Week 8: Depression definition & core features

Question 1

Mood Disorders in Youth (3)

Answer 1

Major depressive disorder

Persistent depressive disorder (Dysthymic disorder)

Bipolar disorder

Question 2

Core Features of Depression

Answer 2

Dysphoria
-prolonged sadness

Irritability

• excessive sensitivity, hostility, and moodiness
• unique to children and adolescents (does not happen in adults)

Anhedonia
-loss of pleasure or interest in previously enjoyable activities

Question 3

Symptom versus Syndrome versus Disorder

Answer 3

Symptom

• Feeling or emotion of sadness
• Very common (40% at any given time)

Syndrome

• Cluster of common symptoms
• “Negative affect” and dimensional view of depression

Disorder / Diagnosis

• Syndrome with minimum duration
• Syndrome with required impairment

3 different ways of looking at something and possibly greater severity

Question 4

Major Depressive Disorder

Answer 4

Defined by presence of a major depressive episode

5 Symptoms Total

During the same two week period at least one of:

(1) Depressed mood, most of the day, nearly every day OR irritability (children and adolescents only), most of the day, nearly every day
(2) Anhedonia (loss of interest or pleasure), most of the day, nearly every day

Plus:
(a) Significant weight loss or gain or decrease or increase in appetite nearly every day (In children, consider
failure to make expected weight gains)
(b) Insomnia or hypersomnia nearly every day
(c) Psychomotor agitation or retardation nearly every day (observable by others)
(d) Fatigue or loss of energy nearly every day
(e) Feelings or worthlessness or excessive or inappropriate guilt nearly every day
(f) Diminished ability to think or concentrate, or indecisiveness, nearly every day
(g) Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or
a suicide attempt or a specific plan for committing suicide

Question 5

Persistent Depressive Disorder (Dysthymia)



Answer 5

Depressed or irritable mood for most of the day, more days than not, as indicated by either subjective account or by observation by others, for at least 1 year
(In adults, mood must be depressed and must last for 2 years)

Presence while depressed, of two (or more) of the following:

• Poor appetite or overeating
• Insomnia or hypersomnia
• Low energy or fatigue
• Low self-esteem
• Poor concentration or difficulty making decisions
• Feelings of hopelessness
• During the 1 year period, the person has never been without the symptoms for more than 2 months at a time

Is like a persistent, lower level depression

Question 6

Persistent Depressive Disorder Subtypes (3)

Answer 6

Pure dysthymic syndrome
Full criteria for major depression have not been met in the preceding year

With persistent major depressive episode

Full criteria for a major depressive episode have been met throughout the preceding year

With intermittent major depressive episodes

Person has met criteria for one or more major depressive episodes
during the preceding year

Question 7

Categorical versus dimensional depression

Subclinical depression and its risks

Answer 7

One disadvantage of a categorical approach is that
there are a group of individuals who will not quite make the cutoff

Many children and adolescents will have subclinical depression

• They will not quite make diagnostic criteria, but they have a significant number of symptoms
• Show significant impairment (e.g., academic, social)
• At greater risk for going on to develop depression as well as other disorders and difficulties (e.g., substance use)