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Psychiatry


Answer 1
  1. Major depressive disorder. Every child or adolescent can be sad occasionally and appropriately. For a diagnosis of major depressive disorder (MDD) to be appropriate, he or she must display at least 2 weeks of pervasive change in mood, manifested by either depressed or irritable mood and/or loss of interest and pleasure. The patient must have other clinical symptoms, including significant changes in patterns of appetite, weight, sleep, activity, concentration, energy level, self-esteem, and motivation. Symptoms must represent a change from previous functioning and produce impairment in relationships or in performance of activities. Symptoms must not solely result from substance abuse, use of medications, bereavement, medical illness, or other psychiatric illness. Children and adolescents with adjustment disorders experience an excessive change in mood and impairment of functioning within 3 months of an identifiable stressor, but they do not meet full criteria for MDD. MDD is often precipitated by stressful events; therefore, even if there is a stressful precipitant, the child or adolescent who has the appropriate symptoms should receive a diagnosis of MDD and be given appropriate additional treatments.

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