Part Four of Depressive Disorders

Part Four of Depressive Disorders describes Depressive Disorder Due to Another Medical Condition, Substance/Medication-Induced Depressive Disorder, Other Specified Depressive Disorder, and Unspecified Depressive Disorder.

Depressive Disorder Due to Another Medical Condition

Depressive Disorder Due to Another Medical Condition is characterized by noticeable and continuous periods of depressed mood, noticeable decreased interest in activities, and a noticeable decrease in pleasure during activities.  (Diagnostic and Statistical Manual of Mental Disorders, 2013).  Diagnosis with this disorder means that the disturbance supersedes the symptoms of the medical condition.

Diagnosis also requires that “there is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition”.  The symptoms of Depressive Disorder Due to Another Medical Condition should not be better explained by the criterion for another mental disorder and the “disturbance does not occur exclusively during the course of a delirium” (Diagnostic and Statistical Manual of Mental Disorders, 2013).  The final criterion, which is shared between most DSM-5 diagnoses, is the symptoms must disrupt the individual’s typical functioning in school, at work, or in other important settings.

Substance/Medication-Induced Depressive Disorder

Substance/Medication-Induced Depressive Disorder is characterized by noticeable and continuous disturbance in mood, specifically the presence of depressive symptoms and/or a decreased interest in or pleasure during activities.

Diagnosis with Substance/Medication-Induced Depressive Disorder requires that there is evidence of two things:  one, the individual’s “symptoms develop during or soon after substance intoxication or withdrawal, or after exposure to a medication”; and two, that “the involved substance/medication is capable of producing the symptoms” (Diagnostic and Statistical Manual of Mental Disorders, 2013).  Evidence can be acquired through medically reported client history, the results of a physical examination, or the conclusions of laboratory tests.

The symptoms of Substance/Medication-Induced Depressive Disorder should not be better explained by the criterion for another Depressive Disorder.  Determining whether the symptoms are due to a substance or medication requires the diagnosing professional to inquire about the presence of depression prior to the use of the substance or medication.

Finally, symptoms must not “occur exclusively during the course of a delirium,” which is characterized by incoherence of thought and speech, delusions, and restlessness (Diagnostic and Statistical Manual of Mental Disorders, 2013).

Other Specified Depressive Disorder

The Other Specified Depressive Disorder diagnosis is applied when the diagnosing professional chooses to specify why the individual does not meet the full criterion for the disorders within this class.  There are three specifications:  recurrent brief depression, short duration depressive episode, and depressive episode with insufficient symptoms.  It is important to note that diagnosis with these specifiers are not appropriate for an individual who has ever met the criteria for a psychotic, bipolar, or another depressive disorder.

Both the ‘recurrent brief depression’ and ‘short-duration depressive episode’ specifiers are used when an individual has a depressed mood and a minimum of four other symptoms of depression.  The ‘recurrent brief depression’ specifier is specific to individual’s whose symptoms occur “for two to thirteen days [within a month] for at least 12 consecutive months” (Diagnostic and Statistical Manual of Mental Disorders, 2013).  If the symptoms only last four to thirteen days the ‘short-duration depressive episode’ is used.

‘Depressive episode with insufficient symptoms’ is appropriate for individuals who have at least one depressive symptom and it persists for at least two weeks.

Unspecified Depressive Disorder

This diagnosis is applied when the diagnosing professional chooses not to specify why the individual does not meet the full criterion for the disorders within this class and/or when there is not enough information available to make a specified diagnosis.  An Unspecified Depressive Disorder diagnosis is appropriate when an individual receives mental health care in a time-limited setting such as an emergency room.

This concludes the fourth class of Mental Health Diagnoses!  We hope you are more knowledgeable about Depressive Disorders, that you feel inspired to share what you have learned with others, and that you will help us stop the stigma and start a conversation about mental illness and mental health!

Stay Tuned!

The Introduction to Anxiety Disorders is up next!

References

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013. Web. [access date: 6 May 2018]. dsm.psychiatryonline.org

 

 

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