Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]
Overview
Differential Diagnosis
Manic episodes with irritable mood or mixed episodes
Substance/medication-induced depressive or bipolar disorder
Attention-deficit hyperactivity disorder
Adjustment disorder with depressed mood
Sadness
Differential diagnosis for Major Depressive Disorder
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Depressive disorder
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Distinguishing feature from Major depressive Disorder
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Bipolar I or Bipolar II disorder
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- One or more manic or hypomanic episodes are required for diagnosis.
- If manic or hypomanic episodes have ever been present, the patient cannot be diagnosed with major depressive disorder.
- If patients with major depressive symptoms have some manic or hypomanic symptoms that are not enough for diagnosis of mania and hypomania (i.e. fewer symptoms or shorter duration), they are specified as "major depressive symptoms with mixed features".
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Depressive disorder due to another medical condition
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- Diagnosis of Depressive disorder due to another medical condition requires the presence of a medical condition as the etiology of depressive symptoms.
- In Fact, Major depressive Disorder is not diagnosed if depressive symptoms are due to the direct physiologic effects of a medical condition.
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Substance/medication-induced depressive disorder
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- Substance/medication-induced depressive disorder is diagnosed when depressive symptoms are due to direct physiologic effects of a substance or medication.
- In Fact, a diagnosis of Major Depressive Disorder cannot be made when depressive symptoms are due to the direct physiologic effects of a substance or medication.
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Persistent depressive disorder (Dysthymia)
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- Persistent depressive disorder is characterized by a depressed mood, on most days, for at least 2 years.
- Of note, a patient can be diagnosed with both Major Depressive Disorder and Persistent Depressive Disorder if the diagnostic criteria are met for both disorders.
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Premenestrual dysphoric disorder
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- Premenstrual dysphoric disorder is characterized by the presence of dysphoric mood in the few days before the onset of menses that improves within a few days after the onset of menses.
- In contrast, no temporal connection is present between the depressive symptoms in Major Depressive Disorder and the menstrual cycles.
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Disruptive mood dysregulation disorder
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- Disruptive mood dysregulation disorder is characterized by severe, recurrent temper outbursts (verbally and/or behaviorally). In between the outbursts, persistently irritable or angry mood, most of the day, almost every day, is present.
- In contrast, in major depressive disorder, irritability is present only during depressive episodes.
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Schizoaffective disorder
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- Schizoaffective disorderis characterized by major depressive episodes with concurrent active-phase symptoms of schizophrenia, AND presence of hallucinations or delusions for two or more weeks in the absence of a major mood episode, AND major depressive episodes are present for the majority of the total duration of illness.
- If psychotic symptoms are present exclusively during major depressive episodes, the diagnosis of "Major depressive disorder with psychotic features" is made.
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References
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