Review of DSM5 Mental Disorders for NCMHCE Study

1. Disruptive Mood Dysregulation Disorder2. Major Depressive Disorder 3. Persistent Depressive Disorder (Dysthymia)4. Premenstrual Dysphoric Disorder5. Substance/Medication-Induced Depressive Disorder6. Depressive Disorder Due to Another Medical

Condition7. Other Specified Depressive Disorder8. Unspecified Depressive Disorder

S2. Assessments1. BDI Beck Depression Inventory2. Hamilton Rating Scale3. SCID Structured Clinical Intervew4. Patient Health Questionnaire-9 5. HAM-D6. Zung Self Rating Depression Scale7. Geriatric Depression Scale8. Mood Disorder Questionnaire9. MMSE10. Physical exam11. Steen Happiness Index

Treatments1. Medications

Antidepressants usually SSRI’s or SNRI’s

TCA’s (Tricyclic antidepressant)

MAOI’s (Monoamine oxidase inhibitor)

2. Therapies BAT Behavioral Activation

Therapy CBT Cognitive Behavioral

Therapy Mindfulness Therapy Electroconvulsive therapy Vagal nerve stimulation Transcranial magnetic

stimulation IPP Interpersonal

psychotherapy Social skills and

assertiveness training

Major Depression 5 criteria For 2 weeks Lower

functioning

Persistent Depression 3 criteria For 2 years

▪ 1 year for youth Milder, higher

functioning

Criteria Sleep problems Disinterest Low self-esteem Energy problems Poor

concentration Appetite change Agitated or slow Suicidal ideation

DiagnosisSevere recurrent temper outbursts, grossly out of proportion in intensity or duration Inconsistent with maturity level Verbal and/or physical rages, against

people or property Persistently irritable or angry most of the

day between outbursts Frequent, 2-3 times weekly For 12 or more months Onset must be between ages 6-10, until

age 18

Rule Out ODD:

More severe

Disruptive Mood Dysregulation 2-3 times weekly For 12 or more

months ages 6-10, until

age 18 Persistently

irritable or angry Verbal and/or

physical rages

Oppositional Defiant Difficult behavior

for 6 months Verbal rages Argumentative Aggressive More severe

Intermittent Explosive

3 times yearly Verbal aggression Assaults Outbursts causing

damage Ages 6-adult Remorseful

S1. Find Out Medical evaluation Affective functioning Cognitive functioning Symptomology development Family history Past trauma Substance use history Work/school history Family meeting

S2. Assess & Refer

S5. TreatmentsMedications Antidepressants usually SSRI’s or SNRI’sTherapies Psychoeducation Individual psychotherapy Family therapy

Diagnosis5 or more symptoms during the same 2 week period Must include

depressed mood or loss of interest or pleasure

1. Depressed mood most of the day, most days

2. Decreased pleasure in activities3. Weight loss or gain; loss of energy4. Insomnia or sleeping too much5. Psychomotor agitation or retardation 6. Feelings of worthlessness and guilt7. Harder to think or make decisions8. Recurrent thoughts of death and

suicide, and/or plans or attempt 9. More likely after puberty

Diagnosis IISpecifiers Mild, moderate, severe With psychotic features In partial remission, in full remission,

unspecified Anxious distress, melancholic features Mixed features, atypical features Mood-congruent psychotic features,

mood-incongruent features Catatonia Peri-partum onset Seasonal pattern

Comorbidity Substance abuse Panic disorders OCD

Anorexia Nervosa Bulimia Nervosa Borderline

Personality

S1. Find Out Medical evaluation Affective functioning Cognitive functioning Symptomology development Family history Past trauma Substance use history Work history Family meeting

S2. Assessments1. Beck Depression Inventory2. Hamilton Rating Scale3. SCID4. Patient Health Questionnaire-9 5. HAM-D6. Zung Self Rating Depression Scale7. Geriatric Depression Scale8. Mood Disorder Questionnaire9. MMSE10. Physical exam

S5. TreatmentsMedications Antidepressants usually

SSRI’s or SNRI’s TCA’s (Tricyclic

antidepressant) MAOI’s (Monoamine

oxidase inhibitor)

Therapies Behavioral Activation

Therapy BAT Cognitive Behavioral

Therapy Mindfulness Therapy Exercise Electroconvulsive

therapy Vagal nerve stimulation Transcranial magnetic

stimulation

S5. Monitoring Medication compliance Interactions with family Use of leisure time Weight gain or loss Sleep quality Social activities

S6. Termination Medication Support group

Diagnosis IDepressed mood, most of the day, most days For at least 2 years (or 1 year for youth) During this period, symptoms ceased for

less than 2 monthsWhile depressed, 2 or more symptoms: Poor appetite or overeating Insomnia or hypersomnia Low energy or fatigue Low self esteem Poor concentration and indecisive Feelings of hopelessness

No manic or hypomanic episodes

Milder and higher functioning than MDD

Comorbidity Anxiety Substance

abuse

S1. Find Out Medical evaluation Affective functioning Cognitive functioning Symptomology development Family history Past trauma Substance use history Work/school history Family meeting

S2. Assess & ReferPsych testing

Beck Depression Inventory (BDI)

Steen Happiness Index

S5. TreatmentsMedications Antidepressants usually SSRI’s or SNRI’s TCA’s (Tricyclic antidepressant) MAOI’s (Monoamine oxidase inhibitor)Therapies CBT Cognitive Behavioral Therapy IPP Interpersonal psychotherapy Social skills and assertiveness training Decisionmaking training

S1. DiagnosisAt least 5 symptoms in the final week before onset of menses With improvement a

few days after the onset Minimal or absent in the

week after menses Same symptoms in

most menstrual cycles in the past year

2 months of symptoms

1 or more of these: Mood swings Irritability, anger, or

increased interpersonal conflicts

In addition, 1 or more symptoms to make 5 total Decreased interest in

activities Difficulty concentrating Lethargy Changes in appetite; Hypersomnia/insomnia Feeling overwhelmed or

out of control Bloating or weight gain

S1. Find Out Medical evaluation Affective functioning Cognitive functioning Symptomology

development Family history Past trauma Substance use history Work history Family meeting

S2. Assess & ReferPsych testing

Beck Depression Inventory (BDI)

Patient Health Questionnaire-9

Diagnosis1. Symptoms start

anytime during pregnancy or up to 12 months following delivery

2. Five of the following nine symptoms, within a two week period: Feelings of sadness, emptiness, or

hopelessness, nearly every day, for most of the day

Loss of interest or pleasure in activities

Weight loss or decreased appetite Changes in sleep patterns Feelings of restlessness Loss of energy Feelings of worthlessness or guilt Loss of concentration or increased

indecisiveness Recurrent thoughts of death

DiagnosisDepressive symptoms associated with the ingestion, injection or inhalation of a substance Persist beyond the anticipated length of physiological

effects, intoxication or withdrawal period

DiagnosisDepressive symptoms directly related to the start or progression of disease Not delirium Not psychological

response to the condition No other stressor or

evidence of tendency towards depression

Conditions causing depression1. Thyroid dysfunction2. Cancer3. Poorly-controlled diabetes4. Chemotherapy5. Endocrine problems6. Post-partum7. Parkinson’s disease