Depressive Disorders PDF

DEPRESSIVE DISORDERS (USED TO BE CALLED MOOD DISORDERS)  In DSM-5-TR Depressive Disorders (unipolar) Major depressive d/o (MDD) Persistent depressive d/o (was dysthymia) Premenstrual dysphoric d/o Disruptive mood dysregulation d/o (ages 6-18)...

DEPRESSIVE DISORDERS (USED TO BE CALLED MOOD DISORDERS)  In DSM-5-TR Depressive Disorders (unipolar) Major depressive d/o (MDD) Persistent depressive d/o (was dysthymia) Premenstrual dysphoric d/o Disruptive mood dysregulation d/o (ages 6-18) (Adjustment disorder with depressed mood) Bipolar Disorders Bipolar disorder I Bipolar disorder II Cyclothymia Q: Are recent life events related to depression? Reactive depression (to stress) (research: 80% of severe episodes occur within 1-2 months of sig. negative event) vs. Endogenous depression Q: What kinds of life events are often correlated with depression? Exit events or losses Certain roles Clinical picture of Major Depressive D/O Emotional symptoms – Including depressed mood, anhedonia, etc. Motivational symptoms – Low motivation, push self to do things Behavioral symptoms – Including psychomotor retardation (or agitation) Cognitive symptoms – Including suicidal ideation Somatic symptoms – Including insomnia, appetite changes  MDD: 5 or More Symptoms: Depressed mood or loss of interest/pleasure + 3-4 more of “SIGECAPS”: Sleep changes Interest/ pleasure is decreased Guilt, worthlessness feelings Energy is low (fatigue) Concentration is difficult Appetite and weight changes Psychomotor retardation (or agitation) Suicidality Some subtypes of Major Depression Melancholic With anxious distress Seasonal pattern Peripartum onset Anxious Psychotic (has delusions &/or hallucinations) Persistent Depressive D/O: What is it? Depressed mood more days than not for at least 2 years Plus at least 2 of: (“L-CLASH”?) Low energy/ fatigue Concentration problems Low self-esteem Appetite changes Sleep changes Hopelessness  Premenstrual Dysphoric D/O (wasn’t official diagnosis in DSM-IV) At least 5 symptoms in week before onset of menstruation; symptoms then disappear: – Mood swings or sensitivity to rejection – Irritability, anger, conflicts – Depressed mood, hopelessness – Anxiety, tension – Decreased interest – Concentration problems – Lethargy, lack of energy – Appetite changes – Sleep changes – Feeling overwhelmed – Physical pains  Disruptive Mood Regulation D/O (new children’s diagnosis as of DSM-5) For at least 12 months (w/ no gap > 3 months): Persistent irritable, angry mood Severe recurrent temper outbursts – Inconsistent with developmental level – Occur at least 3 times/week Aged 6 -18, with onset before age 10 Don’t meet criteria for other mood d/o’s  Two questions to ponder as we think about causes of depression Q1: Why are women twice as likely as men to experience depression? Q2: Why do more recent generations experience more depression?