What are the two primary issues central to the debate regarding definitions of mood disorders? What are the five major considerations we can use in distinguishing clinical depression from normal sadness?

Answer:

(1) should these disorders be defined in a broad or narrow fashion? (2) the issue of heterogeneity. All depressed persons do not have the same set of symptoms, same pattern of onset, or the same course over time. Some patients have manic episodes, whereas others experience only depression. Some exhibit psychotic symptoms, such as delusions and hallucinations. The important considerations in distinguishing clinical depression from normal sadness are: (1) Intensity: The mood change pervades all aspects of the person and impairs social and occupational functions. (2) Absence of precipitants: The mood may arise in the absence of any discernible precipitant or may be grossly out of proportion to those precipitants. (3) Quality: The mood change is different from that experienced in normal sadness. (4) Associated features: The change in mood is accompanied by a cluster of signs and symptoms, including cognitive and somatic features. (5) History: The mood change may be preceded by a history of past episodes of elation and hyperactivity.