Depressive Disorders Flashcards
Disruptive Mood Dysregulation Disorder
A: Severe recurrent temper outbursts manifested verbally and/or behaviorally that are grossly out of proportion in intensity or duration to the situation
B: Temper outbursts are inconsistent w/ developmental level
C: Temper outbursts occur, on average, 3 or more times a week
D: The mood between the temper outbursts is persistently irritable or angry most of the day, nearly everyday, and is observable by others
E: Criteria A-D have been present for 12 or more months. During that time the individual has not had a period of 3 or more consecutive months w/o all of the sx in Criteria A-D
F: Criteria A and D are present in at least 2 of 3 settings and is severe in at least one
G. The dx should not be made for the first time before age 6 years or after 18 years
H. By history of observation, the age of onset is before 10 years old
I. There has never been a distinct period lasting more than 1 day during which the full sx criteria, except duration, for a manic or hypomanic episode have been met
J. The behaviors don’t occur exclusively during an episode of major depressive disorder and not better explained by another mental disorder. Note: CAN’T coexist w/ ODD, intermittent explosive disorder, or bipolar disorder. If they meet criteria for ODD & disruptive mood dysregulation disorder they should be dx w/ disruptive mood dysregulation disorder It CAN coexist w/ MDD, ADHD, conduct disorder and substance use disorder
K. Sx are not due to physiological effects of substance or to another medical or neurological condition
Major Depressive Disorder
A: 5 or more of the following sx have been present during the same 2-week period & represent a change from previous functioning; at least 1 sx is either 1) depressed mood or 2) lost of interest in pleasure
1. Depressed mood most of the day, nearly every day
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly everyday
3. Significant weight loss or weight gain (more than 5% of body weight in a month)
4. Insomnia or hypersomnia nearly every day
5. Psychomotor agitation or retardation nearly every day
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, nearly every day
9. Recurrent thoughts of death (not just fear of dying), recurrent SI w/o specific plan, or a suicide attempt or a specific plan for committing suicide
B. The sx cause clinically significant distress or impairment in important areas of functioning
C. The episode is not due to physiological effects of a substance or another medical condition
Note: A-C represent a major depressive episode
D: The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder or other specified & unspecified schizophrenia spectrum & other psychotic disorders
E. There has never been a manic episode or hypomanic episode
Note: Does not apply if the manic or hypomanic episodes are substance induced, due to physiological effects of another medical condition
Persistent Depressive Disorder (Dysthymia)
A: Depressed mood for most of the day, for more days than not for at least 2 years
Note: in children & adolescents, mood can be irritable & duration at least 1 year
B: Presence, while depressed, 2 (or more) of the following:
1. Poor appetite or overeating
2. Insomnia or hypersomnia
3. Low energy or fatigue
4. Low self-esteem
5. Poor concentration or difficulty making decisions
6. Feelings of hopelessness
C: During the 2 year period (1 for children & adolescents) of the disturbance, the individual has never been w/o the sx in Criteria A & B for more than 2 months
D. Criteria for major depressive disorder may be continuously present for 2 years
E. There has never been a manic or hypomanic episode & criteria have never been met for cyclothymic disorder
F. The disturbance is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder or other specified & unspecified schizophrenia spectrum & other psychotic disorders
G: The episode is not due to physiological effects of a substance or another medical condition
H: The sx cause clinically significant distress or impairment in important areas of functioning
Persistent Depressive Disorder (Dysthymia): Specify IF
Early onset: before age 21
Late onset: after age 21
Persistent Depressive Disorder (Dysthymia): Specify IF
W/ pure dysthymic syndrome: full criteria for a major depressive episode have not been met in at least the preceding 2 years
W/ persistent major depressive episode: full criteria for a major depressive episode have been met throughout the preceding 2 year period
W/ Intermittent major depressive episode, with current episode: full criteria for a major depressive episode are currently met, but there have been periods of at least 8 weeks in the preceding 2 years w/ sx below the threshold for a full major depressive episode
W/ intermittent major depressive episodes, w/o current episode: full criteria for major depressive episode are not currently met, but there has been one or more depressive episodes in the preceding 2 years
Premenstrual Dysphoric Disorder
A: in the majority of menstrual cycles, at least 5 sx must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses & become minimal or absent in the week postmenses
B: One (or more) of the following sx must be present
1. Markedly affective lability (mood swings, feeling suddenly sad or tearful, or increased sensitivity to rejection)
2.Marked irritability or anger or increased interpersonal conflicts
3. Marked depressed mood, feelings of hopelessness or self deprecating thoughts
4. Marked anxiety, tension, and/ or feelings of being keyed up or on edge
C. One (or more) of the following sx must be additionally be present to reach a total of five sx when combined w/ sx from Criterion B:
1. Decreased interest in usual activities
2. Difficulty in concentration
3. Lethargy, easily fatigued, or lack of energy
4. Change in appetite, overeating of specific food cravings
5. Hypersomnia or insomnia
6. Sense of being overwhelmed or out of control
7. Physical sx such a breast tenderness, joint or muscle pain, bloating or weight gain
D. The sx are associated w/ clinically significant distress or interference
E. The disturbance is not an exacerbation of sx of another disorder
F. Criterion A should be confirmed by prospective daily ratings during at least 2 symptomatic cycles
G. The sx are not due to the physiological effects of a substance or another medical condition
Substance/Medication-Induced Depressive Disorder
Depressive Disorder Due to Another Medical Condition
Other Specified Depressive Disorder
Applies to presentations in which sx characteristic of a depressive disorder that cause clinically significant distress or impairment in other important areas of functioning but don’t meet the full criteria for any of the disorders in the depressive disorders category
Examples:
Recurrent brief depression: Concurrent presence of depressed mood & at least 4 other sx of depression for 2-13 days at least once per month (not associated w/ the menstrual cycle) for at least 12 consecutive months. Never met criteria for depressive or bipolar disorder and does not meet active or residual criteria for any psychotic disorder
Short duration depressive episode (4-13 days): Depressed affect & at least 4 of the other 8 sx of major depressive episode that persists for more than 4 days, but less than 14 days.
Depressive episode w/ insufficient sx: Depressed affect & at least one of the other 8 eight sx of a major depressive episode
Unspecified Depressive Disorder
Do not meet full criteria & the clinician chooses not to specify the reason
Specifiers for Depressive Disorder: W/ Anxious Distress
At least 2 of the following sx during the majority of days:
1. Feeling keyed up or tense
2. Feeling unusually restless
3. Difficulty concentrating b/c of worry
4. Fear that something awful may happen
5. Feeling that the individual might lose control of themselves
Specifiers for Depressive Disorder: Current Severity
Mild: 2 sx
Moderate: 3 sx
Severe: 4 or 5 sx w/ motor agitation
Specifiers for Depressive Disorder: w/ mixed features
Specifiers for Depressive Disorder: W/ psychotic features
delusions and/or hallucinations are present
Specifiers for Depressive Disorder: W/ seasonal pattern
Applies to recurrent MDD
A: There has been a regular temporal relationship between the onset of major depressive episodes & a particular time of the year
B: Full remissions ( a change from major depression to mania or hypomania) also occur at a characteristic time of the year
C: In the last 2 years, two major depressive episodes have occurred that demonstrate the temporal seasonal relationships defined above and no nonseasonal major depressive episodes have occurred during that same time period
D: Seasonal major depressive episodes substantially outnumber the nonseasonal major depressive episodes that may have occurred over the individual’s lifetime
