Depressive Disorders

Disruptive Mood Dysregulation Disorder

is chronic severe, persistent irritability. This severe irritability has two prominent clinical manifestations, the first of which is frequent temper outburst. The second manifestation of severe irritability consists of chronic, persistently irritable or angry mood that is present between the severe temper outbursts

3 or more times per week

How often should a temper outburst occur disruptive mood dysregulation disorder?

12 or more months

How long should the symptoms occur in disruptive mood dysregulation disorder?

6, 18

The diagnosis disruptive mood dysregulation disorder should not be made for the first time before age __ years or after age __ years.

10 years

By history or observation, the age at onset of Criteria A–E is disruptive mood dysregulation disorder before ____

Major Depressive Disorder

defined by the presence of at least one major depressive episode occurring in the absence of a history of manic or hypomanic episodes. Period lasting at least 2 weeks during which there is either depressed mood or the loss of interest or pleasure in all or nearly all activities for most of the day nearly every day

Five (or more) symptoms.

How many symptoms must be present for a diagnosis of a Major Depressive Episode?

2-weeks

Over what minimum duration must symptoms persist to meet the criteria for a Major Depressive Episode?

At least one symptom must be either depressed mood or loss of interest or pleasure.

What is the required condition for at least one of the 5 symptoms in a Major Depressive Episode?

No, at least one of those two symptoms must be present.

Can a Major Depressive Episode be diagnosed without depressed mood or loss of interest/pleasure?

At least 2 years

What is the minimum duration of depressed mood required for a diagnosis of Persistent Depressive Disorder in adults?

For most of the day, for more days than not.

In Persistent Depressive Disorder, how often must the depressed mood occur during the 2-year period?

At least 1 year

What is the required duration of symptoms for diagnosing Persistent Depressive Disorder in children and adolescents?

irritable instead of depressed

How may the mood present in children and adolescents with Persistent Depressive Disorder?

At least two (or more)

How many additional symptoms must be present during periods of depressed mood in Persistent Depressive Disorder?

Low self-esteem, Poor concentration or difficulty making decisions

Name at least two common symptoms associated with Persistent Depressive Disorder (besides depressed mood)

No more than 2 months at a time

What is the maximum period a person with Persistent Depressive Disorder can be symptom-free during the 2-year (or 1-year) duration?

At least five symptoms

How many symptoms must be present in most menstrual cycles for a diagnosis of PMDD?

In the final week before the onset of menses, improve within a few days after onset, and become minimal or absent in the week postmenses.

When must PMDD symptoms occur in the menstrual cycle?

For most menstrual cycles in the preceding year

How long must the PMDD symptom pattern be observed for diagnosis?

At least one

What is the minimum number of affective symptoms (Criterion B) that must be present in PMDD?

Through prospective daily ratings during at least two symptomatic cycles

How should PMDD diagnosis be confirmed?

• Hypersomnia or insomnia

• Feeling out of control

• Breast tenderness or bloating

List three common physical or behavioral symptoms from Criterion C in PMDD.

• Marked irritability or anger

• Marked depressed mood or hopelessness

Name one core symptom that must be present for PMDD.

No. Somatic and behavioral symptoms must be accompanied by mood and anxiety symptoms.

Are behavioral and somatic symptoms alone enough to diagnose PMDD?

with onset after medication use

Symptoms began at the start of medication, during a change in medication use, or during withdrawal from the medication.

with onset during withdrawal

When symptoms develop during or shortly after withdrawal, and criteria are met for substance withdrawal

with onset during intoxication

The mental health symptoms develop while the person is intoxicated, and criteria are met for substance intoxication.

major depressive episode with melancholic features

designation is applied when, in addition to meeting the criteria for a major depressive episode, a patient either has lost interest or pleasure in almost all activities or does not react to usually pleasurable stimuli or desired events

Major depressive episode with atypical features

includes a pattern of symptoms characterized by mood reactivity; that is, the person’s mood brightens in response to potential positive events

monoamine oxidase inhibitors

t individuals with atypical fea tures may preferentially respond to a different class of antidepressants

Relapse

refers to the return of symptoms within a fairly short period of time, a situation that probably reflects the fact that the underlying episode of depression has not yet run its course

Recurrence

refers to the onset of a new episode of depression

unipolar depressive disorders

a person experiences only depressive episodes

independent life events

Stressful events that occur outside the person’s control, such as a company shutting down or a natural disaster.

dependent life events

Stressful events that may have been partly caused by the person’s behavior or personality.

oral stage

According to Freud and Abraham, to what developmental stage does the mourner regress?

anger

according to do the psychodynamic theory, depression is ____ turned inward

positive reinforcement

according to behaviorists, people become depressed either when their responses no longer produce _____ or when their rate of negative expe riences increases

depressogenic schemas

re negative, dysfunctional cognitive patterns that can increase an individual's vulnerability to depression

symbolic losses

Imagined losses (e.g., failing in school or love) that are experienced as loss of parental love, triggering depression.

automatic thoughts

They are quick, habitual, negative thoughts that arise just below awareness and are triggered by stress or depressed mood.

Beck’s Negative Cognitive Triad

A pattern of negative thinking involving pessimistic views of:

1. Self – “I’m worthless”

2. World – “No one loves me”

3. Future – “Nothing will ever get better”