155Depressive
Disorders
Depressive disorders  include disruptive mood dysregulation disorder, major
depressive disorder (including  major depressive episode), persistent depressive disorder
(dysthymia), premenstrual dysphoric disord er, substance/medication-induced depres-
sive disorder, depressive disord er due to another medical co ndition, other specified de-
pressive disorder, and unspec ified depressive disorder. Unlike in DSM-IV, this chapter
“Depressive Disorders” has been separated fr om the previous chapter “Bipolar and Re-
lated Disorders.” The common feature of all of these disorders is the presence of sad,
empty, or irritable mood, accompanied by somatic and cognitive changes that signifi-
cantly affect the individual’s capacity to function. What differs among them are issues of
duration, timing, or presumed etiology. 
In order to address concerns about the pote ntial for the overdiagnosis of and treatment
for bipolar disorder in children, a new diagno sis, disruptive mood dysregulation disorder,
referring to the presentation of children wi th persistent irritability and frequent episodes
of extreme behavioral dyscontrol, is added to the depressive disorders for children up to
12 years of age. Its placement in this chapter reflects the finding that children with this
symptom pattern typica lly develop unipolar depressive disorders or anxiety disorders,
rather than bipolar disorders, as they  mature into adolescence and adulthood.
Major depressive disorder represents the clas sic condition in this gr oup of disorders. It
is characterized by discrete episodes of at least 2 weeks’ duration (although most episodes
last considerably longer) involving clear-cut changes in affect, cogn ition, and neurovege-
tative functions and inter-episode remissions.  A diagnosis based on a single episode is