Major depressive disorder vs Persistent depressive disorder and adjustment disorder
How to tell Major depressive disorder and Persistent depressive disorder and adjustment disorder apart when a board question makes them look alike.
MDD is a 2-week full depressive episode; persistent depressive disorder is depressed mood for 2 years; adjustment disorder is stressor-timed distress below another disorder.
Side by side
Major depressive disorder is episodic major depression: at least 2 weeks of depressed mood or anhedonia plus neurovegetative/cognitive symptoms causing impairment.
Persistent depressive disorder is chronic depressed mood for at least 2 years; adjustment disorder is emotional or behavioral symptoms within 3 months of an identifiable stressor.
MDD is defined by a syndromic depressive episode with enough severity and symptom count to impair function.
Persistent depressive disorder is chronic lower-grade depression; adjustment disorder is stressor-linked distress out of proportion to the event.
Sleep, interest, guilt, energy, concentration, appetite, psychomotor change, and suicidal ideation help define a major depressive episode.
Two-year chronicity supports persistent depressive disorder; onset within 3 months of a stressor and resolution after the stressor ends supports adjustment disorder.
The trap
A stressor does not exclude MDD; if full MDD criteria are met, do not downgrade to adjustment disorder.
The repair move
For depressive complaints, check symptom threshold, duration, and whether a stressor fully explains a subthreshold syndrome.
Try a free question
CoreA patient has 3 weeks of depressed mood, anhedonia, insomnia, poor appetite, guilt, low energy, poor concentration, and passive suicidal thoughts causing work impairment. Which diagnosis is most likely?
Show answer and explanation
Answer: A. Major depressive disorder. At least 2 weeks of depressed mood or anhedonia plus multiple depressive symptoms and impairment supports major depressive disorder.
Why the other choices are tempting
- B. Persistent depressive disorder requires chronic depressed mood for at least 2 years.
- C. Adjustment disorder is subthreshold stressor-linked distress and should not replace full MDD criteria.
- D. Cyclothymic disorder involves chronic subthreshold hypomanic and depressive symptoms.
- E. Bereavement can coexist with MDD, but this stem gives a full depressive syndrome.
Flashcards
Tap a card to flip it.
What duration supports major depressive disorder?
At least 2 weeks of a full major depressive episode supports major depressive disorder.
What two gateway symptoms anchor MDD?
Depressed mood or anhedonia anchors major depressive disorder.
Quick answers
What is the fastest way to tell Major depressive disorder from Persistent depressive disorder and adjustment disorder?
MDD is a 2-week full depressive episode; persistent depressive disorder is depressed mood for 2 years; adjustment disorder is stressor-timed distress below another disorder.
What is the key clue for Major depressive disorder?
Major depressive disorder is episodic major depression: at least 2 weeks of depressed mood or anhedonia plus neurovegetative/cognitive symptoms causing impairment.
What is the key clue for Persistent depressive disorder and adjustment disorder?
Persistent depressive disorder is chronic depressed mood for at least 2 years; adjustment disorder is emotional or behavioral symptoms within 3 months of an identifiable stressor.
What is the common trap with Major depressive disorder vs Persistent depressive disorder and adjustment disorder?
A stressor does not exclude MDD; if full MDD criteria are met, do not downgrade to adjustment disorder.