Tag Archives: depressive disorders

Persistent Depressive Disorder (Dysthymia) Symptoms and Related DSM–5 Diagnosis




Persistent Depressive Disorder (Dysthymia) 300.4 (F34.1)

Information related to Persistent Depressive Disorder (Dysthymia) as well as the specific symptoms follow below. While some of these Persistent Depressive Disorder (Dysthymia) symptoms may be recognized by family, teachers, legal and medical professionals, and others, only properly trained mental health professionals (psychologists, psychiatrists, professional counselors etc.) can or should even attempt to make a mental health diagnosis. A multitude of factors are considered in addition to the psychological symptoms in making a proper diagnosis, including medical and psychological testing considerations. This information is for information purposes only and should never replace the judgment and comprehensive assessment of a trained mental health clinician.

Persistent Depressive Disorder (Dysthymia) diagnostic criteria 300.4 (F34.1):

This disorder represents a consolidation of DSM-4-defined Chronic Major Depressive Disorder and Dysthymic Disorder.




A. Depressed mood for most of the day, for more days than not, is indicated by either subjective account or observation by others, for at least two years.
Note: In children and adolescents, mood can be irritable and duration must be at least one year.

B. Presence, while depressed, of two (or more) of the following:
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. During the two-year period (1 year for children or adolescents) of the disturbance, individual has never been without the symptoms in criteria A and B for more than two months at a time.

D. Criteria for a major depressive disorder may be continuously present for two years.

E. There has never been a manic episode or hypomanic episode and criteria have never been met for cyclothymic disorder.

F. The disturbance is not better explained by persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.

G. The symptoms are not attributable to the physiological effects of a substance such as a drug of abuse, a medication, or another medical condition such as hypothyroidism.

H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Note: Because the criteria for major depressive episode include four symptoms that are absent from the symptom list for persistent depressive disorder (dysthymia), a very limited number of individuals will have depressive symptoms that have persisted longer than two years but will not meet criteria for persistent depressive disorder. If the full criteria for major depressive episode have been met at some point during the current episode of illness, they should be given a diagnosis of major depressive disorder. Otherwise, a diagnosis of other specified depressive disorder or unspecified depressive disorder is warranted.

Specify if:

With anxious distress
With mixed features
With melancholic features
With atypical features
With mood-congruent psychotic features
With mood-incongruent psychotic features
With peripartum onset

Specify if:

In partial remission
In full remission

Specify if:

Early onset: If onset is before age 21 years.
Late onset: If onset is at 21 years or older.

Specify if: (For most recent two years of persistent depressive disorder):

With pure dysthymic syndrome: Full criteria for a major depressive episode have not been met in at least the preceding two years.
With persistent major depressive episode: Full criteria for major depressive episode have been met throughout the preceding two-year period.
With intermittent major depressive episodes, with current episode: Full criteria for major depressive episode are currently met, but there have been periods of at least eight weeks in at least the preceding two years with symptoms below the threshold for a full major depressive episode.
With intermittent major depressive episodes, without current episode: Full criteria for a major depressive episode are not currently met, but there has been one or more major depressive episodes in at least the preceding two years.

Specify current severity:

Mild
Moderate
Severe

Adapted by Paul Susic Ph.D. Licensed Psychologist from the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) American Psychiatric Association


Disruptive Mood Dysregulation Disorder Symptoms and Related DSM–5 Diagnosis




Disruptive Mood Dysregulation Disorder 296. 99 (F34.8)

Information related to Disruptive Mood Dysregulation Disorder as well as the specific symptoms follow below. While some of these Disruptive Mood Dysregulation Disorder symptoms may be recognized by family, teachers, legal and medical professionals, and others, only properly trained mental health professionals (psychologists, psychiatrists, professional counselors etc.) can or should even attempt to make a mental health diagnosis. A multitude of factors are considered in addition to the psychological symptoms in making a proper diagnosis, including medical and psychological testing considerations. This information is for information purposes only and should never replace the judgment and comprehensive assessment of a trained mental health clinician.

Disruptive Mood Dysregulation Disorder diagnostic criteria 296. 99 (F34.8):




A. Severe recurrent temper outbursts manifested verbally such as with verbal rages and/or behaviorally such as in physical aggression toward people or property that are grossly out of proportion in intensity or duration to the situation or provocation.

B. The temper outbursts are inconsistent with the developmental level.

C. The temper outbursts occur, on average, three or more times per week.

D. The mood between temper outbursts is persistently irritable or angry most of the day, nearly every day, and is observable by others such as parents, teachers or peers.

E. Criteria A-D have been present for 12 or more months. Throughout that time, the individual has not had a period lasting three or more consecutive months without all of the symptoms in criteria A-D.Criteria A and D are present in at least two or three settings such as at home, at school, with peers, and are severe in at least one of these.

F. The diagnosis should not be made for the first time before age 6 years or after age 18 years.

G. By history or observation, the age of onset of criteria A-E is before 10 years.

H. There’s never been a distinct period lasting more than one day during which the full symptom criteria, except duration, for manic or hypomanic episode has been met. Note: Developmentally appropriate mood elevation, such as occurs in the context of a highly positive event or its anticipation, should not be considered as a symptom of mania or hypomania.

I. The behaviors do not occur exclusively during an episode of major depressive disorder and are not better explained by another mental disorder such as autism spectrum disorder, posttraumatic stress disorder, separation anxiety disorder, persistent depressive disorder [dysthymia].
Note: This diagnosis cannot coexist with oppositional defiant disorder, intermittent explosive disorder, or bipolar disorder, though it can coexist with others, including major depressive disorder, attention-deficit/hyperactivity disorder, conduct disorder, and substance use disorders. Individuals whose symptoms meet criteria for both disruptive mood dysregulation disorder and oppositional defiant disorder should only be given the diagnosis of disruptive mood dysregulation disorder. If an individual has ever experienced a manic or hypomanic episode, the diagnosis of disruptive mood dysregulation disorder should not be assigned.

J. The symptoms are not attributable to the physiological effects of a substance or to another medical or neurological condition.

Diagnostic Information and Criterion for Disruptive Mood Dysregulation Disorders from the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition American Psychological Association

Additional information by Paul Susic Ph.D. Licensed Psychologist