Depressive disorders Flashcards
Disruptive Mood Dysregulation disorder 296.99 (F34.8)
A. Severe recurrent temper outbursts manifested verbally and/or behaviorally (physical aggression toward people or property) that are grossly out of proportion in intensity or duration to the situation or provocation
B. Temper outbursts are inconsistent with developmental level
C. Temper outbursts occur on average 3+ times per week
D. Between episodes, the mood is persistently irritable or angry most of the day, nearly every day and is observable by others (parents, teachers, peers)
E. Criteria A-D have been present for 12+ months, and throughout that time there has not been 3+ months with without all symptoms in A-D
F. Criteria A-D are present in at least 2/3 settings (home, school, with peers) and are severe in at least one of these
G. Diagnosis should not be made for the first time before age 6 or after age 18
H. By history or observation, age at onset of A-E is before 10 years old
I. There has never been a distinct period lasting more than 1 day during which full symptom criteria (except duration) for manic/hypomanic episode have been met
J. Behaviors do not occur exclusively during a MDD episode and are not better explained by another mental disorder (ASD, PTSD, separation anxiety d/o, PDD)
K. Symptoms are not better attributable to the physiological effects of a substance or another medical/neurological condition
DMDD note
diagnosis CANNOT coexist with ODD, IED, bipolar disorder
if meets criteria for ODD or IED, give dx of DMDD
if meets criteria for manic/hypomanic episode DO NOT give dx of DMDD
CAN co-occur with MDD, ADHD, conduct d/o, substance use d/o
MDD
A. 5 or more of the following symptoms have been present for the same 2-week period and represent a change from previous functioning; at least 1 of the following symptoms is either 1. Depressed mood or 2. Loss of interest or pleasure.
1. Depressed mood most the day, nearly every day as indicated by either subjective report (feels sad, empty, hopeless entheses or observation made by others sees appears tearful) (note: In children and adolescents can be irritable mood)
2. Markedly diminished interest or pleasure in all or almost all activities most of the day, nearly every day (as indicated by either subjective account or observation in parentheses
3. Significant weight loss when not dieting or weight gain (a change of more than 5% body weight in a month) or decrease/increase in appetite nearly every day
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 (may be delusional) nearly every day
8. Diminished ability to think or concentrate, indecisiveness, nearly every day
9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan or suicide attempt or specific plan for committing suicide
B. Symptoms cause clinically significant distress or impairment in social, patient or other important areas of functioning sensitive. C. Physiological effects of the substance to another medical condition
D. Recurrence of the major depressive episodes not but explained by schizophrenia, schizoaffective, delusional, schizophreniform disorder, other specified and unspecified schizophrenia spectrum and other psychotic disorders
E. There is never been a manic or hypomanic episode
Persistant Depressive Disorder (Dysthymia)
300.4 (F34.1)
A. Depressed mood for most of the day, for more days than not, as indicated by other subjective encounter observation by others for at least 2 years
Note: Children/adolescents, mood can be irritable and duration must be at least 1 year
B. Presence (while depressed) of 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 making decisions
6. Feelings of hopelessness
C. During the 2 years (1 yr for kids) period the individual has never been without the symptoms and criteria A and B for more than 2 months at a time
D. Criteria for a major depressive disorder may be continuously present for 2 year
E. There is no been a manic/hypomanic episode criteria have never been met for cyclothymic disorder
F. The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder other psychotic disorder
G. The symptoms are not attributed to effects of a substance (medication, drug of abuse) or another medical condition
H. Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
