depression mazeFor most social work exam items covering DSM material, you need just a basic understanding of what's what. The big picture. However, for some diagnoses, a little more detailed knowledge may be tested for in exam questions. The diagnoses that just about always show up in social work practice may also be expected to show up on the social work exam in question requiring a greater degree of specific knowledge. You're a social worker--you know the ones. Major depressive disorder is one such diagnosis. That said, if you know the basic criteria for MDD, questions about specifics shouldn't be all that difficult. Here they are:

1. Depressed mood most of the day, nearly every day. (In children and adolescents, can be irritable mood)

2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.

"Nearly every day" goes for all symptoms. 

3. Significant weight loss when not dieting or weight gain (e.g., plus or minus 5% of body weight in a month). (In children, consider failure to make expected weight gain.)

4. Insomnia or hypersomnia.

5. Psychomotor agitation or retardation.

6. Fatigue or los of energy.

7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional).

8. Diminished ability to think or concentrate, or indecisiveness.

9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

How long do symptoms need to be present? And how many symptoms need to be present? Let's put that in question form.

A client tells a social worker that she feels sad most of the time. "I can't sleep, but I have no energy," she reports. "I can't concentrate, but I can't stop thinking about death and dying." To meet criteria for major depressive disorder these symptoms need to have been present:

A) Nearly every day for at least one week and represent a change from previous functioning.

B) Nearly every day for at least two weeks and represent a change from previous functioning.

C) Nearly every day for at least three weeks and represent a change from previous functioning.

D) The client does not meet criteria for MDD because she has only described five symptoms.

Once you've read the following paragraph, the answer is easy:

Five or more of the [above] symptoms have been present during the same 2-week period and represent a change from previous functioning.

There you have it. The answer is B) "Nearly every day for at least two weeks." The DSM goes on:

At least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

This is a question that doesn't call on your social work super-skills. It just asks you to know what it says in the MDD criteria.

The DSM goes on to discuss when bereavement or loss, other diagnoses to rule out (schizoaffective disorder, schizophrenia...), the absence of a manic or hypomanic episode. Also worth noting, MDD can be coded as Mild, Moderate, Severe, With Psychotic Features, and In Partial Remission. More details, more possible exam questions. Good luck!

To read more about MDD and the DSM:

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June 20, 2016
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