Other Depressive Disorders

Question 1

What are the types of depressive disorders?

Answer 1

• Major Depressive Disorder (as discussed in class)
• Persistent Depressive Disorder
• Premenstrual Dysphoric Disorder
• Disruptive Mood Dysregulation Disorder

Appendix: Persistent Grief Disorder (DSM-5-TR)

Question 2

What are the diagnostic criteria for persistent Depressive disorder?

Answer 2

Diagnostic Criteria
➢ Chronic depressed mood for >2 years

➢ The depressed mood can be in the form of:
• A long-lasting MDE

or

• Dysthymia: Chronic depressed mood plus ≥2 of the following symptoms:
‒ poor appetite or overeating
‒ insomnia/hypersomnia
‒ low energy
‒ low self-esteem
‒ trouble concentrating or making decisions
‒ feelings of hopelessness

Question 3

What are the PDD specifiers?

Answer 3

• Use the following specifiers to describe the nature of their depression during the 2-year interval (i.e., MDE only, dysthymic only; a mixture of MDE and dysthymia):

• PDD with persistent MDE
‒ Depression is characterized by a prolonged MDE

• PDD with pure dysthymic syndrome
‒ Depression is characterized by prolonged dysthymia
(see previous slide) but no MDE occurs

• PDD with intermittent MDEs
‒ Depression is characterized by dysthymic periods and
MDEs

Question 4

What is the treatment method of persistent depression disorder(PDD)?

Answer 4

The same psychotherapeutic and pharmacological methods used for MDD are used for the “dysthymic” subtype of PDD

➢ Brain stimulation therapies used for depression may also be used for PDDs that involve treatment-resistant and/or severe MDEs

Question 5

What are the symptoms of premenstrual dysphoric disorder (PMDD)?

Answer 5

➢ Symptoms must:
• Present in the week before menses onset
• Improve a few days after menses onset
• Minimize in the week post-menses

➢ Symptoms include:
• Mood lability, irritability, dysphoria, and anxiety
symptoms

• Anhedonia, problems concentrating, lethargy, appetite and sleep change, physical symptoms (e.g., breast tenderness, weight gain)

• Symptoms must cause clinically significant
distress or functional impairment (i.e., symptoms beyond “pre-menstrual syndrome”)

• Validated clinical scales are used to confirm the diagnosis

Question 6

What are the diagnostic criteria of Disruptive Mood Dysregulation Disorder (DMDD)?

Answer 6

Diagnostic Criteria

Core Features
• Severe temper outbursts at least 3 times/week
• Sad, irritable or angry mood almost daily
• Reaction is disproportionate to situation
• Symptoms are present in multiple settings

Timelines
• Child must be at least 6 years old
• Symptoms must begin before age 10
• NOT DIAGNOSED AFTER AGE 18

Question 7

Is DMDD a diagnostic entity?

Answer 7

Is this a valid diagnostic entity?
• DMDD diagnosis was developed so that a child’s irritability would not be mislabeled as part of a bipolar disorder

• Labeling DMDD kids with a depressive disorder (when not depressed) may be just as inaccurate and lead to inappropriate treatment