Depressive Disorders Flashcards
Disruptive Mood Dysregulation Disorder
A. Severe recurrent temper outburst manifested verbally or behaviourally out of proportion in intensity/duration to situation
B. Temper outbursts are inconsistent with developmental level
C. Temper outbursts occur >= 3x/week
D. Mood between outbursts is persistently irritable/angry, most of the day, nearly everyday and is observable by others (parents/teachers/peers)
E. Sx for > 12 months without more than 3/12 without sx
F. Sx present in more than 2 settings and are severe in at least 1
G. Not made before 6 yo or for the first time, before 18 yo
H. Age of onset before 10 yo
I. Full criteria not met for mania for more than 1 day
J. Behaviours are not exclusively during a MDE or explained better by another mental d/o (ASD, PTSD, separation anxiety, PDD). Cannot be comorbid with ODD, intermittent explosive d/o, or BPAD.
K. not attributable to physiologic effects of substance, another medical or neurological condition
Major Depressive D/o
A. 5 or more of the following for 2 weeks with either depressed mood or loss of interest/pleasure:
-depressed mood most of the day and every day either subjective or observed
-anhedonia– markedly diminished interest/pleasure in almost all activities (subjective or observed)
-insomnia/hypersomnia
-decrease/increase in appetite or weight loss
-decreased energy
-poor concentration or indecisiveness
-feelings of worthlessness/ excessive or inappropriate guilt
-recurrent thoughts of death or SI (w or w/o plan)
-psychomotor agitation/retardation observed (not subjective)
B. Significant diestress/impairment
C. not physiological effects of substance or another medical condition
D. Not a psychotic disorder
E. There has never been a manic or hypomanic episode (substance induced or due to another medical condition doesn’t count)
MDD specifiers
severity: mild, moderate, severe
with psychotic features (mood congruent/incongruent)
partial remission vs full remission
characteristics: anxious distress, mixed features, melancholic features, atypical features, catatonia, permpartum onset, seasonal pattern
Persistent Depressive d/o
A. Depressed mood for most of the day, >50% of days by subjective account or by observation for 2 years (CAP: depressed or irritable mood for 1 year)
B. 2 or more while depressed:
1. Insomnia or hypersomnie
2. poor appetite or over eating
3. low energy/fatigue
4. low self-esteem
5. poor concentration
6. Feeling hopeless
(no criteria for SI, no anhedonia, no psychomotor agitation/retardation, no guilt)
C. During the 2 years (CAP 1 yr), never w/o sx for 2 months
D. MDE episode criteria may be continuously present for 2 years
E. No manic or hypomanic episodes, not cyclothymia
F. Not a psychotic disorder
G. Not the physiologic effects of substances or another medical condition
H. Clinically significant distress/impairment
Persistent depressive d/o specifiers
severity: mild, moderate, severe
remission: partial, full
onset: early (before 21 yo), or late (after 21 yrs)
with pure dysthymic syndrome- never met MDE
with persistent MDE- full MDE criteria x 2 years
with intermittent MDE- currently meeting full MDE criteria, but periods of 8 weeks in lat 2 years w/ symptoms below criteria for full MDE
with intermittent MDE without current episode: full criteria for MDE not currently met, but one or more MDE in last 2 years
characterisics: anxious distress, mixed features, melancholic features, atypical features, mood congruent/incongruent psychotic features, permpartum onset
Premenstrual Dysphoric DIsorder
A. in the majority of menstrual cycles, at least 5 sx are present in the final week before menses, and start to improve within a few days after menses, and are absent in the week after menses
B. One or more are present:
1. Marked affective lability incl mood swings, sad/tearful/ sensitivity to rejection
2. Irritability, anger, or increased IP conflict
3. Marked depressed mood, hopelessness or self-deprecating thoughts
4. Marked anxiety, tension, feeling keyed up or on edge
C. One or more of the following to reach a total of 5 sx incl B criteria:
1. decreased interest in usual activities (work, school, friends, hobbies)
2. subjective difficulty in conversation
3. poor energy
4. appetite chagne– increased or specific food cravings
5. decreased/increased sleep
6. feeling overwhelmed or out of control
7. physical sx: breast tenderness/swelling, joint/muscle pain, bloating, or wt gain
A-C criteria met for most mentsrual cycles in the preceding year
D. clinically significant distress or functional impairment
E. Not an exacerbation of another disorder like MDD, panic d/o, PDD, or PD (although may co-occur with any)
F. Criterion A met in prospective daily rating through 2 cycles
G. No due to effects of substance or another medical condition
