Mood Disorders - Depressed or Elevated Moods - Differential Diagnosis Algorithm

Major Depressive Disorder

 • 2 week period, depressed mood nearly everyday

Persistent Depressive Disorder

 • Depressed mood more days than not for > 2 years

Adjustment Disorder with Depressed Mood

 • Depressed mood in context of specific stressor < 6 months

Bereavement

 • Depressed mood in context of personal loss < 2 months

Bipolar I

• Manic Episode (may have hx > 1 MDE)

• MANIA: 1 week elevated or irritable mood PLUS 3 or more:

   1) Grandiosity

   2) Decreased sleep

   3) Pressure of speech

   4) Flight of ideas

   5) Distractibility

   6) Increase in goal directed activity

   7) Excessive pleasureable but harmful activities

Bipolar II

 • Hypomanic Episode (must have hx of >1 MDE)

 • HYPOMANIA: No marked impairment, no psychosis, no hospitalization. At least 4 days. PLUS 3 or more

Cyclothymia

 • Symptoms without clear mood episode

 • 2 Years Hypomanic Episodes and Depressed Mood



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