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6XEMHFW 'UDIW 'DWH 20 ,QWHUYLHZHU 20 'HSUHVVLYHDQG%LSRODU5HODWHG'LVRUGHUV6XSSOHPHQW: Depression SDJHRI
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Duration of Depressed/Irritable Duration of Depressed/Irritable Mood (weeks): Mood (weeks):
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E'HSUHVVHGDQGRULUULWDEOHPRRGLVSUHVHQW 0 -1RLQIRUPDWLRQ PRUHGD\VWKDQQRWIRUDWOHDVWRQH\HDU 1 -1RW3UHVHQW +DYH\RXHYHUKDGDWLPHZKHQ\RXIHOWGHSUHVVHGDQGRULUULWDEOHIRUPRVW 2 -3UHVHQW'HSUHVVHGDQGRULUULWDEOHPRRG RIWKHGD\PRUHGD\VWKDQQRWWKDWODVWHGIRUDWOHDVWRQH\HDU" SUHVHQWIRUPRUHGD\VWKDQQRWIRUDW OHDVWRQH\HDU
PAST:
3 & 6
If 1b and 1c are both rated 2, after completing the remainder of the Depression section, GO TO DYSTHYMIA SECTION ON PAGE 16.
'UDIW 6XEMHFW 'HSUHVVLYHDQG%LSRODU5HODWHG'LVRUGHUV6XSSOHPHQW: 20 Depression SDJHRI
P C S ,QVRPQLD 0 -1RLQIRUPDWLRQ
6OHHSGLVRUGHULQFOXGLQJLQLWLDOPLGGOHDQGWHUPLQDOGLIILFXOW\LQJHWWLQJWR 1 -1RW3UHVHQW VOHHSRUVWD\LQJDVOHHS'RQRWUDWHLIKHVKHIHHOVQRQHHGIRUVOHHS7DNH LQWRDFFRXQWWKHHVWLPDWHGQXPEHURIKRXUVVOHSWDQGWKHVXEMHFWLYHVHQVH 2 -6XEWKUHVKROG ,QVRPQLDDWOHDVWGD\VSHU RIORVWVOHHS1RUPDOO\D\HDUROGFKLOGVKRXOGVOHHSDERXWKRXUV ZHHN RQHKRXU \HDUV KRXUVKRXU\HDUVKRXUVRQH KRXU 3 - 7KUHVKROG ,QVRPQLDQHDUO\HYHU\QLJKW QLJKWVSHUZHHN 6HHEHORZIRUW\SHRI NOTE: DO NOT RATE IF INSOMNIA IS EXCLUSIVELY DUE TO ADHD, LQVRPQLD LQLWDOPLGGOHDQGRUWHUPLQDO OPPOSITIONALITY, MEDICAL PROBLEMS 6/((3 ',625'(5 OR OTHER PSYCHIATRICDISORDERS. PAST:
3 & 6 P C S
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PAST:
3 & 6 P C S
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PAST:
3 & 6 P C S
0 - 1RLQIRUPDWLRQ F 7HUPLQDO,QVRPQLD 1 -1RW3UHVHQW :KHQ\RXDUHIHHOLQJGRZQGHSUHVVHGZKDWWLPHGR\RXZDNHXSLQWKH PRUQLQJV" 2 - 6XEWKUHVKROG :DNLQJXSOHVVWKDQPLQXWHV $UH\RXZDNLQJXSHDUOLHUWKDQ\RXKDGWR" HDUOLHUDWOHDVWGD\VSHUZHHN
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PAST:
3 & 6
'UDIW 6XEMHFW 20 'HSUHVVLYHDQG%LSRODU5HODWHG'LVRUGHUV6XSSOHPHQW: Depression SDJHRI
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,QFUHDVHGQHHGWRVOHHSVOHHSLQJPRUHWKDQXVXDO,QTXLUHDERXW 1 -1RW3UHVHQW2UQHHGVOHVVVOHHSWKDQ K\SHUVRPQLDHYHQLILQVRPQLDZDVUDWHG6OHHSLQJPRUHWKDQQRUPDOLQ XVXDO KRXUSHULRG 2 - 6XEWKUHVKROG 2IWHQVOHHSVDWOHDVWKRXU Do not rate positive if daytime sleep time plus nighttime true sleep PRUHWKDQXVXDO DWOHDVWWLPHVSHU equals normal sleep time (compensatory naps). ZHHN
Do not include "catch-up" sleep on weekends and/or holidays if child 3 -7KUHVKROG 0RVWQLJKWV QLJKWVZHHN is not getting sufficient sleep on school nights. VOHHSVDWOHDVWKRXUVPRUHWKDQXVXDO
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Parents may say that if child was not awakened he/she would regularly sleep > 11-12 hours and he/she actually does so, everyWLPH KHVKHLVOHIWRQKLVKHURZQ7KLVVKRXOGEHUDWHG NOTE: DO NOT RATE IF HYPERSOMNIA IS EXCLUSIVELY DUE TO NARCOLEPSY, MEDICAL PROBLEMS (e.g., infection), OR OTHER PSYCHIATRIC DISORDERS.
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7KLVLVDVXEMHFWLYHIHHOLQJ (Do not confuse with lack of interest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
NOTE: DO NOT RATE POSITIVELY IF EXCLUSIVELY DUE TO MEDICAL PROBLEMS, OTHER PSYCHIATRIC PROBLEMS (e.g., GAD), MEDICATIONS OR USE OF DRUGS OR ALCOHOL.
'UDIW 6XEMHFW 'HSUHVVLYHDQG%LSRODU5HODWHG'LVRUGHUV6XSSOHPHQW: 20 Depression SDJHRI
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NOTE: IF CHILD HAS ATTENTION DEFICIT DISORDER, DO NOT RATE POSITIVELY, UNLESS THERE WAS A WORSENING OF THE CONCENTRATION PROBLEMS ASSOCIATED WITH THE ONSET OF DEPRESSED MOOD.
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PAST:
3 & 6
'UDIW 6XEMHFW 20 'HSUHVVLYHDQG%LSRODU5HODWHG'LVRUGHUV6XSSOHPHQW: Depression SDJHRI
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Rate here loss of appetite only. 3 -7KUHVKROG &OHDUGHFUHDVHLQDSSHWLWHHYHU\RU QHDUO\HYHU\GD\ GD\VZHHN HJ +RZLV\RXUDSSHWLWH"'R\RXIHHOKXQJU\RIWHQ" UHJXODUVQDFNVQRWFRQVXPHGHDWVVPDOOHU $UH\RXHDWLQJPRUHRUOHVVWKDQEHIRUH" PHDOVWKDQXVXDOVRPHPHDOVPLVVHG 'R\RXOHDYHIRRGRQ\RXUSODWH" :KHQGLG\RXEHJLQWRORVH\RXUDSSHWLWH" PAST: 'R\RXVRPHWLPHVKDYHWRIRUFH\RXUVHOIWRHDW" :KHQZDVWKHODVWWLPH\RXIHOWKXQJU\" $UH\RXRQDGLHW":KDWNLQGRIGLHW" 3 & 6
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NOTE: DO NOT RATE POSITIVELY IF WEIGHT LOSS IS MAINLY ACCOUNTED FOR BY ANOREXIA NERVOSA. WEIGHT LOSS MUST BE DUE TO MOOD AND NOT OTHER FACTORS (MEDICAL PROBLEMS, MEDICATIONS, SUBSTANCE USE, ETC.)
'UDIW 6XEMHFW 20 'HSUHVVLYHDQG%LSRODU5HODWHG'LVRUGHUV6XSSOHPHQW: Depression SDJHRI
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NOTE: DO NOT RATE POSITIVELY IF WEIGHT GAIN IS RELATED TO 3 & 6 OTHER FACTORS (MEDICAL PROBLEMS, MEDICATIONS, SUBSTANCE USE, ETC.) WEIGHT GAIN MUST BE DUE TO MOOD DISTURBANCE.
'UDIW 6XEMHFW 20 'HSUHVVLYHDQG%LSRODU5HODWHG'LVRUGHUV6XSSOHPHQW: Depression SDJHRI
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Make sure it does not refer to content of speech or acts or to facial expression. Refer only to speed and tempo.
NOTE: IF CHILD HAS ATTENTION DEFICIT DISORDER, DO NOT RATE THE PSYCHOMOTOR AGITATION ITEM POSITIVELY UNLESS THERE WAS A WORSENING OF AGITATION THAT CORRESPONDED WITH THE ONSET OF THE DEPRESSED MOOD.
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For many young children it is preferable to give a concrete example such as:,DPJRLQJWRWHOO\RXDERXWWKUHHFKLOGUHQDQG\RXWHOOPHZKLFK RQHLVPRVWOLNH\RX7KHILUVWLVDFKLOGZKRGRHVVRPHWKLQJZURQJWKHQ IHHOVEDGDERXWLWJRHVDQGDSRORJL]HVWRWKHSHUVRQWKHDSRORJLHVDUH DFFHSWHGDQGKHMXVWIRUJHWVDERXWLWIURPWKHQRQ7KHVHFRQGFKLOGLVOLNH WKHILUVWEXWDIWHUKLVDSRORJLHVDUHDFFHSWHGKHMXVWFDQQRWIRUJHWDERXW ZKDWKHKDGGRQHDQGFRQWLQXHVWRIHHOEDGDERXWLWIRURQHWRWZRZHHNV 7KH WKLUGLVDFKLOGZKRKDVQRWGRQHPXFKZURQJEXWZKRIHHOVJXLOW\IRUDOO NLQGVRIWKLQJVZKLFKDUHUHDOO\QRWKLVIDXOWOLNH:KLFKRQHRIWKHVHWKUHH FKLOGUHQLVOLNH\RX"
It is also useful to double check the child's understanding of the questions by asking him to give an example, like the last time he felt guilty "like the child in the story." NOTE: IF GUILT APPEARS TO BE OF DELUSIONAL INTENSITY, COMPLETE THE PSYCHOSIS SUPPLEMENT.
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As the validity of the COBY threshold has not been definitely established, a reasonable, more conservativethreshold would alter COBY criterion #1 to three '60 manic symptoms (four if the mood is irritable only)and criterion #4 to a minimum of ten days over a subject's lifetime, in which they meet criteria 1-3. 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