3.4 Affective Disorders
Lectures
& DSM-5 Criteria
,Lecture 1 → Introduction & Depression
● Major depressive disorder (MDD)
○ Majority of people experience symptoms in their life but does not necessarily
mean diagnosis
○ Associated with shame & stigma
● Learning goals
○ Characteristics of MDD
○ Distinguish between symptoms & emotional states
○ Identify etiologies (causes)
■ Compare & distinguish different features
● Prevalence & development
● Risk & prognostics
● Culture & sex diff
○ Apply to clinical examples
○ Evaluate compare distinguish various theoretical models
○ Evaluate compare distinguish various treatment models
What is depression (overview)
● DSM 5 criteria for MDD
○ Five or more of the nine following symptoms present during the same two week
period and represent change from previous functioning one has to be at least (*)
■ Depressed mood*
■ Loss of interest/pleasure*
■ Significant weight loss/gain or increase/decrease of appetite
■ Insomnia or hypersomnia
■ Psychomotor agitation or retardation (observable by others, not
subjective)
■ Fatigue or loss of energy
■ Feelings of worthlessness or excessive/inappropriate guilt
■ Diminished ability to think or concentrate
■ Recurrent thoughts of death (with or without specific plan)
○ Needs to cause significant impairment in daily life (social, occupational, other
functioning)
○ Not attributable to physiological effects of a substance or other medical condition
○ Occurrence is not better explained by other psychiatric condition
○ No (hypo)manic episode present
● Specified diagnoses
○ With anxious distress, mixed features, melancholic features, atypical features,
mood congruent psychotic features, catatonia, peripartum onset, seasonal
pattern (recurrent episodes only)
● Criteria for persistent depressive disorder (dysthymia, chronic but less intense)
○ Depressed mood observable for most of the day (no loss of interest)
, ■ Children & adolescents only 1 year
○ Two or more of following symptoms
■ Poor appetite or overeating
■ Insomnia or hypersomnia
■ Low energy or fatigue
■ Low self-esteem
■ Poor concentration
■ Feelings of hopelessness
○ During the two year period not more than 2 months without symptoms at a time
○ Criteria for MDD may be present continuously for 2 years
○ Never hypomanic episode and no cyclothymic disorder
○ Disturbance not better explained by schizoaffective, schizophrenia, delusional
disorder
○ Can be present together with MDD (double depression)
● Presents itself differently for different people (chameleon)
Theories on depression
● Contemporary integrative interpersonal theory (CIIT)
○ Based on humans being social creatures → interpersonal dynamics
○ Grounded in personality theory
○ Many forms of psychopathology are associated with interpersonal impairment,
not just depression (more general theory of disorders)
Lectures
& DSM-5 Criteria
,Lecture 1 → Introduction & Depression
● Major depressive disorder (MDD)
○ Majority of people experience symptoms in their life but does not necessarily
mean diagnosis
○ Associated with shame & stigma
● Learning goals
○ Characteristics of MDD
○ Distinguish between symptoms & emotional states
○ Identify etiologies (causes)
■ Compare & distinguish different features
● Prevalence & development
● Risk & prognostics
● Culture & sex diff
○ Apply to clinical examples
○ Evaluate compare distinguish various theoretical models
○ Evaluate compare distinguish various treatment models
What is depression (overview)
● DSM 5 criteria for MDD
○ Five or more of the nine following symptoms present during the same two week
period and represent change from previous functioning one has to be at least (*)
■ Depressed mood*
■ Loss of interest/pleasure*
■ Significant weight loss/gain or increase/decrease of appetite
■ Insomnia or hypersomnia
■ Psychomotor agitation or retardation (observable by others, not
subjective)
■ Fatigue or loss of energy
■ Feelings of worthlessness or excessive/inappropriate guilt
■ Diminished ability to think or concentrate
■ Recurrent thoughts of death (with or without specific plan)
○ Needs to cause significant impairment in daily life (social, occupational, other
functioning)
○ Not attributable to physiological effects of a substance or other medical condition
○ Occurrence is not better explained by other psychiatric condition
○ No (hypo)manic episode present
● Specified diagnoses
○ With anxious distress, mixed features, melancholic features, atypical features,
mood congruent psychotic features, catatonia, peripartum onset, seasonal
pattern (recurrent episodes only)
● Criteria for persistent depressive disorder (dysthymia, chronic but less intense)
○ Depressed mood observable for most of the day (no loss of interest)
, ■ Children & adolescents only 1 year
○ Two or more of following symptoms
■ Poor appetite or overeating
■ Insomnia or hypersomnia
■ Low energy or fatigue
■ Low self-esteem
■ Poor concentration
■ Feelings of hopelessness
○ During the two year period not more than 2 months without symptoms at a time
○ Criteria for MDD may be present continuously for 2 years
○ Never hypomanic episode and no cyclothymic disorder
○ Disturbance not better explained by schizoaffective, schizophrenia, delusional
disorder
○ Can be present together with MDD (double depression)
● Presents itself differently for different people (chameleon)
Theories on depression
● Contemporary integrative interpersonal theory (CIIT)
○ Based on humans being social creatures → interpersonal dynamics
○ Grounded in personality theory
○ Many forms of psychopathology are associated with interpersonal impairment,
not just depression (more general theory of disorders)
