Depressive disorders Flashcards
(17 cards)
List all the depressive disorders on the DSM5.
- MDD
- Persistent DD
- Disruptive mood dysregulation disorder
- Premenstrual dysphoria disorder
- Substance / Medicine induced DD
- DD due to another medical condition
- Other specified DD
- Unspecified DDs
DISRUPTIVE MOOD DYSREGULATION DISORDERS:
What is the age range in which this diagnosis can be given?
NOT before the age of 6 y/o
NOT after the age of 18 y/o
>6 y/o - <18 y/o
DISRUPTIVE MOOD DYSREGULATION DISORDERS:
Before which age does onset of symptoms occur?
“By history and observation the age of onset of symptoms before the age of 10 y/o.”
DISRUPTIVE MOOD DYSREGULATION DISORDERS:
List the clinical features of this diagnosis.
- Severe recurrent temper outbursts manifested verbally or behaviourally
- Temper outburst are inconsistent with normal developmental level
- 3 or more temper outbursts per week
- The mood between the temper outburst is persistently irritable or angry
- The symptoms have been present for >12 MONTHS
DISRUPTIVE MOOD DYSREGULATION DISORDERS:
What possible cause for the presenting symptoms have to be ruled out before the formal diagnosis of DMDD?
Substance use
MDD:
Explain the “range” of MDD.
- MILD = Minimal/no impairment but the pt. is disengaged
- MODERATE = Impaired functioning
- SEVERE = Hallucinations (psychosis) and suicidal ideation
*** Moderate and severe = antidepressants prescribed
MDD:
“5 or more of the symptoms which have been present for 2 WEEKS”
1. List the symptoms.
2. There are two core diagnostic criteria - one of which has to be present (1 of the 5). Name these two core diagnostic criteria.
- MDD Symptoms:
* Depressed mood
* Diminished interest or pleasure at all (anhedonia)
* Significant weight loss when not dieting or weight gain
* Insomnia or hypersomnia
* Psychomotor agitation or retardation
* Fatigue
* Feelings of worthlessness or excessive or inappropriate guilt
* Diminished ability to think
* Recurrent thoughts about death - Core diagnostic criteria:
* Depressed mood
* Anhedonia (loss of interest or pleasure)
MDD:
Can a diagnosis of MDD be made if the pt. has the clinical symptoms of MDD but can actively engage in all aspects of life?
NO.
If the pt. can actively engage in a functional manner in all occupations the diagnosis of MDD is disregarded.
“Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of function”
MDD:
Can MDD be the primary diagnosis if the pt. has experienced a manic episode or hypomanic episode previously?
NO.
MDD is NOT the primary diagnosis if the pt. has had or is currently in a manic or hypomanic episode.
Diagnostic criteria of MDD include ruling out schizophrenia, schizoaffective disorder, and schizophreniform as the primary diagnosis.
PERSISTENT DEPRESSIVE DISORDER:
What is Persistent Depressive Disorder also known as?
DYSTHYMIA + Chronic MDD
PERSISTENT DEPRESSIVE DISORDER:
How long does the pt. have to have a depressed mood (subjective or observed) to have this diagnosis?
Adult = 2 years
Children and adolescents = 1 year
PERSISTENT DEPRESSIVE DISORDER:
What other symptoms must be present along with depressed mood? (at least 2)
- Poor appetite
- Insomnia or hypersomnia
- Low energy or fatigue
- Low self-esteem
- Poor concentration
- Feelings of hopelessness
** NO manic/hypomanic or cyclothymic disorder
** NO psychotic illnesses
PERSISTENT DEPRESSIVE DISORDER:
Do pts. with this diagnosis have normal functioning in their everyday lives?
NO
“There is a clinically significant impairment or distress in social, occupational, or other important areas of functioning.”
List all the specifiers for depressive disorders. (total of 7)
- With anxious distress…
- With mixed feelings…
- With melancholic features…
- With atypical features…
- With mood-congruent psychotic features… (realistic delusions e.g. a part of them doesn’t exist)
- With mood-incongruent psychotic features… (unrealistic delusions e.g. they believe that they are a healer)
- With peripartum onset… (4 weeks postpartum)
What are some of the features of melancholy?
CORE feature = Empty / despondent mood
Other features:
* Inappropriate guilt
* Excessive weight loss
* Feelings of inadequacy early in the morning
PREMENSTRUAL DYSPHORIC DISORDER:
How does this disorder relate to the timeline of a period cycle?
At least 5 symptoms must be present in the FINAL WEEK BEFORE the onset of menses, start to improve within a few days after the onset of senses, and become minimal or absent in the week post menses.
PREMENSTRUAL DYSPHORIC DISORDER:
List the symptoms for this disorder from criterion B and C.
One or more must be present B:
* Marked affective liability
* Irritability or anger or increased interpersonal conflicts
* Depressed mood, feelings of hopelessness or self deprecating thoughts
* Marked anxiety, tension or feelings of being keyed up or on edge
One or more additional to B to reach a total of 5 - criterion C:
* Anhedonia
* Difficulty in concentrating
* Fatigue
* Changes in appetite, overeating, specific food cravings
* Hypersomnia/insomnia
* A sense of being overwhelmed or out of control
* Physical symptoms
