Text of Listing 12.04 - Affective Disorders

12.04 Affective disorders: Characterized by a disturbance of mood, accompanied by a full or partial manic or depressive syndrome. Mood refers to a prolonged emotion that colors the whole psychic life; it generally involves either depression or elation.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied, or when the requirements in C are satisfied.

  1. Medically documented persistence, either continuous or intermittent, of one of the following:
    1. Depressive syndrome characterized by at least four of the following:
      1. Anhedonia or pervasive loss of interest in almost all activities; or
      2. Appetite disturbance with change in weight; or
      3. Sleep disturbance; or
      4. Psychomotor agitation or retardation; or
      5. Decreased energy; or
      6. Feelings of guilt or worthlessness; or
      7. Difficulty concentrating or thinking; or
      8. Thoughts of suicide; or
      9. Hallucinations, delusions, or paranoid thinking; or
    2. Manic syndrome characterized by at least three of the following:
      1. Hyperactivity; or
      2. Pressure of speech; or
      3. Flight of ideas; or
      4. Inflated self-esteem; or
      5. Decreased need for sleep; or
      6. Easy distractibility; or
      7. Involvement in activities that have a high probability of painful consequences which are not recognized; or
      8. Hallucinations, delusions or paranoid thinking; or
    3. Bipolar syndrome with a history of episodic periods manifested by the full symptomatic picture of both manic and depressive syndromes (and currently characterized by either or both syndromes);

    2. AND

  2. Resulting in at least two of the following:
    1. Marked restriction of activities of daily living; or
    2. Marked difficulties in maintaining social functioning; or
    3. Marked difficulties in maintaining concentration, persistence, or pace; or
    4. Repeated episodes of decompensation, each of extended duration;

    3. OR

  3. Medically documented history of a chronic affective disorder of at least 2 years' duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:
    1. Repeated episodes of decompensation, each of extended duration; or
    2. A residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate; or
    3. Current history of 1 or more years’ inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.