ࡱ> M i)bjbj== WW#`lvvvD.(-&>>>>>,,,,,,,$N. n0Z,v,>>s,:>v>,,'V(@hv3)>2 եG` ) 3)t,0(-') 003)  ICD - 10  D E P R E S S I V E D I S O R D E R S DSM-IV CodeDIAGNOSISDESCRIPTION / CRITERIA296.2x Major Depressive Disorder, Single Episode A. Five (or more) of the following symptoms have been present during the same two week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations. depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others markedly diminished interest or pleasure in all, or almost all activities most of the day, nearly every day, as indicated by either subjective account or observation made by others significant weight loss when not dieting or weight gain (a change of more than 5% of body weight in a month), or decrease/increase in appetite nearly every day insomnia or hypersomnia nearly every day psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down) fatigue or loss of energy nearly every day feelings of worthlessness, or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick) diminished ability to think or concentrate, or indecisiveness, nearly every day, (either by subjective account or as observed by others) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide B. The symptoms do not meet criteria for a Mixed Episode. C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The symptoms are not due to the direct physiological effects of a substance (drug of abuse/medication) or a general medical condition (hypothyroidism). E. The symptoms are not better accounted for by Bereavement.296.3xMajor Depressive Disorder, Recurrent EpisodeAny condition classifiable as 296.2 that is recurrent. See above description.300.4Dysthymic DisorderA. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least two years. B. Presence, while depressed of two or more of the following: poor appetite or overeating insomnia or hypersomnia low energy or fatigue low self-esteem poor concentration or difficulty making decisions feelings of hopelessness C. During the two year period the person has never been without the symptoms of A or B for more than 2 months at a time. D. No Major Depressive Episode has been present during the first two years of the disturbance; the disturbance is not better accounted for by chronic Major Depressive Disorder or Major Depressive Disorder, in Partial Remission. E. There has never been a Manic Episode, a Mixed Episode or a Hypomanic Episode and criteria has never been met for Cyclothymic D/O. F. Disturbance does not occur exclusively during course of a chronic Psychotic D/O. G. The symptoms are not due to the direct physiological effects of a substance (drug of abuse/medication) or a general medical condition (hypothyroidism). H. The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.DSM-IV 5th Digit Subclassification Codes: Add to 296.0 to 296.6 where the x is located0 Unspecified2 Moderate4 Severe, with Psychotic Behavior6 In Full Remission 1 Mild 3 Severe, No Psychotic Behavior 5 In Partial or Unspecified Remission ICD - 10 A D J U S T M E N T R E A C T I O N S DSM-IV CodeDIAGNOSISDESCRIPTION / CRITERIA309.0Adjustment D/O w Depressed MoodA. The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressors. B. Symptoms/behaviors are clinically significant as evidenced by either: (1) distress in excess of what would be expected from exposure to the stressor (2) significant impairment in social, occupational or academic functioning C. Stress related disturbance does not meet the criteria for another specific Axis I disorder and not an exacerbation of a preexisting Axis I or Axis II disorder. D. The symptoms do not represent bereavement. E. Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional six months.309.24w Anxiety309.28w Mixed Anxiety and Depressed MoodNote: Use the appropriate subtype based on the predominate symptoms: 309.0 for depressed mood/tearfulness/hopelessness or 309.24 for nervousness/worry or 309.28 for a combination of both.311Depressive D/O NOS Minor Depressive D/O Recurrent Brief Depressive D/OMinor Depressive D/O - at least two weeks duration of depressive symptoms with fewer than the five items required for Major Depressive Disorder. An episode involves either a sad or depressed mood or loss of interest or pleasure in nearly all activities. These symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning. Recurrent Brief Depressive D/O - depression lasts from two days up to two weeks, occurring at least monthly for twelve months (not associated with the menstrual cycle).Note: Depressive D/O NOS may be used in situations where 1) the clinician has concluded that a depressive disorder is present but is unable to determine if it is primary, due to a general medical condition or substance induced.B I P O L A R D I S O R D E R S ( BIPOLAR TYPE I )296.0xSgl Manic EpisodePresence of only one Manic Episode and no past Major Depressive Episodes. 296.40Most Recent Episode HypomanicCurrently (or most recently) in a Hypomanic Episode. At least one previous Manic Episode or Mixed Episode. The mood symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.296.4xMost Recent Episode ManicCurrently (or most recently) in a Manic Episode. At least one previous Major Depressive Episode, Manic Episode or Mixed Episode.296.5xMost Recent Episode DepressedCurrently (or most recently) in a Major Depressive Episode. At least one previous Manic Episode or Mixed Episode.296.6xMost Recent Episode MixedCurrently (or most recently) in a Mixed Episode. At least one previous Major Depressive Episode, Manic Episode or Mixed Episode.296.7Most Recent Episode UnspecifiedCriteria, except for duration, are currently or most recently met for a Manic, Hypomanic, Mixed or Major Depressive Episode. At least one previous Manic Episode or Mixed Episode. The mood symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning. The mood symptoms are not due to the direct physiological effects of a substance (drug of abuse/medication or other treatment) or a general medical condition Note: To support a Bipolar I diagnosis the mood symptoms can not be better accounted for by a Schizoaffective D/O and are not superimposed on Schizophrenia, Schizophreniform D/O, Delusional D/O or Psychotic D/O NOS.B I P O L A R D I S O R D E R S ( BIPOLAR TYPE II )296.89Recurrent Major Depressive Episodes with Hypomanic EpisodesPresence (or history) of one or more Major Depressive Episodes. Presence (or history of at least one Hypomanic Episode. No history of a Manic Episode or a Mixed Episode. The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning. Specify current or most recent episode: Hypomanic or Depressed.Note: To support a Bipolar II diagnosis the mood symptoms can not be better accounted for by a Schizoaffective D/O and are not superimposed on Schizophrenia, Schizophreniform D/O, Delusional D/O or Psychotic D/O NOS.301.13Cyclothymic DisorderAt least 2 years of numerous periods of hypomanic and depressive symptoms that do not meet the criteria for a Major Depressive Episode. Symptoms have not been absent for longer than 2 months at a time. No Major Depressive Episode, Manic Episode, or Mixed Episode during the first two years of the disturbance. Symptoms are not due to the direct physiological effects of a substance (drug of abuse or medication) or a general medical condition. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.Note: To support a Cyclothymic D/O diagnosis the mood symptoms can not be better accounted for by a Schizoaffective D/O and are not superimposed on Schizophrenia, Schizophreniform D/O, Delusional D/O or Psychotic D/O NOS. VA / DOD DEPRESSION PRACTICE GUIDELINE PROVIDER CARE CARD DSM-IV - COMMON MOOD DISORDERS (not inclusive) VA / DOD DEPRESSION PRACTICE GUIDELINE PROVIDER CARE CARD DSM-IV - COMMON MOOD DISORDERS (not inclusive) Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Copyright 1999, American Psychiatric Association. VA/DoD Depression Clinical Practice Guideline April 2002 CARD 13 CARD 14 Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Copyright 1999, American Psychiatric Association.   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