Exam 5: Depressive Disorders

Which of the following cities would be expected to have the lowest prevalence of recurrent major depressive disorder with a seasonal pattern?

Kevin Stover is a 14 year-old boy who was referred to the school social worker for problems focusing on his studies. Kevin admits to difficulties concentrating and confides that he has been feeling "down" all the time for the past school year. He remembers the only time this feeling went away was, "only for a coupla weeks last summer when I went to visit my Uncle Mark. He's really cool. But then that down feeling came back as soon as I got home," states Kevin. He denies any suicidal thoughts but admits to feelings of hopelessness, and low self-esteem. What is the most likely diagnosis for Kevin?

Of the following features, what differentiates disruptive mood dysregulation disorder from bipolar disorder in children?

Vegetative features are not important to consider as part of the competency-based assessment of mood disorders.

Match each term with the appropriate definition: Term: Definition: a) Depressive disorders \_\_\_ Relatively low-grade, but chronic depression often lasting for years b) Persistent depressive \_\_\_ Use of substances of abuse and several medical disorder (dysthymia) conditions associated with depression-like phenomena c) Disruptive mood \_\_\_ Symptoms for this disorder must be a dysregulation disorder depressed mood present for most of the day in addition to being present nearly ev ery day d) Mixed episode \_\_\_ Refers to the presence of sadness, emptiness or irritable mood accompanied by somatic and cognitive changes significantly affecting functioning e) Substance/medication- induced depressive disorder \_\_\_ At least 3 of a combination of manic and depressive symptoms present during the majority of days of a major depressive episode f) Major depressive disorder \_\_\_ Refers to the presentation in children with persistent irritability and frequent episodes of extreme behavioral dyscontrol $\quad$

Scott Manhattan has been prescribed an anti-depressant medication. His physician, Dr. Andre Hitchcock, instructs him to avoid tyramine rich foods such as aged cheeses, organ meats, red wine, canned figs, and beer while he is on the medication. Scott is most likely taking:

George Langwasser is a 45 year-old gentleman whose case history describes classic features of schizophrenia but the social worker notices in his chart that he has always experienced co-occurring symptoms of depression - that is, feeling "down in the dumps," poor appetite, feelings of hopelessness and insomnia - during his episodes of active psychosis and only during the 2-year period of the active symptoms of schizophrenia. Currently, his psychotic episodes are successfully controlled by medication and his chart reflects no further symptoms of depression. In fact, Mr. Langwasser has never met full diagnostic criteria for major depressive disorder at any time. Should his diagnosis of schizophrenia be changed?

Claire Gilliam is a 23 year-old single young woman who makes an appointment with her internist complaining that lately she has been experiencing "crying jags" for no apparent reason. She adds, "I feel like I'm living in a fog. You know, there but not really." Claire also reports fatigue, and a loss of interest in just about everything. She has a poor appetite, and has begun to lose weight. Overall, Claire feels irritable and overwhelmed. She is concerned about her work performance since she's finding it harder and harder to concentrate. Further, her boyfriend is started to complain about their relationship. Reluctantly, Claire admits to a loss of interest in sex. She has never been nor is currently) pregnant. Her physician suggested blood work and the test confirmed 12.hyperthyroidism. Claire was referred to an endocrinologist who put her on the beta-blocker Toprol XL as well as Tapazole, an anti-thyroid medication that prevents the thyroid gland from over-producing thyroid hormone. What is the most likely diagnosis for Claire?

In order to meet the diagnostic criteria for a major depressive mood disorder, the symptoms must be present for at least a one-week period of time.

Premenstrual dysphoric disorder PMDD) is included in the DSM-5 but the name of the diagnosis has been changed from how it was listed in the DSM-IV-TR.

This disorder was previously called "depressive neurosis" and considered less severe than major depressive disorder. The onset is insidious and occurs more often in persons who have a history of long-term stress. Symptoms should include at least two of the following: poor appetite or overeating, sleep problems, fatigue, low self-esteem, difficulty concentrating and/or feeling hopeless. This disorder often coexists with other psychiatric disorders, e.g., substance abuse, personality disorders, and obsessive compulsive disorder. What is the most likely diagnosis?

One major complication commonly associated with persons who are clinically depressed is the presence of suicidal ideation.

Complications with major depression typically center on interpersonal difficulties related to employment, relationships with others, marital discord, and/or substance abuse.

Jeff Coggins is a 12 year-old youngster who has always been seen by his teachers as "hard to manage." Recently, he started to have new episodes of temper outbursts that are clearly out of proportion to the situation. Which of the following diagnoses is not a possibility?

The diagnostic criteria for a major depressive disorder includes all of the following except:

Disruptive mood dysregulation disorder, premenstrual dysphoric disorder, and persistent depressive disorder dysthymia) are new depressive disorder diagnoses in the DSM-5.

Children with disruptive mood dysregulation disorder often meet criteria for oppositional defiant disorder.

According to the DSM-5 criteria for a major depressive episode, feelings of worthlessness and self-loathing are common in grief, but self-esteem is generally preserved.

Danny Flynn is a 6 and a half year-old boy who lives with his parents, and younger sister. Mrs. Flynn began, "To look at my Danny, you would never know why we brought him to the mental health clinic. He looks like an angel… those greenish-blue eyes, and that curly blonde hair of his. But to live with him, he's more like the devil reincarnated. Don't get me wrong. I love my son but the problems we're having with him are just not normal." The reason the Laughlin's are seeking counseling is for John's history of severe temper outbursts, both verbal and behavioral, and usually when "things don't go his way" which is just about all the time. "And when he's not having a tantrum, Danny is just plain old angry," adds Mr. Flynn. Danny's most likely diagnosis is: