9990 · 1.2.1
Diagnostic criteria for mood (affective) disorders flashcards
Revision flashcards for Cambridge 9990 Diagnostic criteria for mood (affective) disorders (syllabus 1.2.1). Flip, recall, then mark a real past-paper question.
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DSM-5 MDD core symptoms?
Depressed mood OR anhedonia (loss of interest/pleasure) — at least one required for diagnosis.
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How many symptoms for MDD?
Five or more symptoms (including core) during the same two-week period, causing clinically significant distress or impairment.
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Anhedonia?
Markedly diminished interest or pleasure in almost all activities — core symptom distinguishing clinical depression from transient low mood.
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Depression vs normal sadness?
Sadness is proportionate and time-limited; MDD requires symptom cluster, duration (≥2 weeks), and functional impairment — not explained by bereavement alone.
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Validity issue in mood diagnosis?
Symptoms overlap with grief, physical illness, and stress — risk of **over-diagnosis** or **medicalisation** of normal emotional responses.
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Cultural bias?
Somatoform expression of distress (e.g. bodily complaints) may be missed by Western mood-focused criteria — **ethnocentrism** in classification.
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What is anhedonia?
A core symptom of major depressive disorder, referring to a markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
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What is the primary diagnostic rule for MDD in the DSM-5?
The presence of five or more of the nine specified symptoms during the same 2-week period, where at least one symptom is either depressed mood or anhedonia.
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Define 'comorbidity' in the context of clinical diagnosis.
The simultaneous presence of two or more diseases or medical conditions in a patient. For example, a person being diagnosed with both Major Depressive Disorder and Generalised Anxiety Disorder.
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What are somatic symptoms of depression?
Physical symptoms affecting the body. In MDD, these include significant changes in weight or appetite, sleep disturbance (insomnia/hypersomnia), and fatigue or loss of energy.
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What is 'inter-rater reliability' in diagnosis?
The degree of agreement among different clinicians on the diagnosis of a patient. Low inter-rater reliability is a criticism of psychiatric diagnosis, as different clinicians may arrive at different conclusions for the same patient.
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What was the 'bereavement exclusion' controversy in DSM-5?
DSM-IV excluded people who had lost a loved one within two months from an MDD diagnosis. DSM-5 removed this, arguing grief can trigger a major depressive episode. Critics argue this risks medicalising normal grief.
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What is the difference between a categorical and a dimensional approach to diagnosis?
A categorical approach (like DSM-5) places disorders into distinct categories (you either have it or you don't). A dimensional approach views symptoms on a continuum of severity, which may better reflect the reality of mental illness.
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What is the role of 'clinically significant distress or impairment' in diagnosis?
It is a crucial criterion in DSM-5. The symptoms must cause problems in social, occupational, or other important areas of functioning, or cause the individual significant emotional pain. This helps distinguish a disorder from benign, non-problematic symptoms.
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What is psychomotor retardation/agitation?
A behavioural symptom of MDD. Retardation is a visible slowing of thought and physical movement. Agitation is observable restlessness, like pacing or hand-wringing. Both must be observable by others, not just subjective feelings.