DSM 5 Depression (A Detailed Guide)

This comprehensive guide will provide the details of the most significant DSM depression disorders and the diagnostic criteria for each depression disorder.

DSM 5 Depression Types

There are now eight specific disorders mentioned in the depressive disorders chapter of DSM 5. These categories are listed below:

  • Major Depressive Disorder
  • Disruptive mood Dysregulation Disorder
  • Persistent Depressive Disorder (Dysthymia)
  • Premenstrual Dysphoric Disorder 
  • Substance//Medication-induced Depressive Disorder
  • Depressive Disorder due to other medical condition
  • Other Specified Depressive Disorder
  • Unspecified Depressive Disorder

The clinical definition of depression, according to the fifth edition of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), is “a period of at least two weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified symptoms, such as problems with sleep, eating, energy, concentration, or self-worth.”

Let’s go into the details of the DSM 5 depression types.

  • Major Depressive Disorder

Five or more of the symptoms have been persistent in the two weeks and show a change from previous functioning; at least one of the symptoms is either loss of pleasure or interest or depressed mood.

  • Depressed mood most of the day, almost daily, as shown by either subjective reports (feeling sad, hopelessness, emptiness) or observation made by others (apparently tearful). In children and adolescents, it can be irritability.
  • Significant loss of interest or joy in all, or almost all activities, most of the day, almost daily (as shown by either subject account or observation).
  • Significant weight loss or weight gain without conscious efforts.
  • Loss or increase in appetite.
  • Hypersomnia or insomnia
  • Loss of energy or fatigue
  • Psychomotor agitation or retardation almost daily. 
  • Feelings of worthlessness or excessive misplaced guilt (maybe delusional) almost every day (not just self-reproach or guilt about being ill).
  • Loss of concentration and focus, indecisiveness, almost every day ( either by the subject themself or observations).
  • Recurring thoughts of death (not just fear of death), recurrent suicidal thoughts, and ideation without.

1.  Precise plan, or a suicide attempt, or a planned scheme for committing suicide.

2. The symptoms that result in clinically significant worry or change in occupation, social, or other important areas of functioning.

3. The depressive episode is not characterized by the physiological impacts of a substance or other medical condition.

Note: 1-3 are the symptoms of a major depressive episode.

4. The existence of the major depressive episode is not better explained by schizophrenia, schizoaffective disorder, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.

5. There has never been a hypomanic or manic episode. 

  • Disruptive Mood Dysregulation Disorder (DMDD)

DSM 5 criteria for disruptive mood dysregulation disorder includes the following

  • Intense, recurring (more than three times a week) temper outbursts (verbal and/or behavioral) that are severely out of proportion in intensity or duration to the event and inconsistent with the developmental level
  • The mood between temper outbursts a consistently irritable or angry most part of the day, almost every day, and observed by others.
  • The symptoms should be prevalent for a year or more, with no more than three consecutive months of symptom-free duration.
  • The behaviors/symptoms must be seen in at least two of the three environments (i.e., school, home, or peers) and, to a great degree, at least in one setting.
  • The diagnosis is not made for the first time between six years or after eighteen years.
  • By history or observations, the age at the start is before ten years.

Some exclusion criteria include:

 “ (1) the behaviors do not occur exclusively during an episode of major depressive disorder and are not better explained by another mental disorder (e.g., autism spectrum disorder, persistent depressive disorder/dysthymia, posttraumatic stress disorder, separation anxiety disorder); and (2) DMDD cannot co-exist with bipolar disorder, intermittent explosive disorder or ODD (individuals whose symptoms meet criteria for both DMDD and ODD should only be given the diagnosis of DMDD).”

  • Persistent Depressive Disorder (Dysthymia)

DSM 5 criteria for dysthymia include depressed mood for most of the day, for more days as indicated by others’ subject or observations, for at least two days. It is attributed to the occurrence of the following symptoms while depressed:

  • Overeating or loss of appetite
  • Hypersomnia or insomnia
  • Low energy or fatigue
  • Low self-esteem
  • Lack of concentration or difficulty in making decisions
  • Feelings of hopelessness

There has never been a hypomanic or manic episode, and the criteria for cyclothymia have never been met.

Criteria for MDD may be persistently there for two years; in that case, patients should be comorbidly diagnosed with persistent depressive disorder and MDD.

The symptoms are not better explained by a psychotic disorder.

The symptoms result in clinically significant worry or change in occupation, social, or other important areas of functioning.

The depressive episode is not characterized by the physiological impacts of a substance or other medical condition.

  • Premenstrual Dysphoric Disorder (PMDD)
  1. In most of the menstrual cycles, at least five symptoms must be present in the final week before the start of the period, start to improve within a few days after the start of the period, and minimize or absent in the week post menses.
  2. One or more symptoms should be present:
  1. Notable affective lability (i.e., mood swings, sadness, and tearful attitude, or high sensitivity to rejection.
  2. Notable irritability or anger or higher interpersonal conflicts.
  3. Notably depressed mood, feelings of hopelessness, or self-worthless thoughts.
  4. Notable tension, anxiety, and/or feelings of being on edge or keyed up.

      C. One or more of the following symptoms must additionally exist to reach a total of five symptoms when included with symptoms from criterion B 

  1. Lowered interest in usual activities.
  2. Subjective difficulty in concentration
  3. Fatigue, lethargy, or lack of energy
  4. A notable change in appetite, overeating, or certain food cravings
  5. Insomnia or hypersomnia
  6. A feeling of overwhelm or out of control.
  7. Physical symptoms like tenderness or swelling of breasts, muscle or joint pains, bloating, or weight gain.

      D. The symptoms are linked with clinically significant distress or change in occupation, social, or other important areas of functioning.

E. The disturbance is not just due to symptoms of other disorders, like major depressive disorder, panic disorder, Dysthymia, or a personality disorder (although it may coexist with any of these disorders.)

F. Criterion A should be confirmed by daily observations during at least two symptomatic cycles, excluding other medical explanations.

G. The depressive episode is not characterized by the physiological impacts of a substance or other medical condition.

  • Substance//Medication-Induced Depressive Disorder
  1. A significant and persistent disturbance in mood that predominates in the clinical setup and is attributed to depressed mood or notably the loss of interest or pleasure in all, or almost all activities.
  2. There is evidence from history, physical examination, or laboratory findings of the following: 1) the symptoms in criterion A developed during or soon after substance intoxication or withdrawal or after medicine exposure; 2) the involved medication/substance is capable of inducing the symptoms in criterion A.
  3. The disturbance is not better explained by a depressive disorder that is not substance-induced. Such evidence of independent depressive disorder include the following: 1) the symptoms preceded the start of the medicine/substance use; the symptoms stay for a significant period after the cessation of acute withdrawal or intense intoxication, or there is proof suggesting the occurrence of an independent non-substance/medication-induced depressive disorder (e.g., a history of recurring non-substance/medication-related episodes).
  4.  The condition does not exist exclusively during delirium.
  5. The symptoms result in clinically significant worry or change in occupation, social, or other important areas of functioning.
  • Depressive disorder due to other medical condition

Examination of whether another medical condition along a depressive disorder is causing the disorder is dependent on 

a) the absence of an episode(s) of depressive episodes prior to the onset of the medical condition,

 b) the chance that the linked medical condition has the potential to induce or cause a depressive disorder, and 

c) a course of the depressive symptoms soon after the initiation or worsening of the medical condition, especially if the depressive symptoms occur near the time that the medical disorder is effectively treated or remits.

  • Other Specified Depressive Disorder

The other specified depressive disorder category is employed in circumstances in which the clinician opts to communicate the specific reason/ causes that the presented issue does not meet the criteria for any specific depressive disorder.

  • Unspecified Depressive Disorder

According to DSM 5, DD-NOS or Unspecified depressive disorder includes “any depressive disorder that does not meet the criteria for a specific disorder.” Examples in this disorder category include minor depressive disorder or brief recurrent depression.

Conclusion

This comprehensive guide provided the details of the most significant DSM depression disorders and the diagnostic criteria for each disorder.

Depression disorders, according to the DSM 5 are a period of at least two weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified symptoms, such as problems with sleep, eating, energy, concentration, or self-worth.

Do you have any of the DSM-5 depression disorders, let us know how you manage your condition.

Frequently Asked Questions (FAQs): DSM 5 Depression

What is the DSM 5 definition of depression?

The clinical definition of depression, according to the fifth edition of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), is “a period of at least two weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified symptoms, such as problems with sleep, eating, energy, concentration, or self-worth.”

What is the new depressive disorder diagnosis in the DSM 5?

DSM-5 includes some new depressive disorders, namely premenstrual dysphoric disorder and disruptive mood dysregulation disorder.

How many categories of depression does the DSM 5 recognize?

There are now eight specific disorders mentioned in the depressive disorders chapter of DSM 5. These categories are listed below:

  • Major Depressive Disorder
  • Disruptive mood Dysregulation Disorder
  • Persistent Depressive Disorder (Dysthymia)
  • Premenstrual Dysphoric Disorder 
  • Substance//Medication-induced Depressive disorder
  • Depressive disorder due to other medical condition
  • Other specified depressive disorder
  • Unspecified depressive disorder

What are the DSM IV criteria for depression?

DSM IV criteria for depression include depressed mood throughout or most part of the day, for at least two years with the existence of two or more of the following symptoms that can cause a clinically prominent change in work, social, or other important aspects of functioning:

  1. Lack of appetite or overeating.
  2. Insomnia or hypersomnia
  3. Fatigue or lack of energy
  4. Worthlessness or excessive guilt
  5. Recurring death thoughts
  6. Loss of interest or pleasure in most activities
  7. The depressed mood throughout the day
  8. Unintentional weight gain or loss.
  9. Agitation or psychomotor retardation is experienced by others.

Citations

https://www.psycom.net/depression-definition-dsm-5-diagnostic-criteria/

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). Arlington, VA: American Psychiatric Publishing; 2013.

Leave a Comment