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Friday, October 16, 2009

Diagnosis

Notice how often the word ‘mood’ is used? As is ‘bad mood’?
Diagnostic and Statistical Manual of Mental Disorders (DSM IV)
.
Mood Disorders

The depressive disorders under a category in the DSM-IV called Mood Disorders. Included in this category are
1. Major depressive disorder,
2. A chronic mood disorder
3. Bipolar disorder,
4. A milder form of bipolar II consisting of recurrent mood disturbances between a mood state of elevated or irritable mood and chronic depression mood
5. Mood disorder due to a general medical condition,
a. seasonal affective disorder
b. substance-induced mood disorder.
6. Premenstrual disorder - refers only to a condition of mood and may be experienced in response to ordinary life events, such as illness or grief
7. Postpartum depression, has been proposed as a diagnosis for further study.

Once a diagnosis of a particular mood disorder is made, more detailed information about the diagnosis can be provided in the form of "specifiers."
For instance;

1. Major Depressive Disorder, Single Episode, Moderate, With Atypical Features
2. Major Depressive Disorder, Single Episode, Moderate, With Melancholic Features

Both diagnoses indicate the presence of the mood disorder- major depressive disorder.
Specifiers associated with the mood disorders are listed below:

1. Mild: A few symptoms, if any, are present beyond what is needed to make a diagnosis, and a person can function normally although with extra effort.
2. Moderate: The severity of symptoms is between mild and severe. For a manic episode, a person's activity is increased or judgment is impaired.
3. Severe Without Psychotic Features: Most symptoms are present and a person clearly has little or no ability to function.
4. A manic or mixed episode, a person needs to be supervised to protect him/her from harm to self or others.
5. Severe With Psychotic Features:
....a. A person experiences hallucinations or delusions.
....b. The presence of delusions and hallucinations often interfere with a person's ability to make sound judgments about consequences of their actions.
....c. A person in this condition needs immediate medical attention and possibly hospitalization.
6. Single Episode/Recurrent: A first episode is considered "single," subsequent episodes are "recurrent."
7. Chronic: For at least two years a person's symptoms have met criteria for a major depressive episode.
8. Catatonic Features: Unusual behaviors or movements such as immobility, excessive activity that is purposeless, rigid or peculiar posturing, mimicking others' words or behaviors.
9. Melancholic Features: A loss of pleasure in most activities or an inability to feel better, even for a short time when something pleasurable happens. Also, at least three of following is present:
....a. The depressed mood is distinct (i.e., unlike feelings of bereavement),
....b. It is worse in the morning, a person wakes too early in the morning
....c. There is distinct agitation or movements are slowed down
....d. Substantial weight loss/gain
....e. Extreme feelings of guilt.
10. Atypical Features:
....a. During the last two weeks of major depression or bipolar disorder
....b. Or the last two years of chronic depression,
....c. A person is able to experience brightened mood when good things happen
11. Postpartum Onset: The depressive episode begins within four weeks of giving birth.
12. With/Without Full Interepisode Recovery: Describes a long-term course of major depression or bipolar disorder.
13. Seasonal Pattern: Describes a pattern of depressive episodes which tend to begin (usually fall or winter) and end (usually spring).
14. Rapid-Cycling: Describes a recurrent pattern of depressive and manic episodes in bipolar disorder.
....a. A person has had at least four mood episodes during the last 12 months.
....b. There is either a general absence of symptoms between episodes or a clear switch from depression to mania.

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