning, at least either depressed mood or loss of pleasure or interest
- depressed mood most of the day (irritable in kids)
- Markedly diminished interest or pleasure in all, or almost all, nearly every day
- Significant weight loss or weight gain, increase or decrease of appetite
- insomnia or hypersomia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Diminshed ability to think or concentrate or indecisiveness
- Recurrent thoughts of dealth, recurrent suicidal ideation but no pleans or attempt
B. The symptoms cause clinically significant distress
C. No substance.
D. Not better explained by schizoid
E. There has NEVER been a manic or hypomanic episode
Persistent Depressive Disorder (Dysthymia) Criteria
A. Depressive mood for most of the day, for more days than not, as indicated by either subjective account or observation FOR AT LEAST 2 YEARS (in kids and adolescents, irritable, at least 1 year)
B. Presence, while depressed, of 2 or more of the following.
- poor appetite or overeating
- insomnia or hypersomnia
- low energy or fatigue
- low self esteem
- Poor concentration or difficulty making choices
- Feelings of hoplesness
C. During the 2 year period of the disturbance, the individual has never been without the sumptoms in criteria A and B for more than 2 months at a time
D. Criteria for a ,ajor depressive disorder may be continuously present for 2 years.
E. There has NEVER been a MANIC or HYPOMANIC episod, not met for cyclothymic
F. The disturbance is not better explained by schizo
G. Not attributable to substance
H. Cause clinically significant distress or impairment in function
Persistent Depressive Disorder (Dysthymia) Specifiers
with anxious distress (keyed up)
with mixed features
with melancholic features
Persistent Depressive Disorder (Dysthymia) Severity Levels
Mild
moderate
severe
Premenstrual Dysphoric Disorder Criteria
A. In the majority of menstrual cycles, at least 5 symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the weeks postmenses.
B. One (or more) of the following symptoms must be present:
- Marked affective lability (eg mood swings, suddenly feeling sad)
- Marked irritability or anger, or increased interpersonal conflicts.
- Marked depressed mood, feelings of hopelessness, self deprecating thoughts
- Marked anxiety, tension, and or feelings of being keyed up
C. One or more of the following symptoms must be additionally presebtm ti reach a total of 5 symptoms when combined with the dymptoms above.
- Decreased interest in usual activities
- Subjective Difficulty in concentration
- Lethargy, easy fatiguability
- Marked change in appetite, overeating, or specific food cravings
- Hypersomnia or insomnia
- A sense of being overwhelmed or out of control
- Physicial symptoms like boob tenderness, joint pain, bloating, weight gain
SYMPTOMS IN A-C MUST HAVE BEEN MET FOR MOST MENSTRUAL CYCLES IN THE PAST YEAR
D. The symptoms are associated with clinically significant distress or interference with work, school, usual activities or relationship
E. The disturbance is not merely an exacerbation of another depressive disorder
F. Criteria for A should be confirmed by prospective daily raitings of at least two symptomatic cycles
G. Not attributable to a substance
