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Depression |
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essential feature of Major Depressive Disorder is a clinical course that is
characterized by one or more Major Depressive Episodes without a history of
Manic, Mixed, or Hypomanic Episodes (Criteria A and
C). Episodes of Substance -Induced Mood Disorder (due to the direct
physiological effects of a drug of abuse, a medication, or toxin exposure) or
of Mood Disorder due to a General Medical Condition do not count toward a
diagnosis of Major Depressive Disorder. In addition, the episodes must
not be better accounted for by Schizoaffective Disorder and are not
superimposed on Schizophrenia, Schizophreniform
Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified
(Criterion B). The essential feature of a Major Depressive
Episode is a period of at least 2 weeks during which there is either
depressed mood or the loss of interest or pleasure in nearly all
activities. In children and adolescents, the mood may be irritable
rather than sad. The individual must also experience at least four
additional symptoms drawn from a list that includes changes in appetite or
weight, sleep, and psychomotor activity; decreased energy; feelings of
worthlessness or guilt; difficulty thinking, concentrating, or making
decisions; or recurrent thoughts of death or suicidal ideation, plans, or
attempts. To count toward a Major Depressive Episode, a symptom must
either be newly present or must have clearly worsened compared with the
person's pre-episode status. The symptoms must persist for most of the
day, nearly every day, for at least 2 consecutive weeks. The episode
must be accompanied by clinically significant distress or impairment in
social, occupational, or other important areas of functioning. For some
individuals with milder episodes, functioning may appear to be normal, but
requires markedly increased effort. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, American Psychiatric Association, 1994, p.339, p.320. |
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