definition of "Abnormal"
"3 D's"
Deviation (not norm)
Discomfort
Dysfunction
3 Criterion that need to be met
for ALL of the DSM-5
... [Show More] criterion
for psychiatric disorders
1) Causes Significant distress or impairment in functioning (social or occupational)
2) Not caused by a drug
3) Not caused by a medical condition
Major Depressive Disorder
5 or more sxs present during the same 2 wk period. MUST have #1 or #2
1) Depressed mood most of the day, every day
2) diminished interest, anhedonia
3) weight loss or weight gain
4) insomnia or hypersomnia
5) Psychomotor agitation or retardation
6) Fatigue, energy loss
7) Feeling worthless, inappropriate guilt
8) Diminished concentration or indecisiveness
9) SI, with or w/out plans, with or w/out attempt, thoughts of death
MDD Single Episode
Presence of single 2 week MD episode that...
1) is not better accounted for by schizoaffective d/o
2) never been a manic, mixed episode, or hypomanic state
MDD, Recurrent
Presence of 2 or more MD episodes
At least 2 months apart
MDD in Children <18
5 or more sxs during the same 2 wk period. MUST have #1 or #2
1) Depressed mood; For children & adoles, this can also be an irritable mood
2) diminished interest, anhedonia
3) weight loss or weight gain; For children, this can be failure to achieve expected weight gain
4) insomnia or hypersomnia
5) Psychomotor agitation or retardation
6) Fatigue, energy loss
7) Feeling worthless, inappropriate guilt
8) Diminished concentration or indecisiveness
9) SI, with or w/out plans, with or w/out attempt, thoughts of death
Persistent Depressive Disorder
(AKA Dysthymic Disorder)
A) Depressed mood most of the day, more days than not, as indicated by either subjective account or observation by others, for at least 2 yrs
B)2 or more of these present
1. Poor appetite or overeating.
2. Insomnia or hypersomnia.
3. Low energy or fatigue.
4. Low self-esteem.
5. Poor concentration or difficulty making decisions.
6. Feelings of hopelessness.
C) Never w/out A & B for > 2 months at a time
D) Criteria for MDD may be continuously present for 2 years.
E) never had manic or a hypomanic episode, & have never been met for cyclothymic disorder.
Persistent Depressive Disorder in Children < 18y.o.
Only difference is
Depressed mood most of the day, more days than not, as indicated by either subjective account or observation by others, for at least 1 year
Premenstrual Dysphoric Disorder (PMDD)
In majority of menstrual cycles, a/L 5 sxs must be present in the final wk before onset of menses, improve within a few days after the onset, & become minimal or absent in the wk postmenses
B) One (or more) of the following must be present:
1) Emotional lability (mood swings; feel suddenly sad or tearful, or inc sensitivity to rejection).
2) Irritability or anger or interpersonal conflicts.
3) Depressed mood, feelings of hopelessness, or self-deprecating thoughts.
4) Anxiety, tension, and/or feelings of being keyed up or on edge.
C) One (or more) of the following symptoms must additionally be present, to reach a total of 5
1) Diminished interest, anhedonia
2) Subjective difficulty in concentration.
3) Fatigue, energy loss
4) Change in appetite; overeat; or specific food cravings.
5) Hypersomnia or insomnia.
6) Sense of being overwhelmed or out of control.
7) Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of "bloating," or weight gain.
Note: A-C must have been met for most menstrual cycles that occurred in the preceding year
D) NOT merely an exacerbation of underlying mood disorder
E) Should be confirmed by daily ratings prospectively
Manic Episode
A) Distinct period of abnormally & persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day.
B) 3 or more of the following (DIG FAST)
1. Distractibility or easily frustrate
2. Irresponsibility and erratic behavior; decreased Inhibitions
3. Grandiosity
4. Flight of ideas, racing thoughts
5. Activity increased, goal oriented activities, and/or increased sexual activity
6. Sleep, decreased need for sleep
7. Talkative, pressure to keep talking
Hypomanic Episode
A) Distinct period of abnormally & persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 4 days and present most of the day, nearly every day.
B) 3 or more of the following (DIG FAST)
1. Distractibility or easily frustrate
2. Irresponsibility and erratic behavior; decreased Inhibitions
3. Grandiosity
4. Flight of ideas, racing thoughts
5. Activity increased, goal oriented activities, and/or increased sexual activity
6. Sleep, decreased need for sleep
7. Talkative, pressure to keep talking
C) Must be change from baseline behavior
D)The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic.
Bipolar I Disorder
Must meet the criteria for a Manic Episode.
The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes.
But hypomania or MDD episode is not required for BP I diagnosis, just need the manic episode
Bipolar II Disorder
Must meet criteria for a current or past Hypomanic Episode
AND
Meet criteria for a current or past Major Depressive Episode
Bipolar Disorder Criteria in Children < 18y.o.
Same Criteria as adults
Cyclothymic Disorder
A) Presence of Hypomania symptoms but do not meet hypomania episode criteria and Depressive symptoms but do not meet MDD episode criteria
For at least 2 years
B) During these 2 years, the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for > 2 months at a time [Show Less]