Depressive Disorders: Major Depressive Disorder

Question 1

Major Depressive Disorder (Criteria Overview)

Answer 1

A. Depressive symptoms
B. Distress or impairment
C. Not due to substance/med use
D. Not better explained by another dx
E. Absence of mania/hypomania

Question 2

Criterion A (9)

Answer 2

A. 5+ of the following symptoms for 2 weeks. At least one symptom must be 1 or 2

1. Depressed mood most of the time (sad, empty, hopeless, irritable - esp children and adolescents)
2. Loss of interest or pleasure
3. Weight loss or gain, changes in appetite
4. Insomnia/hypersomnia
5. Psychomotor agitation/retardation
6. Fatigue
7. Feelings of worthlessness or inappropriate guilt
8. Trouble concentrating/indecisiveness
9. Suicidality

Question 3

Criterion B

Answer 3

B. Significant distress/impair functioning

Question 4

Criterion C

Answer 4

C. Not due to use of substance/medication

Question 5

Criterion D

Answer 5

D. Not better explained by another disorder

Question 6

Criterion E

Answer 6

E. Absence of manic or hypomanic episode

Question 7

Specifiers (9)

Answer 7

1. with anxious distress
2. with mixed features
3. with melancholic features
4. with atypical features
5. with mood-congruent psychotic features
6. with mood-incongruent psychotic features
7. with catatonia
8. with peripartum onset
9. with seasonal pattern

Question 8

Specifier: with anxious distress

Answer 8

At least two of the following are present during the majority of depressive episodes

1. feeling tense
2. unusually restless
3. difficulty concentrating due to worry
4. fear that something awful will happen
5. feelings of losing control or self

Severity: 
mild: 2 symptoms
moderate: 3 symptoms
moderate-severe: 4-5 symptoms
severe: 4-5 symptoms + motor agitation

Question 9

Specifier: with mixed features (manic/hypomanic symptoms)

Answer 9

3+ of the following almost always present during depressive episode:

1. elevated mood
2. grandiosity/inflated self-esteem
3. pressured speech
4. racing thoughts/flight of ideas
5. increase in energy and goal oriented activity
6. increased engagement in high risk bx
7. decreased need for sleep