Major Depressive Disorder

El el DSM-IV-TR, todos los Mood Disorders estaban juntos, ahora hay una sección única de depression

Cambios en Criteria:

Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or
hallucinations

Criterion B: The symptoms do not meet criteria for a Mixed Episode

DSM-V: “with mixed features”

Note: Criteria A-C represent a major depressive episode

Bereavement Exclusion

En el DSM-IV, se excluía al duelo menor a dos meses después de la muerte de un ser querido. Esto fue
quitado en el DSM-V porque los síntomas de duelo duran más, y porque el duelo puede ser la causa de un
episodio de depression mayor.

Note: Responses to a significant loss (e.g., bereavement, financial ruin, losses from a natural
disaster, a serious medical illness or disability) may include the feelings of intense sadness,
rumination about the loss, insomnia, poor appetite, and weight loss noted in Criterion A,
which may resemble a depressive episode. Although such symptoms may be understandable
or considered appropriate to the loss, the presence of a major depressive episode in
addition to the normal response to a significant loss should also be carefully considered. This
decision inevitably requires the exercise of clinical judgment based on the individual's history
and the cultural norms for the expression of distress in the context of loss.

DSM IV-TR
Criterion E. The symptoms are not better accounted for by Bereavement, i.e. after the loss of a loved one, the
symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid
preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

Grief
Predominant emptiness and loss
Dysphoria decreases in intensity over days or weeks.
Occurs in waves associated with thoughts of the deceased
Pain accompanied by positive emotions and humor
Thoughts related to preoccupation, thoughts and
memories of the deceased
Self-esteem preserved
Derogatory ideation about failings with the deceased
Thoughts about death and dying are focused on the
deceased (joining him/her)
MDE
Predominant depressed mood and inability to anticipate
happiness or pleasure
Dysphoria is persistent, not tied with specific thought or
preoccupations
Pervasive unhappiness and misery
Self-critical or pessimistic ruminations
Feelings of worthlessness and self-loathing
Derogatory ideation in general
Thoughts about death and dying are focused on ending
one’s life because of feeling worthless, undeserving of
life, or unable to cope with the pain of depression

DSM-V
D. The occurrence of the major depressive episode is not better explained by schizoaffective
disorder, schizophrenia, schizophreniform disorder, delusional disorder, or
other specified and unspecified schizophrenia spectrum and other psychotic disorders.
E. There has never been a manic episode or a hypomanic episode.
Note: This exclusion does not apply if all of the manic-like or hypomanic-like episodes
are substance-induced or are attributable to the physiological effects of another medical
condition.
Mixed features: p. 227 (184)