Depressive Disorders

Question 1

Disruptive Mood Dysregulation Disorder

Answer 1

Diagnosis applies only to 6-18 year olds [replaces Bipolar Diagnosis in children/adolescence]

Severe recurrent temper outbursts manifested verbally and/or behaviorally that are grossly out of proportion in intensity or duration to the situation or provocation

Temper outbursts occur on average 3 (or more) times per week

Mood in between outbursts is persistently irritable or angry most of the day, nearly every day

Criteria has been present for 12 (or more) months without a symptom-free interval lasting 3 or more consecutive months

Symptoms are present in at least 2 of 3 settings (home, school, with peers) and are severe in at least one

Question 2

Major Depressive Disorder

Answer 2

5 (or more) of the following symptoms have been present during the dame 2-week period and represent a change from previous functioning; at least one symptom must be depressed mood or loss of interest or pleasure

• depressed mood most of the day, nearly ever day; objective or subjective data
• markedly diminished interest or pleasure in almost all activities most of the day, nearly every day
• significant weight loss or appetite disturbance
• insomnia or hypersomnia nearly every day
• psychomotor agitation
• fatigue or loss of energy nearly every day
• feelings of worthlessness; excessive inappropriate guilt
• diminished ability to think or concentrate; indecisiveness
• recurrent thoughts of death; suicidal ideation

Must have no history of Manic or Hypomanic episode

Question 3

Risk Factors

Answer 3

• Neuroticism (negative affectivity) increases likely onset of depressive disorders
• adverse childhood experiences
• 40% heritability
• substance use, anxiety, borderline personality can all be comorbid or increase risk in both directions

Question 4

Persistent Depressive Disorder

Answer 4

Depressed mood that occurs for most of the day, for more days than not, for at least 2 years
(1 year for children/adolescents)

Presence of 2 (or more) of following symptoms:

• poor appetite or overeating
• insomnia or hypersomnia
• low energy or fatigue
• low self-esteem
• poor concentration or difficulty making decisions
• feelings of hopelessness

Never without symptoms for more than 2 consecutive months

No history of manic or Hypomanic episode

[if major depressive disorder surpasses 2 years, tag on PDD as additional diagnosis]

Question 5

Premenstrual Dysphoric Disorder

Answer 5

Expression of mood lability, irritability, dysphoria, and anxiety symptoms that occur repeatedly during the premenstrual phase of the cycle and remit around the onset of menses or shortly after

Symptoms must have occurred in most menstrual cycles during the past year

• affective liability (mood swings, increased sensitivity to rejection)
• irritably and anger; increased interpersonal conflicts
• depressed mood, feelings of hopelessness, self-deprecating thoughts
• anxiety, tension, and/or feelings of being on edge

1 (or more) symptoms must be present in addition to above:

• any marked symptom in Major Depressive Disorder Criterion
• sense of being overwhelmed or out of control
• breast swelling and/or tenderness, joint pain, bloating

Clinically significant experiences of distress

Question 6

Endogenous depression

Answer 6

Caused by biochemical imbalance

Question 7

Exogenous depression

Answer 7

Caused by external events or psychosocial stressors