Major depressive disorder differential diagnosis: Difference between revisions
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{{Major depressive disorder}} | {{Major depressive disorder}} | ||
{{CMG}}; {{Mitra}} | {{CMG}}; {{AE}} {{Mitra}} | ||
==Overview== | ==Overview== | ||
[[Major depressive disorder]] must be differentiated from other causes of depressive symptoms. | [[Major depressive disorder]] must be differentiated from other causes of [[depressive symptoms]]. | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Major depressive disorder]] is characterized by one or more episodes of | *[[Major depressive disorder]] is characterized by one or more episodes of [[depressed mood]] or diminished interest or pleasure ([[anhedonia]]) that last at least 2 weeks and are accompanied by 4 or more of the characteristic associated [[symptoms]] (including changes in [[sleep]], [[appetite]], or activity level); energy loss and [[fatigue]]; difficulty concentrating; excessive [[guilt]] or feelings of [[worthlessness]]; [[suicidal ideation]] or suicidal behavior). <ref>{{cite book | last = LastName | first = FirstName | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association,American Psychiatric Association | location = Arlington, VA Washington, D.C | year = 2013 | isbn = 978-0-89042-554-1 }}</ref> | ||
*Major depressive disorder must be differentiated from other causes of depressive symptoms: <ref>{{cite book | last = LastName | first = FirstName | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association,American Psychiatric Association | location = Arlington, VA Washington, D.C | year = 2013 | isbn = 978-0-89042-554-1 }}</ref> <ref>{{cite book | last = First | first = Michael | title = DSM-5 handbook of differential diagnosis | publisher = American Psychiatric Publishing, a division of American Psychiatric Association | location = Washington, DC | year = 2014 | isbn = 9781585624621 }}</ref> | *[[Major depressive disorder]] must be differentiated from other causes of [[depressive symptoms]]: <ref>{{cite book | last = LastName | first = FirstName | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association,American Psychiatric Association | location = Arlington, VA Washington, D.C | year = 2013 | isbn = 978-0-89042-554-1 }}</ref> <ref>{{cite book | last = First | first = Michael | title = DSM-5 handbook of differential diagnosis | publisher = American Psychiatric Publishing, a division of American Psychiatric Association | location = Washington, DC | year = 2014 | isbn = 9781585624621 }}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
| colspan="2" align="center" style="background: #4479BA; color: #FFFFFF " |'''Differential diagnosis for Major Depressive Disorder''' | | colspan="2" align="center" style="background: #4479BA; color: #FFFFFF " |'''Differential diagnosis for [[Major Depressive Disorder]]''' | ||
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| align="center" |'''Depressive disorder''' | | align="center" |'''Depressive disorder''' | ||
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*One or more [[manic]] or [[hypomanic]] episodes are required for diagnosis. | *One or more [[manic]] or [[hypomanic]] episodes are required for diagnosis. | ||
*If [[manic]] or [[hypomanic]] episodes have ever been present, the patient cannot be diagnosed with [[major depressive disorder]]. | *If [[manic]] or [[hypomanic]] episodes have ever been present, the patient cannot be diagnosed with [[major depressive disorder]]. | ||
*If patients with major depressive symptoms have some manic or hypomanic symptoms that are not enough for diagnosis of mania and hypomania episode (i.e. fewer symptoms or shorter duration), they are specified as "major depressive disorder with mixed features". | *If patients with major depressive symptoms have some [[manic]] or [[hypomanic]] [[symptoms]] that are not enough for diagnosis of [[mania]] and [[hypomania]] episode (i.e. fewer symptoms or shorter duration), they are specified as "[[major depressive disorder with mixed features]]". | ||
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*Diagnosis of Depressive disorder due to another medical condition requires the presence of a medical condition as the etiology of depressive symptoms. | *Diagnosis of Depressive disorder due to another medical condition requires the presence of a medical condition as the etiology of depressive symptoms. | ||
*In Fact, | *In Fact, [[major depressive disorder]] is not diagnosed if depressive symptoms are due to the direct physiologic effects of a medical condition. | ||
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|'''[[Substance/medication-induced depressive disorder]]''' | |'''[[Substance/medication-induced depressive disorder]]''' | ||
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*Substance/medication-induced depressive disorder is diagnosed when depressive symptoms are due to direct physiologic effects of a substance or medication. | *[[Substance/medication-induced depressive disorder]] is diagnosed when depressive symptoms are due to direct physiologic effects of a [[substance]] or [[medication]]. | ||
*In Fact, a diagnosis of | *In Fact, a diagnosis of [[major depressive disorder]] cannot be made when depressive symptoms are due to the direct physiologic effects of a [[substance]] or [[medication]]. | ||
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|'''[[Persistent depressive disorder]] ([[Dysthymia]])''' | |'''[[Persistent depressive disorder]] ([[Dysthymia]])''' | ||
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*Persistent depressive disorder is characterized by a depressed mood, on most days, for at least 2 years. | *[[Persistent depressive disorder]] is characterized by a depressed mood, on most days, for at least 2 years. | ||
*Of note, a patient can be diagnosed with both | *Of note, a patient can be diagnosed with both [[major depressive disorder]] and [[persistent depressive disorder]] if the diagnostic criteria are met for both disorders. | ||
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|'''[[Premenestrual dysphoric disorder]]''' | |'''[[Premenestrual dysphoric disorder]]''' | ||
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*[[Premenstrual dysphoric disorder]] is characterized by the presence of dysphoric mood in the few days before the onset of menses that improves within a few days after the onset of menses. | *[[Premenstrual dysphoric disorder]] is characterized by the presence of [[dysphoric mood]] in the few days before the onset of menses that improves within a few days after the onset of [[menses]]. | ||
*In contrast, no temporal connection is present between the depressive symptoms in | *In contrast, no temporal connection is present between the depressive symptoms in [[major depressive disorder]] and the [[menstrual cycles]]. | ||
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|'''[[Disruptive mood dysregulation disorder]]''' | |'''[[Disruptive mood dysregulation disorder]]''' | ||
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*Disruptive mood dysregulation disorder is characterized by severe, recurrent temper outbursts (verbally and/or behaviorally). In between the outbursts, persistently irritable or angry mood, most of the day, almost every day, is present. | *[[Disruptive mood dysregulation disorder]] is characterized by severe, recurrent [[temper outbursts]] (verbally and/or behaviorally). In between the outbursts, persistently [[irritable]] or angry mood, most of the day, almost every day, is present. | ||
*In contrast, in major depressive disorder, irritability is present only during depressive episodes. | *In contrast, in [[major depressive disorder]], [[irritability]] is present only during depressive episodes. | ||
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|'''[[Schizoaffective disorder]]''' | |'''[[Schizoaffective disorder]]''' | ||
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*[[Schizoaffective disorder]]is characterized by major depressive episodes with concurrent active-phase symptoms of schizophrenia, AND presence of hallucinations or delusions for two or more weeks in the absence of a major mood episode, AND major depressive episodes are present for the majority of the total duration of illness. | *[[Schizoaffective disorder]]is characterized by major depressive episodes with concurrent active-phase symptoms of [[schizophrenia]], AND presence of [[hallucinations]] or [[delusions]] for two or more weeks in the absence of a major mood episode, AND [[major depressive episodes]] are present for the majority of the total duration of illness. | ||
*If psychotic symptoms are present exclusively during major depressive episodes, the diagnosis of "Major depressive disorder with psychotic features" is made. | *If [[psychotic symptoms]] are present exclusively during [[major depressive episodes]], the diagnosis of "[[Major depressive disorder with psychotic features]]" is made. | ||
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|'''[[Adjustment disorder with depressed mood]]''' | |'''[[Adjustment disorder with depressed mood]]''' | ||
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*It is characterized by depressive symptoms occurring within 3 months of an identifiable psychological stressor that last <6 months after the stressor has ended. | *It is characterized by [[depressive symptoms]] occurring within 3 months of an identifiable psychological stressor that last <6 months after the stressor has ended. | ||
* Symptoms should not meet the criteria for a major depressive episode. | * Symptoms should not meet the criteria for a [[major depressive episode]]. | ||
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|'''[[Bereavement]]''' | |'''[[Bereavement]]''' | ||
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*Bereavement occurs in response to the loss of a loved one. The symptoms are generally milder than a major depressive episode. Feelings of emptiness and loss are the predominant | *Bereavement occurs in response to the loss of a loved one. The [[symptoms]] are generally milder than a [[major depressive episode]]. Feelings of emptiness and loss are the predominant affective symptoms in [[bereavement]], in contrast to depressed mood and inability to experience pleasure (anhedonia) in [[major depressive episodes]]. | ||
*The dysphoric mood in grief usually decreases in intensity over days to weeks, occurs in wanes, and | *The [[dysphoric mood]] in grief usually decreases in intensity over days to weeks, occurs in wanes, and tends to be associated with thoughts and reminders of the deceased, whereas the [[depressed mood]] in [[major depressive episode]] that is more persistent and not related to particular thoughts or preoccupations. | ||
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|'''[[Sadness]]''' | |'''[[Sadness]]''' | ||
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*Nonpathological periods of sadness are characterized by the short duration of few depressive symptoms that are not associated with significant functional impairment or distress. | *Nonpathological periods of sadness are characterized by the short duration of few [[depressive symptoms]] that are not associated with significant functional impairment or distress. | ||
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Revision as of 09:35, 25 May 2021
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Major depressive disorder Microchapters |
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Differentiating Major depressive disorder from other Diseases |
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Diagnosis |
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Treatment |
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Follow-up |
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Case Studies |
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Major depressive disorder differential diagnosis On the Web |
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American Roentgen Ray Society Images of Major depressive disorder differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mitra Chitsazan, M.D.[2]
Overview
Major depressive disorder must be differentiated from other causes of depressive symptoms.
Differential Diagnosis
- Major depressive disorder is characterized by one or more episodes of depressed mood or diminished interest or pleasure (anhedonia) that last at least 2 weeks and are accompanied by 4 or more of the characteristic associated symptoms (including changes in sleep, appetite, or activity level); energy loss and fatigue; difficulty concentrating; excessive guilt or feelings of worthlessness; suicidal ideation or suicidal behavior). [1]
- Major depressive disorder must be differentiated from other causes of depressive symptoms: [2] [3]
| Differential diagnosis for Major Depressive Disorder | |
| Depressive disorder | Distinguishing feature from Major depressive Disorder |
| Bipolar I or Bipolar II disorder |
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| Depressive disorder due to another medical condition |
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| Substance/medication-induced depressive disorder |
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| Persistent depressive disorder (Dysthymia) |
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| Premenestrual dysphoric disorder |
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| Disruptive mood dysregulation disorder |
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| Schizoaffective disorder |
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| Adjustment disorder with depressed mood |
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| Bereavement |
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| Sadness |
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References
- ↑ LastName, FirstName (2013). Diagnostic and statistical manual of mental disorders : DSM-5. Arlington, VA Washington, D.C: American Psychiatric Association,American Psychiatric Association. ISBN 978-0-89042-554-1.
- ↑ LastName, FirstName (2013). Diagnostic and statistical manual of mental disorders : DSM-5. Arlington, VA Washington, D.C: American Psychiatric Association,American Psychiatric Association. ISBN 978-0-89042-554-1.
- ↑ First, Michael (2014). DSM-5 handbook of differential diagnosis. Washington, DC: American Psychiatric Publishing, a division of American Psychiatric Association. ISBN 9781585624621.