Depressive disorders Flashcards by Amy Collins

diagnostic criteria for disruptive mood dysregulation disorder

-verbal/severe temper outbursts
-outbursts inconsistent w/ developmental level
-outbursts occur 3x/weekly
-mood between outbursts in mostly angry/irritable

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how long must symptoms be present for a diagnosis of disruptive mood dysregulation

12+ months w/ no period of 3+ months where all criteria are not met

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what age range can be diagnosed with disruptive mood dysregulation

6-18

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when is the onset of disruptive mood dysregulation

must be before 10

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differences between disruptive mood dysregulation and pediatric bipolar disorder

-bipolar has episodic issues that are different from regular mood
-irritability is not persistent in bipolar

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what is dx if criteria is met for both ODD and disruptive mood dysregulation disorder

only dx disruptive mood dysregulation disoreder

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how severe do temper outbursts and persistent irritability have to be for dx of disruptive mood dysregulation disorder

must be present in at least 2 settings and severe in at least 1

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difference between disruptive mood dysregulation disorder and intermittent explosive disorder

irritability in intermittent explosive disorder does not have to be persistent between episodes

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how many and often do symptoms have to be present for dx of major depressive disorder

5+ symptoms occurring during the same 2 week time period

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9 potential symptoms for major depressive disorder

-depressed mood
-loss of interest/pleasure
-sig weight loss/gain or change in appetite
-insomnia/hypersomnia
-psychomotor agitation/retardation
-fatigue/loss of energy
-feelings of worthless or excessive guilt
-decreased concentration/indecisiveness
-SI or attempt

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how can depressed mood present in children different than adults

may present as irritability

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what constitutes significant weight loss

5% in one month

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what are exclusions for dx of MDD

-if there has ever been a manic/hypomanic episode
-if it is better explained by a substance or medical/mental disorder

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when is it more likely MDD will transition to bipolar

-if onset in adolescence
-if there are psychotic features
-family hx of bipolar

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what is the biggest risk factor for likelihood of suicide attempt

past hx of suicide attempts

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what is diagnosed if MDD has a history of hypomanic but not manic episodes

bipolar 2

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what is dx if MDD has hx of manic episodes

bipolar 1

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diagnostic criteria for persistent depressive disorder

-depressed mood for at least 2 years
-never had a manic/hypomanic episode
-2+:
-appetite change
-insomnia/hypersomnia
-fatigue/low energy poor
-concentration/indecisive
-feeling hopeless

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how long do symptoms have to present for a dx of persistent depressive disorder

at least 2 years w/ no symptom-free periods lasting longer than 2 months. 1 year in children

can MDD dx be comorbid w/ persistent depressive disorder

yes

how many symptoms must be present and when for dx of premenstrual dysphoric disorder

5+ (at least 1 from each category) in the final week prior to period, improve within a few days of onset and remit by 1st week after period (for at least 2 cycles)

category 1 of symptoms for premenstrual dysphoric disorder

-marked affective lability
-marked irritability/anger
-marked depressed mood or self-deprecating thoughts
-marked anxiety/tension

7possible sx for category 2 of symptoms for premenstrual dysphoric disorder

-decreased interest in activities
-difficulty concentrating
-lethargy/lack of energy
-change in appetite
-hypersomnia/insomnia
-feeling overwhelmed
-physical symptoms

possible physical symptoms of premenstrual dysphoric disorder

breast tenderness/swelling
joint/muscle pain
bloating or weight gain

what is the difference between premenstrual dysphoric disorder and premenstrual syndrome

syndrome is less severe and does not require 5 symptoms

recording procedures for substance/medication induced depressive disorder

-name of disorder begins with name of substance -if comorbid substance abuse disorder it is listed first followed by "with" substance induced depressive disorder and specifier of onset -if more than one substance, list all separately

medications likely to cause depressive disorders

steroids antihypertensives reserpine interferon L-dopa

coding specifiers for depressive disorder d/t another medical condition

-with depressive features (criteria not met for MDD) -with major depressive-like episode (criteria met for MDD) -with mixed features (manic/hypomanic features but don't predominate clinical picture)

medical conditions that often cause depressive disorder

cerebrovascular disease Huntington's Parkinson's TBI hypothyroidism

diagnostic criteria for other specified depressive disorder

when depressive symptoms cause clinically significant distress/impairment but do not meet full criteria for disorder and clinician wants to specify why

diagnostic criteria for unspecified depressive disorder

when depressive symptoms cause clinically significant distress/impairment but do not meet full criteria for disorder and clinician does not want to specify why

criteria for 'with anxious distress' specifier

2+ -feeling tense -feeling restless -difficulty concentrating because of worry -fear that something awful will happen -feel might lose control or their mind

mild 'with anxious distress'

2 symptoms

moderate 'with anxious distress'

3 symptoms

moderate-severe 'with anxious distress'

4-5 symptoms

severe 'with anxious distress

4-5 symptoms and psychomotor agitation

criteria for MDD 'with mixed features' specifier

3+ -elevated/expansive mood -grandiosity/inflated self-esteem -more talkative/pressured speech -flight of ideas/racing thoughts -increased energy/goal-directed activity -decreased need for sleep

criteria for 'melancholic features' specifier categories

1+ symptoms from category 1 and 3+ symptoms from category 2

category 1 symptoms for melancholic features (must have 1)

-loss of pleasure in most/all activities -lack of reactivity to pleasurable stimuli

category 2 for melancholic features (must have 3)

-depressed mood characterized by profound sadness/emptiness -depression worse in morning -early morning awakening -marked psychomotor agitation/retardation -anorexia/weight loss -excessive/inappropriate guilt

what symptoms have to predominate most of the days to get specifier of atypical features

mood reactivity 2+ -weight gain/increased appetite -hypersomnia -leaden paralysis -long-standing pattern of interpersonal rejection sensitivity

criteria for 'with psychotic features' specifier

delusions/hallucinations present at any time

if psychotic features are present what else has to be specified

if mood-congruent or mood-incongruent

criteria for peri-partum onset specifier

begins during pregnancy or within 4 weeks postpartum

criteria for with seasonal pattern specifier

temporal relationship between onset/remission of symptoms and seasons assess for period of at leat 2 years to establish pattern