Depression specifiers Flashcards
with anxious distress
anxious distress with MDE incl 2 of: 1. feeling keyed up or tense 2. unusually restless 3. difficulty concentrating b/c worry 4. fear that something awful will happen 5. feeling that you might lose control Severity: mild- 2 sx, moderate- 3 sx, moderate-severe 4-5 sx, severe- 4-5 sx with motor agitation
with mixed features
A. 3 manic/hypomanic sx are present nearly every day during the majority of days of a MDE:
1. elevated, expansive mood
2. inflated self-esteem, grandiosity
3. more talkative/pressured speech
4. flight of ideas or subjective thought racing
5. increased energy or goal directed activity
6. increased/excessive involvement in activities likely to produce painful consequences
7. decreased need for sleep
B. sx are observable and a change
C. not full mania/hypomania
D. not due to substance
with melancholic features
A. either is present the most severe period of current episode:
1. loss of pleasure in all, or almost all, activities
2.lack or reactivity to pleasurable stimuli
B. 3 or more:
1. depressed mood characterized by despondency, despair, moroseness or empty mood
2. worse in morning
3. early morning wakening (approx 2 hr)
4. marked psychomotor agitation/retardation
5. significant anorexia/weight loss
6. excessive or inappropriate guilt
with atypical features
these features predominate during most days of current or most recent MDE/PDD
A. mood reactivity (mood brightens with positive event)
B. Two or more of:
1. significant weight gain or increased appetite
2. hypersomnia
3. leaden paralysis
4. longstanding pattern of interpersonal hypersensitivity (not limited to mood disturbance) causing significant social/occupational impairment
C. criteria not met for “with melancholic features” or “with catatonia” in the same episode
with psychotic features
delusions and hallucinations are present
specify:
mood congruent psychotic features– content of delusions/hallucinations are with typical depressive themes of inadequacy, guilt, disease, death, nihilism, or deserved punishment
mood incongruent psychotic features– not involving those themes, or content is a mixture
with catatonia
catatonic features present for most of episode
with peripartum onset
current or most recent episode of MDE onset of sx occurs during pregnancy or within 4 weeks of delivery
- often includes prominent anxiety sx, incl panic
- with or without psychotic features which can include infanticidal delusions or command hallucinations
with seasonal pattern
during recurrent MDD
A. regular temporal relationship between onset of MDE and a particular time of year (eg fall/winter)
B. full remissions (or switch to mania) also at a particular time of year (eg spring)
C. in the lats 2 years, 2 MDE have occurred that demonstrate the temporal associations, and no non-seasonal MDE have occurred
D. Seasonal MDE substantially outnumber non-seasonal MDE over pt life time
*does not apply if timing is associated with a life stressor (eg school starting, seasonal unemployment)
*associated with hypersomnia, overeating/wt gain, carb craving
*bipolar II > bipolar I; younger > older; high latitudes >equititorial
with partial remission
sx of MDE are present, but no longer meet full criteria or there is a period lasting less than 2 months without any significant sx of MDE following the end of an episode
in full remission
during the past 2 months, no significant signs or sx of MDE
current severity: mild
based on number of criterion met, severity of sx and impairment
mild: few if any sx in excess of necessary criteria, intensity is distressing but manageable, minor impairment in social/occupational function
current severity: moderate
number of sx, severity and impairment is between mild and severe
current severity: severe
number of sx is substantially excess of requirements, intensity is seriously distressing and unmanageable, sx markedly interfere with social and occupational function
