Specifiers for Depressive Disorder

With anxious distress

It is the presence of at least two anxiety-related symptoms during most days of a current or recent depressive episode.

• Feeling keyed up or tense

• Feeling unusually restless

Name two symptoms associated with anxious distress in depressive disorders.

2

How many symptoms are needed to specify mild anxious distress?

3

How many symptoms are needed to specify moderate anxious distress?

4 or 5

How many symptoms are needed to specify moderate-severe anxious distress?

MDD and Bipolar Disorder

In which disorders is anxious distress a common specifier?

• Loss of pleasure in all or almost all activities

• Lack of reactivity to usually pleasurable stimuli

What are the two required symptom options for diagnosing melancholic features in depression? (At least one must be present.)

3 or more

How many additional symptoms must be present for melancholic features besides one of the core symptoms?

Mood reactivity

What is the hallmark feature of depression with atypical features?

leaden paralysis

A sensation of heaviness or being weighed down, usually in the arms or legs, lasting at least an hour a day.

Hypersomnia

What sleep pattern is typical in atypical depression?

No

Can the specifier “with atypical features” be applied if melancholic or catatonic features are also present?

When symptoms occur at the most severe stage of the depressive episode.

When should the “with melancholic features” specifier be applied?

presence of delusions and/or hallucinations at any time during the current or most recent major depressive episode

What defines the “with psychotic features” specifier in depression?

Delusions or hallucinations that align with depressive themes

What are mood-congruent psychotic features in depression?

Delusions or hallucinations that are not consistent with typical depressive themes

What are mood-incongruent psychotic features in depression?

depressive symptoms began during pregnancy or within 4 weeks after delivery

What does the “with peripartum onset” specifier indicate in depression?

No , the specifier only applies if onset occurs during pregnancy or within 4 weeks postpartum

Can the peripartum onset specifier apply if the depression starts months after birth?

yes

Can peripartum-onset mood episodes include psychotic features?

Infanticide

linked to command hallucinations or delusions that the infant is possessed

Maternity blues involves

brief mood swings, tearfulness, and sleep disturbances without functional impairment.
It is not a mental disorder and resolves within a week.