Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Depressive Psychosis


Related Terms

  • Major Depressive Episode with Psychotic Features
  • Psychotic Reactive Depression
  • Severe Depression with Psychotic Features

Differential Diagnosis

  • Bipolar disorder
  • Dementia
  • Hypothyroidism
  • Mood disorder due to a general medical condition
  • Other psychotic disorders
  • Psychotic disorder due to a general medical condition
  • Schizoaffective disorder
  • Substance-induced mood disorder
  • Substance-induced psychotic disorder

Specialists

  • Psychiatrist

Comorbid Conditions

Factors Influencing Duration

The length of disability is influenced by the duration and severity of the depressive episode and psychotic features, any underlying mental illness, any substance abuse, the individual's social support system, the appropriateness of the treatment choice, the individual's compliance with treatment and response to medications, and the adequacy of ongoing care.

Medical Codes

ICD-9-CM:
298.0 - Depressive Type Psychosis; Psychogenic Depressive Psychosis; Psychotic Reactive Depression; Reactive Depressive Psychosis

Overview

Depressive psychosis is an older term for what is now referred to in DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision) as a "major depressive episode, severe, with psychotic features," and in ICD-10 as a "severe depressive episode with psychotic symptoms." This disorder includes symptoms of both depression and psychosis in an individual without an underlying diagnosis of a psychotic disorder. A major depressive episode occurs when there is a period of at least 2 weeks during which there is either depressed mood; a loss of interest or pleasure in nearly all activities; and at least three other symptoms, including significant, unintended weight gain or loss; insomnia or sleeping excessively (hypersomnia); psychomotor agitation or retardation; fatigue or loss of energy; feelings of worthlessness or inappropriate guilt; lack of concentration; or recurrent thoughts of death or suicidal ideation. The presence of a major depressive episode is a required criterion for the diagnosis of major depressive disorder.

In a major depressive episode with psychotic features, the individual reports or exhibits false beliefs (delusions) and / or hears or sees things that aren't there (usually auditory but sometimes visual hallucinations). The delusions or hallucinations usually refer to depressive themes (mood-congruent psychotic features), such as the belief that one is responsible for the death of a loved one or that one is being punished because of a moral transgression. Hallucinations are usually temporary and may involve voices that berate the individual for perceived wrongs. Occasionally, the content of the delusions or hallucinations has no apparent relationship to depressive themes (mood-incongruent psychotic features) and may include delusions that one is being persecuted or that others can control one's thoughts. In general, mood-incongruent psychotic features are associated with a poorer prognosis than mood-congruent psychotic features.

It is not known why some individuals with major depressive episodes develop psychotic features, but it is most likely related to disturbances in brain chemistry (dysregulation of neurotransmitter systems). Involved brain chemicals may include serotonin, dopamine, norepinephrine, acetylcholine, and gamma-aminobutyric acid, as well as other hormones and enzyme systems. Psychotic symptoms are most likely to emerge in the 3-month period following any major life event, such as bereavement or job loss.

Culture can influence the way in which an individual experiences and expresses a depressive psychosis. Somatic complaints of nervousness or headaches in Latino cultures, weakness or imbalance in Asian cultures, heart problems in Middle Eastern cultures, or feelings of sadness and guilt in North American and Western European cultures may all be expressions of depression that combine features of depressive, anxiety, and somatoform disorders. An individual's culturally guided fear of being bewitched or feeling of being visited by the dead must be distinguished from actual hallucinations or delusions.

Incidence and Prevalence: Approximately 10% to 25% of women and 5% to 12% of men are at a lifetime risk for developing a major depressive disorder, with only a small percentage of those exhibiting psychotic features.

Source: Medical Disability Advisor






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