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PMHNP ANCC BOARD EXAM

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MOOD D/O: MDD CRITERIA A - A. Five (or more) of the following symptoms have been present during the same 2-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 attributable to another medical condition. 1. Depressed mood daily 2. Loss of pleasure of joy in activities/inerests 3. Significant weight loss/gain 4. insomnia/hypersomnia 5. fatigue or loss of energy daily 6. psychomotor retardationagitation 7. feelings of worthlessness or guilt 8. diminished ability to think/concentrate, indecisiveness 9. recurrent thoughts of death, SI, or SI attempt MOOD D/O: MDD CRITERIA B-E - B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. C. The episode is not attributable to the physiological effects of a substance or to another medical condition. D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders. E. There has never been a manic episode or a hypomanic episode.

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PMHNP ANCC BOARD EXAM
MOOD D/O:

MDD CRITERIA A - ✔✔A. Five (or more) of the following symptoms have been present during the same
2-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 attributable to another medical condition.

1. Depressed mood daily

2. Loss of pleasure of joy in activities/inerests

3. Significant weight loss/gain

4. insomnia/hypersomnia

5. fatigue or loss of energy daily

6. psychomotor retardationagitation

7. feelings of worthlessness or guilt

8. diminished ability to think/concentrate, indecisiveness

9. recurrent thoughts of death, SI, or SI attempt



MOOD D/O: MDD CRITERIA B-E - ✔✔B. The symptoms cause clinically significant distress or impairment
in social, occupational,

or other important areas of functioning.

C. The episode is not attributable to the physiological effects of a substance or to another

medical condition.

D. The occurrence of the major depressive episode is not better explained by schizoaffective

disorder, schizophrenia, schizophreniform disorder, delusional disorder, or

other specified and unspecified schizophrenia spectrum and other psychotic disorders.

E. There has never been a manic episode or a hypomanic episode.

,Note: This exclusion does not apply if all of the manic-like or hypomanic-like episodes

are substance-induced or are attributable to the physiological effects of another medical

condition.



MOOD D/O: MDD PREVALENCE - ✔✔Twelve-month prevalence of major depressive disorder in the
United States is approximately

7%, with marked differences by age group such that the prevalence in 18- to 29-year-old individuals

is threefold higher than the prevalence in individuals age 60 years or older. Females experience

1.5- to 3-fold higher rates than males beginning in early adolescence.



MOOD D/O: MDD DEVELOPMENT AND COURSE - ✔✔-Recovery typically begins within 3 months of
onset for two in five individuals with major

depression and within 1 year for four in five individuals.

-The risk is higher in individuals whose preceding episode was severe,

in younger individuals, and in individuals who have already experienced multiple episodes.

-The persistence of even mild depressive symptoms during remission is a powerful

predictor of recurrence.



MOOD D/O: MDD RISK FACTORS - ✔✔-Neuroticism (negative affectivity) is a well-established risk factor
for the

onset of major depressive disorder

-Adverse childhood experiences, particularly when there are multiple experiences of diverse types,
constitute a set of potent risk factors for major depressive disorder.

-Stressful life events are well recognized as precipitants of major depressive episodes,but the presence
or absence of adverse life events near the onset of episodes does not appear to provide a useful guide
to prognosis or treatment selection.

-First-degree family members of individuals with major depressive disorder have a risk for major
depressive disorder two- to fourfold higher than that of the general population.

, -Relative risks appear to be higher for early-onset and recurrent forms. Heritability is approximately
40%, and the personality trait neuroticism accounts

for a substantial portion of this genetic liability.



MOOD D/O: PDD (DYSTHYMIA) DSM5 CRITERIA - ✔✔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 2 years.

Note: In children and adolescents, mood can be irritable and duration must be at least

1 year.

B. Presence, while depressed, of two (or more) of the following:

1. Poor appetite or overeating.

2. Insomnia or hypersomnia.

3. Low energy or fatigue.

4. Low self-esteem.

5. Poor concentration or difficulty making decisions.

6. Feelings of hopelessness.

C. During the 2-year period (1 year for children or adolescents) of the disturbance, the individual has
never been without the symptoms in Criteria A and B for more than 2 months at a time.

D. Criteria for a major depressive disorder may be continuously present for 2 years.

E. There has never been a manic episode or a hypomanic episode, and criteria have never been met for
cyclothymic disorder.

F. The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia,
delusional disorder, or other specified or unspecified schizophrenia

spectrum and other psychotic disorder.

G. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a
medication) or another medical condition (e.g. hypothyroidism).

H. The symptoms cause clinically significant distress or impairment in social, occupational,

or other important areas of functioning.

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