Tratornos del estado de nimo

criterios de clasificacin
Trastornos depresivos
depresivo mayor
The patient has one Major Depressive Episode
Schizoaffective disorder doesn't explain the
episode better, and it isn't superimposed on
Schizophrenia, Schizophreniform Disorder,
Delusional Disorder or Psychotic Disorder Not
Otherwise Specified.
If the patient has ever had Manic, Mixed or
Hypomanic Episodes, all were directly
precipitated by substance use or by
antidepressant therapy, such as with ECT,
medication or bright light.
distmico
On the majority of days for 2 years or
more, the patient reports depressed mood
or appears depressed to others for most
of the day.
When depressed, the patient has 2 or
more of:
-Appetite decreased or increased
-Sleep decreased or increased
-Fatigue or low energy

distmico. Continue.
-Poor self-image
-Reduced concentration or indecisiveness
-Feels hopeless
During this 2 year period, the above
symptoms are never absent longer than 2
consecutive months.
During the first 2 years of this syndrome,
the patient has not had a Major
Depressive Episode.

distmico. Continue.
The patient has had no Manic,
Hypomanic or Mixed Episodes.
The patient has never fulfilled criteria for
Cyclothymic Disorder.
The disorder does not exist solely in the
context of a chronic psychosis (such as
Schizophrenia or Delusional Disorder) .
The symptoms are not directly caused by
a general medical condition or the use of
distmico. Continue.
substances, including prescription
medications.
The symptoms cause clinically important
distress or impair work, social or personal
functioning.

depresivo mayor recurrente
The patient has had at least two Major
Depressive Episodes.
Schizoaffective disorder doesn't explain the
above episodes better, and they aren't
superimposed on Schizophrenia,
Schizophreniform Disorder, Delusional
Disorder or Psychotic Disorder Not Otherwise
Specified.
If the patient has ever had Manic, Mixed or
depresivo mayor recurrente.
Continue.
Hypomanic Episodes, all were precipitated by
substance use or by antidepressant therapy,
such as with ECT, medication or bright light.

trastornos bipolares
bipolar I
con un solo episodio manaco
con episodio manaco reciente
con episodio hipomanaco reciente
con episodio reciente mixto
con episodio depresivo reciente
con episodio reciente no indentificado
con un solo episodio manaco
The patient has had just one Manic Episode
(page 166) and no Major Depressive Episodes
(page 160).
Schizoaffective disorder doesn't explain the
Manic Episode better, and it isn't superimposed
on Schizophrenia, Schizophreniform Disorder,
Delusional Disorder or Psychotic Disorder Not
Otherwise Specified.

con episodio manaco reciente
The patient's most recent episode is of mania.
The patient has had at least one Major
Depressive (page 162), Manic (page 167) or
Mixed Episode (page 168).
Schizoaffective disorder doesn't explain the
above episodes better, and they aren't
superimposed on Schizophrenia,
Schizophreniform Disorder, Delusional
Disorder or Psychotic Disorder Not Otherwise
con episodio manaco reciente.
Continue.
Specified.

con episodio hipomanaco reciente
The patient's most recent episode is hypomanic.
The patient has previously had one or more Manic or
Mixed Episodes.
The symptoms cause clinically important distress or
impair work, social or personal functioning.
Schizoaffective disorder doesn't explain the above
episodes better, and they aren't superimposed on
Schizophrenia, Schizophreniform Disorder, Delusional
Disorder or Psychotic Disorder Not Otherwise
Specified.

con episodio reciente mixto
The patient's most recent episode is of mixed
mania and depression.
The patient has had at least one Major
Depressive, Manic or Mixed Episode.
Schizoaffective disorder doesn't explain the
above episodes better, and they aren't
superimposed on Schizophrenia,
Schizophreniform Disorder, Delusional
Disorder or Psychotic Disorder Not Otherwise
con episodio reciente mixto.
Continue.
Specified.

con episodio depresivo reciente
The patient's most recent episode is Major Depressive.
The patient has had at least one previous Manic or
Mixed Episode.
Schizoaffective disorder doesn't explain the above
episodes better, and they aren't superimposed on
Schizophrenia, Schizophreniform Disorder, Delusional
Disorder or Psychotic Disorder Not Otherwise
Specified.

con episodio reciente no
indentificado
Other than duration, the patient currently or recently
meets criteria for Major Depressive, Manic, Mixed, or
Hypomanic episode.
The patient has had at least one previous Manic or
Mixed episode.
These symptoms cause clinically important distress or
impair work, social or personal functioning.
Schizoaffective disorder doesn't explain the above
episodes better, and they aren't superimposed on
Schizophrenia, Schizophreniform Disorder, Delusional
con episodio reciente no
indentificado. Continue.
Disorder or Psychotic Disorder Not Otherwise
Specified.
The symptoms are not directly caused by a
general medical condition or the use of
substances, including prescription medications.

bipolar II
The patient has had at least one Major
Depressive Episode.
The patient has had at least one Hypomanic
Episode.
There have been no Manic or Mixed episodes.
Schizoaffective disorder doesn't explain the
above episodes better, and they aren't
superimposed on Schizophrenia,
Schizophreniform Disorder, Delusional Disorder
or Psychotic Disorder Not Otherwise Specified.

bipolar II. Continue.
These symptoms cause clinically
important distress or impair work, social
or personal functioning.
ciclotmico
For at least 2 years,* the patient has had
many periods of hypomanic symptoms
and many periods of low mood that don't
fulfill criteria for Major Depressive
Disorder.
The longest the patient has been free of
mood swings during this period is 2
months.
During the first 2 years of this disorder, a
ciclotmico. Continue.
the patient has not fulfilled criteria for
Manic, Mixed, or Major Depressive
Episode.
Schizoaffective disorder doesn't
explain the disorder better, and it isn't
superimposed on Schizophrenia,
Schizophreniform Disorder,
Delusional Disorder or Psychotic
Disorder Not Otherwise Specified.

ciclotmico. Continue.
The symptoms are not directly caused by
general medical condition or the use of
substances, including prescription
medications.
These symptoms cause clinically
important distress or impair work, social
or personal functioning
trastorno del estado de nimo
debido a enfermedad fsica
The patient's clinical presentation is dominated
by a mood disorder that persists and is
characterized by either or both of:
-Depressed mood or markedly decreased
interest or pleasure in nearly all activities, or
-Mood that is elevated, expansive or irritable.
History, physical exam or laboratory findings
suggest a general medical condition that seems
likely to have directly caused these symptoms.
No other mental disorder (such as Adjustment
trastorno del estado de nimo
debido a enfermedad fsica.
Continue.
Disorder secondary to having a medical
disorder) better accounts for these
symptoms.
The symptoms don't occur solely during a
delirium.
These symptoms cause clinically
important distress or impair work, social
or personal functioning.

criterios generales
episodio depresivo mayor
In the same 2 weeks, the patient has had 5 or
more of the following symptoms, which are a
definite change from usual functioning. Either
depressed mood or decreased interest or
pleasure must be one of the five.
-Mood. For most of nearly every day, the
patient reports depressed mood or appears
depressed to others.
-Interests. For most of nearly every day, interest
episodio depresivo mayor.
Continue.
or pleasure is markedly decreased in nearly all
activities (noted by the patient or by others).
-Eating and weight. Although not dieting, there
is a marked loss or gain of weight (such as five
percent in one month) or appetite is markedly
decreased or increased nearly every day.
-Sleep. Nearly every day the patient sleeps
excessively or not enough.
-Motor activity. Nearly every day others can see
episodio depresivo mayor.
Continue.
that the patient's activity is agitated or retarded.
-Fatigue. Nearly every day there is fatigue or
loss of energy.
-Self-worth. Nearly every day the patient feels
worthless or inappropriately guilty. These
feelings are not just about being sick; they may
be delusional.
-Concentration. Noted by the patient or by
others, nearly every day the patient is indecisive
episodio depresivo mayor.
Continue.
or has trouble thinking or concentrating.
-Death. The patient has had repeated thoughts
about death (other than the fear of dying),
suicide (with or without a plan) or has made a
suicide attempt.
These symptoms cause clinically important
distress or impair work, social or personal
functioning.
They don't fulfill criteria for Mixed Episode
episodio depresivo mayor.
Continue.
(page 168).
This disorder is not directly caused by a general
medical condition or the use of substances,
including prescription medications.
Unless the symptoms are severe (defined as
severely impaired functioning, severe
preoccupation with worthlessness, ideas of
suicide, delusions or hallucinations or
psychomotor retardation), the episode has not
episodio depresivo mayor.
Continue.
begun within two months of the loss of a loved
one.

episodio manaco
For at least one week (or less, if hospitalized)
the patient's mood is abnormally and
persistently high, irritable or expansive.
To a material degree during this time, the
patient has persistently had 3 or more of these
symptoms (4 if the only abnormality of mood is
irritability):
-Grandiosity or exaggerated self-esteem
-Reduced need for sleep

episodio manaco. Continue.
-Increased talkativeness
-Flight of ideas or racing thoughts
-Easy distractibility
-Psychomotor agitation or increased goal-
directed activity (social, sexual, work or school)
-Poor judgment (as shown by spending sprees,
sexual adventures, foolish investments)
Symptom severity results in at least 1 of:
-causes material distress

episodio manaco. Continue.
-causes psychotic features
-requires hospitalization to protect the patient
or others
-impairs work, social or personal functioning.
The symptoms don't fulfill criteria for Mixed
Episode.
They are not directly caused by a general
medical condition or the use of substances,
including prescription medications.

episodio mixto
The patient has fulfilled symptom criteria for both
Major Depressive and Manic Episodes nearly every
day for a week or more.
The symptoms are severe enough that they (one or
more of):
-Include psychotic features
-Require hospitalization to protect the patient or
others
-Impair work, social or personal functioning
They are not directly caused by a general medical
episodio mixto. Continue.
condition or the use of substances, including
prescription medications.

episodio hipomanaco
For at least 4 days the patient has a distinct, sustained
mood that is elevated, expansive or irritable. This is
different from the patient's usual nondepressed mood.
During this time, the patient has persistently had 3 or
more of the following symptoms (4 if the only
abnormality of mood is irritability). They have been
present to an important degree.
-Grandiosity or exaggerated self-esteem
-Reduced need for sleep
-Increased talkativeness

episodio hipomanaco. Continue.
-Flight of ideas or racing thoughts
-Easy distractibility
-Psychomotor agitation or increased goal-
directed activity (social, sexual, work or school)
-Poor judgment (as shown by spending sprees,
sexual adventures, foolish investments)
The patient has no features of psychosis
(delusions, hallucinations, bizarre behavior or
speech).

episodio hipomanaco. Continue.
These symptoms represent a distinct change
from the patient's usual functioning.
Other people can notice the change in mood
and functioning.
The episode does not require hospitalization or
markedly impair work, social or personal
functioning.
The symptoms are not directly caused by a
general medical condition or the use of
episodio hipomanaco. Continue.
substances, including prescription medications.
curso reciente
atpicos
catatnico
melanclico
postparto
atpicos
For the most recent 2 weeks or more of a
Major Depressive Episode or predominating
during the most recent 2 years of Dysthymic
Disorder:
The patient experiences mood reactivity, with
improved mood when something good happens
or seems about to happen (e.g., presence of
friends).
At least 2 of the following:

atpicos. Continue.
-Material increase in appetite or weight
-Excessive sleeping
-Arms or legs feel heavy, leaden
Work or interpersonal relations are impaired by
sensitivity to rejection that is long-standing and
not limited to periods of depression.
During the same episode, the patient does not
qualify for With Melancholic Features or With
Catatonic Features.
catatnico
Two or more of the following dominate the clinical
picture:
-Immobility (catalepsy or waxy flexibility) or stupor
-Apparently purposeless hyperactivity not influenced
by external stimuli
-Mutism or extreme negativism
-Prominent posturing, stereotypies, mannerisms, or
grimacing
-Echolalia (repeating words or phrases someone else
has just said) or echopraxia (mimicking another's
catatnico. Continue.
gestures)

melanclico
When symptoms of a Major Depressive Episode are
most severe, the patient has either or both of:
-Loses pleasure in nearly all activities
-Feels no better when something good happens (when
in the company of friends; when given a raise)
The patient has 3 or more of the following:
-Perceives the depressed mood as different from what
would be experienced at the death of a relative
-Diurnal variation of mood in which the depression is
consistently worse in the mornings

melanclico. Continue.
-Terminal insomnia, awakening at least 2 hours
early
-Marked agitation or psychomotor retardation
-Marked loss of appetite or weight
-Guilt feelings that have been inappropriate or
excessive

postparto
An episode of the disorder begins within four
weeks after childbirth.

curso longitudinal de episodios
recientes
sin recuperacin plena
con cliclo rpido
con patrn estacional
con cliclo rpido
In the past year there have been four or more
episodes that meet criteria for Major Depressive
Episode, Manic Episode, Mixed Episode, or
Hypomanic Episode. The boundaries of these
episodes are indicated by a switch between high
and low or by a period of remission.

con patrn estacional
Major Depressive Episodes regularly begins at a
particular season of the year.
Complete recovery or change of polarity also occurs
regularly during a particular season.
These seasonal changes have occurred in each of the
previous two years, during which no other nonseasonal
Major Depressive Episodes have occurred.
Over the patient's lifetime, seasonal Major Depressive
Episodes materially outnumber nonseasonal episodes.

trastorno del estado de nimo
inducido por sustancias
The patient's clinical presentation is dominated
by a mood disorder that persists and is
characterized by either or both
-Depressed mood or markedly decreased
interest or pleasure in nearly all activities, or
-Mood that is elevated, expansive or irritable.
History, physical exam or laboratory data
substantiate that either
-These symptoms have developed within a
month of Substance Intoxication or Withdrawal,
trastorno del estado de nimo
inducido por sustancias.
Continue.
or
-Medication use has caused the
symptoms
The symptoms cause clinically important
distress or impair work, social or personal
functioning.
This disorder does not occur solely during
a delirium.
A nonsubstance-induced mood disorder
trastorno del estado de nimo
inducido por sustancias.
Continue.
does not better explain the symptoms.*