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Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun.
| Criteria1 | DSM-IV | DSM-52 |
|---|---|---|
| Class: Mood Disorders | ✓ | |
| Class: Depressive Disorders | ✓ | |
| Five or more of the following A Criteria (at least one includes A1 or A2) | ✓ | ✓ |
| A1 Depressed mood—indicated by subjective report or observation by others (in children and adolescents, can be irritable mood). | ✓ | ✓ |
| A2 Loss of interest or pleasure in almost all activities—indicated by subjective report or observation by others. | ✓ | ✓ |
| A3 Significant (more than 5 percent in a month) unintentional weight loss/gain or decrease/increase in appetite (in children, failure to make expected weight gains). | ✓ | ✓ |
| A4 Sleep disturbance (insomnia or hypersomnia). | ✓ | ✓ |
| A5 Psychomotor changes (agitation or retardation) severe enough to be observable by others. | ✓ | ✓ |
| A6 Tiredness, fatigue, or low energy, or decreased efficiency with which routine tasks are completed. | ✓ | ✓ |
| A7 A sense of worthlessness or excessive, inappropriate, or delusional guilt (not merely self-reproach or guilt about being sick). | ✓ | ✓ |
| A8 Impaired ability to think, concentrate, or make decisions—indicated by subjective report or observation by others. | ✓ | ✓ |
| A9 Recurrent thoughts of death (not just fear of dying), suicidal ideation, or suicide attempts. | ✓ | ✓ |
| The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. | ✓ | ✓ |
| The symptoms are not due to the direct physiological effects of a substance (e.g., drug abuse, a prescribed medication’s side effects) or a medical condition (e.g., hypothyroidism). | ✓ | ✓ |
| The symptoms do not meet criteria for a mixed episode3 | ✓ | |
| There has never been a manic episode or hypomanic episode. | ✓ | ✓ |
| MDE is not better explained by schizophrenia spectrum or other psychotic disorders. | ✓ | ✓ |
| 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).4 | ✓ |
The symptom must either be new or must have clearly worsened compared with the person’s pre-episode status and must persist most of the day, daily, for at least 2 weeks in a row. Exclude symptoms that are clearly due to a general medical condition, mood-incongruent delusions, or mood-incongruent hallucinations.
Symptom must persist most of the day, daily, for at least 2 weeks in a row, excluding A3 and A9.
A mixed episode is characterized by the symptoms of both a major depressive episode and a manic episode occurring almost daily for at least a 1-week period. This exclusion does not include episodes that are substance induced (e.g., caffeine) or the side effects of a medication.
This differentiation requires clinical judgment based on cultural norms and the individual’s history.
From: 3, DSM-5 Child Mental Disorder Classification
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