Adjustment disorder with depressed mood

The analyses reviewed thus far are all observational studies using econometric procedures. In contrast, Kravitz et al. (2005) examined prescribing behavior of antidepressant drugs in a randomized controlled trial setting. Mostly professional actors, middle-aged, white, nonobese women, called standardized patients, were trained to depict to physicians two types of patients with differing severity of symptoms one with symptoms of major depression of moderate severity, and the other having an adjustment disorder with depressed mood. 

Approximately three-quarters of children with OCD have comorbid diagnoses. These include tic disorders (24%-30%) and mood disorders, especially major depression (26%-29%). Riddle and colleagues (1990) found that 38% of children with OCD have other anxiety disorders, while Swedo (1989) more specifically identified increased rates of simple phobias (17%), overanxious disorder (16%), and separation anxiety disorder (7%). Other reported comorbidities include specific developmental disabilities, adjustment disorder with depressed mood, oppositional defiant disorder, attention-deficit hyperactivity disorder (ADHD), conduct disorder, and enuresis/encopresis (Swedo et ah, 1989b Riddle et ah, 1990). 

A typical example of diagnostic splintering provides the group of mood disorders. One reads about major depression, minor depression, double depression, dysthymia, unipolar and bipolar depression, depressive personality, depression not otherwise specified, brief recurrent depression, subsyndromal symptomatic depression, mixed anxiety depression disorder, seasonal depression, and adjustment disorder with depressive mood. 

For the diagnosis of major depressive disorder, a person must have either symptom 1 or 2, plus five out of nine symptoms, and these symptoms must occur most of the day, nearly every day, for at least two weeks. Major depressive disorder is differentiated from other depressive disorders, including minor depression (dysthymia), recurrent brief depression, and adjustment disorder with depressed mood. 

Classic reactive depressions (sometimes referred to as psychological depressions) can range in intensity from mild or moderate (for example, adjustment disorders with depressed mood) to severe (major depression). These disorders occur in response to identifiable psychosocial stressors. These stressors may be acute and intense (such as loss of a loved one), insidious (as in the case of a gradual deterioration in the quality of marital relationship), or in the distant past (for example, the emotions experienced by a survivor of child abuse who in adulthood begins to recall long-forgotten abusive events). 

In addition, Nakao et al. have examined the effects of mood states on persistent versus temporary hypercholesterolemia in students entering a university [29]. They found that depressive mood appeared to relate to hypercholesterolemia when the university students were screened with tension-anxiety, depression, anger-hostility, vigor, fatigue, and confusion scales [29]. In children, after covariance adjustment for age, race, and sex, Glueck et al. pointed out that children having adjustment disorders with depression had much lower covariance-adjusted TC values than control... 

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