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Clinical Competency: Depression 2 Hours Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
| Date post: | 18-Nov-2014 |
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Clinical Competency: Depression2 Hours
Copyright AllCEUs 2011-2020 Unlimited CEUs $99/year
Major Depressive Episode
◦Five (or more) of the following have been present nearly every day during the same 2-week period depressed mood most of the day markedly diminished interest or pleasure
in all, or almost all, activities significant changes in eating patterns. insomnia or hypersomnia
Depression and Dysthymia
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psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or slowing)
fatigue or loss of energy feelings of worthlessness or excessive or
inappropriate guilt diminished ability to think or concentrate, or
indecisiveness, recurrent thoughts of death (not just fear of
dying), recurrent suicidal ideation
Depression cont…
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The symptoms do not meet criteria for a Mixed Episode.
The symptoms are not due to ◦ the direct physiological effects of a substance◦ a general medical condition (e.g.,
hypothyroidism).◦ Bereavement, i.e., after the loss of a loved one,
the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation
Depression cont…
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Symptoms similar to depression that last for more than 6 months
Dysthymia
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Disorder in which the person experiences both manic and depressive type symptoms
Symptoms can alternate, co-occur(mixed) or be present to a greater or lesser degree (hypomania/dysthymia)
Bipolar
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Criteria for Manic Episode (DSM-IV, p. 332)◦ A distinct period of abnormally and persistently elevated,
expansive, or irritable mood, lasting at least 1 week◦ During the period of mood disturbance, three (or more) of the
following symptoms have been present to a significant degree: inflated self-esteem or grandiosity decreased need for sleep (e.g., feels rested after only 3 hours of
sleep) more talkative than usual or pressure to keep talking flight of ideas or subjective experience that thoughts are racing distractibility increase in goal-directed activity (either socially, at work or school,
or sexually) or psychomotor agitation excessive involvement in pleasurable activities that have a high
potential for painful or negative consequences
Mania
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Criteria for Hypomanic Episode (DSM-IV, p. 338)◦ The manic episode is not severe enough to
cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.
Hypomania
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Criteria for Mixed Episode (DSM-IV, p. 335)◦ The criteria are met both for a Manic Episode and
for a Major Depressive Episode (except for duration) nearly every day during at least a 1-week period.
Mixed Episode
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Bipolar I: Major Depression and Mania Bipolar II:
◦ Major Depression and Hypomania◦ No history of manic or mixed episodes
Bipolar I and II
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Diagnostic Criteria for Cyclothymic Disorder◦ For at least 2 years, the presence of numerous periods of
hypomanic symptoms and numerous periods of depressive symptoms that do not meet criteria for a Major Depressive Episode.
◦ During the above 2-year period the person has not been without symptoms for more than 2 months
◦ The symptoms in Criterion A are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
◦ The symptoms are not due to the direct physiological effects of a substance or a general medical condition (e.g., hypothyroidism).
◦ The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Cyclothymic Disorder
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Depressive-Like Symptoms◦ Diabetes◦ Hypothyroid◦ Fibromyalgia◦ Chronic Fatigue
Manic-Like Symptoms◦ Hyperthyroid
Medical Differential Diagnosis
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Depression◦ Opiates◦ Anxianxiety/Benzodiazepines◦ Depressants/Barbiturates◦ Inhalants◦ GHB
Mania◦ Ecstasy/MDMA◦ Methamphetamine◦ Cocaine◦ Steroids
Substances and Symptoms
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Depression Dysthymia Mania Hypomania Bipolar I Bipolar II Cyclothymia Differential Diagnosis
Summary Depressive & Bipolar Disorders
