Download DSM-IV Diagnostic and Statistical Manual of Mental Disorders

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Common Presentations
Depression and Anxiety
Diagnostic and Statistical Manual
of Mental Disorders
Major Depressive Episode
Five (or more) of the following symptoms
during the same 2-week period;
includes at least
(1)depressed mood or
(2)loss of interest or pleasure.
1, depressed mood
2, diminished interest or pleasure
3, significant weight loss, or decrease or increase
in appetite
4, insomnia or hypersomnia
5, psychomotor agitation or retardation
6, fatigue or loss of energy
7, feelings of worthlessness or excessive or
inappropriate guilt
8, inability to think or concentrate
9, recurrent thoughts of death, suicidal ideation or
a suicidal attempt
Anxiety Disorders
Panic Attack
Period of intense fear or discomfort,
4 (or more) of the following developed
within 10 minutes:
1, palpitation
2, sweating
3, trembling or shaking
4, shortness of breath
5, feeling of choking
6, chest pain or discomfort
7, nausea or abdominal distress
8, feeling dizzy or lightheaded
9, derealization (feelings of unreality) or depersonalization
(being detached from oneself)
10, fear of losing control or going crazy
11, fear of dying
12, numbness or tingling sensation
13, chills or hot flushes
1, Panic Disorder
2, Agoraphobia
3, Specific Phobia
4, Social Phobia (Social Anxiety Disorder)
5, Obsessive-Compulsive Disorder
6, Post Traumatic Stress Disorder
7, Generalized Anxiety Disorder
‘Poor performance’
1st year student
Foreign student from mainland China
Failed to show up for classes
Did not attend all her examinations
Discontinued by the university
Asked to come to UHS for advice
Insomnia since October
Early morning wakening
Depressed mood
Binge eating, gained 40 lbs in a few months
Unable to concentrate and focus
Lack of confidence, feeling of worthlessness
Feeling of hopelessness
Socially withdrawn and isolated
Complicated by involving in a ‘difficult’
relationship, confused about her own sexual
‘It was close’
Referred by student counseling service
2nd year student
Feeling depress for 3 months
Feeling of hopelessness
Very poor motivation
Unable to concentrate, affecting his school
• Sleeps more than 12 hours a day
• No apparent precipitating factor
Attempted suicide 3 times
• 1st - electrocution
• 2nd - tied a plastic bag over his head
• 3rd – tried to strangulate himself by tying
clothes around his neck
• All done in isolation
• Left a written statement
Suicidal Risk Assessment
Has a plan
Lethality of the plan
Has written about the plan
Has informed others
Previous history of attempted suicide
Co-morbidity e.g. depression, substance
• Recent crisis
• Depression is a medical condition
• Depression is NOT a personality flaw or a
sign of weakness
• There is a 20% chance of developing into
a clinical depression in one’s life time
• Depression is the most treatable mental
• 80% of depression will respond positively
to treatment