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Dsm 5 > Depression > Flashcards

Depression Flashcards

1
Q

What is disruptive mood dysregulation disorder’s(DMDD) criteria?

A

A) Severe recurrent temper outbursts ( either verbal or behavioral) that are grossly out of proportion
B) Temper outbursts are inconsistent with developmental level
C) Temper outbursts occur 3 or more time per week.
D) Mood between temper outbursts is persistently irritable or angry most of the day.
E) Criteria A-D have been present for 12 or more months although is not consecutive for 3 months or more.
F) Criteria A and D are present in at least two of three settings
G) Diagnosis should not be made for the first time before age 6 years or after age 18 years.
H) By history or observation, the age at onset of criteria A-E is before 10 years.
I) There has never been distinct period lasting more than 1 day of mania or hypomanic episode.
K) the symptoms are not attributable to the physiological effects of a substance or to another medical or neurological condition.

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2
Q

What disorder does not coexist with DMDD?

A

oppostional defiant disorder(ODD), intermittent explosive disorder ( IED), bipolar disorder (BPD).

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3
Q

What disorders do coexist with DMDD?

A

major depressive disorder( MDD), attention deficit/hyperactivity disorder(ADHD), conduct disorder (CD), substance abuse disorders.

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4
Q

Is This a true statement. If individuals whose symptoms meet criteria for both DMDD and ODD should only be given diagnosis of DMDD?

A

True

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5
Q

What age limit should DMDD be Dx?

A

Before age 10 but not < age 6

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6
Q

Is DMDD more common than BPD?

A

yes

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7
Q

IS DMDD more common in adolescents or children? Which sex is likely?

A

Male Children

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8
Q

What is DMDD likely to occur the most risk?

A

Chronic irritability is first sign.

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9
Q

What are rates of comorbidity in DMDD?

A

EXTREMELY HIGH-if child has met criteria of ODD and IED

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10
Q

IF child has comorbidity in DMDD with anxiety, should DMDD be ruled out?

A

YES

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11
Q

What is crieteria A of Major Depression Disorder ( MDD)?

A

A) meet 5 or more during the same 2 week period and MUST Have at least one symptom: depressed mood or loss of interest or pleasure.

1) Depressed mood most of the day or nearly every day
2) marked diminished interests of pleasure in all or almost all activities
3) significant weight loss when not dieting or weight gain
4) insomnia
5) psychomotor agitation or retardation nearly every day
6) fatigue or loss of energy
7) Feelings of worthlessness or excessive or inappropriate guilt
8) Diminished ability to think or concentrate or indecisiveness.
9) recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

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12
Q

What is criteria B in MDD?

A

B) The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

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13
Q

What is criteria C in MDD?

A

C) The episode is not attributable to the physiological effects of a substance or to another medical condition.
Note: Criteria A–C represent a major depressive episode.
Note: Responses to a significant loss (e.g., bereavement, financial ruin, losses from a natural disaster, a serious medical illness or disability) may include the feelings of intense sadness, rumination about the loss, insomnia, poor appetite, and weight loss noted in Criterion A, which may resemble a depressive episode.

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14
Q

What is criteria D in MDD?

A

D) the occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.

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15
Q

What is criteria E in MDD?

A

E) There has never been a manic episode or a hypomanic episode

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16
Q

What is the age group for diagnosis of MDD?

A

Twelve-month prevalence of major depressive disorder in the United States is approximately 7%, with marked differences by age group such that the prevalence in 18- to 29-year-old individuals is threefold higher than the prevalence in individuals age 60 years or older.

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17
Q

Does MDD occur later on or earlier?

A

Major depressive disorder may first appear at any age, but the likelihood of onset increases markedly with puberty. In the United States, incidence appears to peak in the 20s; however, first onset in late life is not uncommon.

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18
Q

What is the course of MDD?

A

The course of major depressive disorder is quite variable, such that some individuals rarely, if ever, experience remission (a period of 2 or more months with no symptoms, or only one or two symptoms to no more than a mild degree), while others experience many years with few or no symptoms between discrete episodes.

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19
Q

What does recovery from MDD occur?

A

Recovery typically begins within 3 months of onset for two in five individuals with major depression and within 1 year for four in five individuals

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20
Q

Is there gendar differences?

A

no clear differences by gender in phenomenology, course, or treatment response.

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21
Q

Who are at risk of developing MDD?

A

1) neuotic personality
2) adverse childhood experiences
3) Genetics
4) females although there is no gender differences in symptoms.

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22
Q

What is Comorbidity of MDD?

A

1) substance abuse
2) panic disorders
3) Obessive compulsive disorder( OCD)
4) anorexia nervosa
borderline personality disorder.

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23
Q

Is it ok to be sad according to DSM V ‘s section in MDD?

A

yes

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24
Q

What is criteria A of Dysthymia disorder?

A

A) Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years.

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25
Q

What is criteria B of Dysthymia disorder?

A

B) Presence, while depressed, of two (or more) of the following:
Poor appetite or overeating.
Insomnia or hypersomnia.
Low energy or fatigue.
Low self-esteem.
Poor concentration or difficulty making decisions.
Feelings of hopelessness.

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26
Q

What is criteria C in Dysthymia disorder?

A

During the 2-year period (1 year for children or adolescents) of the disturbance, the individual has never been without the symptoms in Criteria A and B for more than 2 months at a time.

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27
Q

What is criteria D in Dysthymia disorder?

A

Criteria for a major depressive disorder may be continuously present for 2 years.

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28
Q

What is criteria E in Dysthymia disorder?

A

There has never been a manic episode or a hypomanic episode, and criteria have never been met for cyclothymic disorder.

29
Q

What is criteria F in Dysthymia disorder?

A

The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.

30
Q

What is criteria G in Dysthymia disorder?

A

The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g. hypothyroidism).

31
Q

What is criteria H in Dysthymia disorder?

A

The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

32
Q

What is prevalence of Dysthymia disorder?

A

The 12-month prevalence in the United States is approximately 0.5% for persistent depressive disorder and 1.5% for chronic major depressive disorder.

33
Q

Does Dysthymia likely occur early on or later developmental life?

A

Persistent depressive disorder often has an early (Mondimore et al. 2006) and insidious onset (i.e., in childhood, adolescence, or early adult life) and, by definition, a chronic course

34
Q

What are risk factors of developing dysthymia disorder?

A

1) untreated neuroticism
2) parental loss or separation
3) brain regions: prefrontal, anterior cigulate, amygdala, and hippocampus.

35
Q

Psychotic disorders are likely to develop Dysthymia?

A

Depressive symptoms are a common associated feature of chronic psychotic disorders (e.g., schizoaffective disorder, schizophrenia, delusional disorder).

36
Q

What is criteria A for Premenstrual Dysphoric Disorder(PDD)?

A

A) In the majority of menstrual cycles, at least five 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 week postmenses.

37
Q

What is criteria B for PDD?

A

B) One (or more) of the following symptoms must be present:
Marked affective lability (e.g., mood swings; feeling suddenly sad or tearful, or increased sensitivity to rejection).
Marked irritability or anger or increased interpersonal conflicts.
Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts.
Marked anxiety, tension, and/or feelings of being keyed up or on edge.

38
Q

What is Criteria C for PDD?

A

One (or more) of the following symptoms must additionally be present, to reach a total of five symptoms when combined with symptoms from Criterion B above.
Decreased interest in usual activities (e.g., work, school, friends, hobbies).
Subjective difficulty in concentration.
Lethargy, easy fatigability, or marked lack of energy.
Marked change in appetite; overeating; or specific food cravings.
Hypersomnia or insomnia.
A sense of being overwhelmed or out of control.
Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain.

39
Q

What is Criteria D for PDD?

A

The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others (e.g., avoidance of social activities; decreased productivity and efficiency at work, school, or home).

40
Q

What is Criteria E for PDD?

A

The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder (dysthymia), or a personality disorder (although it may co-occur with any of these disorders).

41
Q

What is criteria F for PDD?

A

Criterion A should be confirmed by prospective daily ratings during at least two symptomatic cycles. (Note: The diagnosis may be made provisionally prior to this confirmation.)

42
Q

What is criteria G for PDD?

A

The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or another medical condition (e.g., hyperthyroidism).

43
Q

What is prevalence of PDD?

A

Twelve-month prevalence of premenstrual dysphoric disorder is between 1.8% and 5.8% of menstruating women.

44
Q

Developmental course of PDD?

A

premenstrual dysphoric disorder can occur at any point after menarche. Incidence of new cases over a 40-month follow-up period is 2.5% (95% confidence interval = 1.7–3.7) (Wittchen et al. 2002).

45
Q

What are environmental risk factors in PDD?

A

Environmental factors associated with the expression of premenstrual dysphoric disorder include stress (Deuster et al. 1999; Girdler et al. 2004), history of interpersonal trauma (Girdler et al. 2004), seasonal changes (Maskall et al. 1997), and sociocultural aspects of female sexual behavior in general, and female gender role in particular.

46
Q

What are physiological risk factors in PDD?

A

Heritability of premenstrual dysphoric disorder is unknown. However, for premenstrual symptoms, estimates for heritability range between 30% and 80%, with the most stable component of premenstrual symptoms estimated to be about 50% heritable (Kendler et al. 1998).

47
Q

What is Comorbidity in PDD?

A

A major depressive episode is the most frequently reported previous disorder in individuals presenting with premenstrual dysphoric disorder (Pearlstein et al. 1990). A wide range of medical (e.g., migraine, asthma, allergies, seizure disorders) or other mental disorders (e.g., depressive and bipolar disorders, anxiety disorders, bulimia nervosa, substance use disorders) may worsen in the premenstrual phase; however, the absence of a symptom-free period during the postmenstrual interval obviates a diagnosis of premenstrual dysphoric disorder.

48
Q

What is criteria A in substance induced depression disorder( SIDD)?

A

A) A prominent and persistent disturbance in mood that predominates in the clinical picture and is characterized by depressed mood or markedly diminished interest or pleasure in all, or almost all, activities.

49
Q

What is criteria B in SIDD?

A

There is evidence from the history, physical examination, or laboratory findings of both (1) and (2):
The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication.
The involved substance/medication is capable of producing the symptoms in Criterion A.

50
Q

What is criteria C in SIDD?

A

C) he symptoms preceded the onset of the substance/medication use; the symptoms persist for a substantial period of time (e.g., about 1 month) after the cessation of acute withdrawal or severe intoxication; or there is other evidence suggesting the existence of an independent non-substance/medication-induced depressive disorder (e.g., a history of recurrent non-substance/medication-related episodes).

51
Q

What is criteria D in SIDD?

A

The disturbance does not occur exclusively during the course of a delirium.

52
Q

What is criteria E in SIDD?

A

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

53
Q

What is prevalence in SIDD?

A

In a nationally representative U.S. adult population, the lifetime prevalence of substance/medication-induced depressive disorder is 0.26%

54
Q

What is developmental course of SIDD?

A

A depressive disorder associated with the use of substance (i.e., alcohol, illicit drugs, or a prescribed treatment for a mental disorder or another medical condition) must have its onset while the individual is using the substance or during withdrawal, if there is a withdrawal syndrome associated with the substance.

55
Q

What are risk temperamental factors of SIDD?

A

Factors that appear to increase the risk of substance/medication-induced depressive disorder can be conceptualized as pertaining to the specific type of drug or to a group of individuals with underlying alcohol or drug use disorders.

56
Q

What are environmental risk factors in SIDD?

A

There are also risks factors pertaining to a specific type of medication. high doses of corticosteroids or high plasma concentrations of efavirenz; and high estrogen/progesterone content in oral contraceptives.

57
Q

What is comorbidity in SIDD?

A

Compared with individuals with major depressive disorder and no comorbid substance use disorder, those with substance/medication-induced depressive disorder have higher rates of comorbidity with any DSM-IV mental disorder; are more likely to have specific DSM-IV disorders of pathological gambling and paranoid, histrionic, and antisocial personality disorders; and are less likely to have persistent depressive disorder (dysthymia)

58
Q

What is criteria A in Depressive disorder due to another medical condition( DDDAMC)?

A

A) A prominent and persistent period of depressed mood or markedly diminished interest or pleasure in all, or almost all, activities that predominates in the clinical picture.

59
Q

What is criteria B in DDDAMC?

A

There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition.

60
Q

What is criteria C in DDDAMC?

A

The disturbance is not better explained by another mental disorder

61
Q

What is Criteria D in DDDAMC?

A

he disturbance does not occur exclusively during the course of a delirium.

62
Q

What is Criteria E in DDDAMC?

A

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

63
Q

What is developmental course of DDDAMC?

A

Following stroke, the onset of depression appears to be very acute, occurring within 1 day or a few days of the cerebrovascular accident (CVA) in the largest case series

64
Q

What are risk factors of DDDAMC?

A

The risk of acute onset of a major depressive disorder following a CVA (within 1 day to a week of the event) appears to be strongly correlated with lesion location, with greatest risk associated with left frontal strokes and least risk apparently associated with right frontal lesions in those individuals who present within days of the stroke

65
Q

What are gender related diagnostic issues in DDDMAC?

A

Gender differences pertain to those associated with the medical condition (e.g., systemic lupus erythematosus is more common in females; stroke is somewhat more common in middle-age males compared with females).

66
Q

What is comrbidity in DDDMAC?

A

Conditions comorbid with depressive disorder due to another medical condition are those associated with the medical conditions of etiological relevance

67
Q

What is recurrent brief depression?

A

Concurrent presence of depressed mood and at least four other symptoms of depression for 2–13 days at least once per month (not associated with the menstrual cycle) for at least 12 consecutive months in an individual whose presentation has never met criteria for any other depressive or bipolar disorder and does not currently meet active or residual criteria for any psychotic disorder.

68
Q

What is Short duration depressive episode?

A

Depressed affect and at least four of the other eight symptoms of a major depressive episode associated with clinically significant distress or impairment that persists for more than 4 days, but less than 14 days, in an individual whose presentation has never met criteria for any other depressive or bipolar disorder, does not currently meet active or residual criteria for any psychotic disorder, and does not meet criteria for recurrent brief depression.

69
Q

What is depressive episode with insufficient symptoms?

A

Depressed affect and at least one of the other eight symptoms of a major depressive episode associated with clinically significant distress or impairment that persist for at least 2 weeks in an individual whose presentation has never met criteria for any other depressive or bipolar disorder, does not currently meet active or residual criteria for any psychotic disorder, and does not meet criteria for mixed anxiety and depressive disorder symptoms.

Dsm 5 (11 decks)

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