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.

Persistent Depressive Disorder (Dysthymia)


Related Terms

  • Dysthymia
  • Neurotic Depression
  • Reactive Depression

Differential Diagnosis

  • Major depression
  • Mood disorder due to general medical condition
  • Personality disorders
  • Substance-induced mood disorder

Specialists

  • Clinical Psychologist
  • Internal Medicine Physician
  • Psychiatrist

Comorbid Conditions

Factors Influencing Duration

Length of disability may be influenced by severity of symptoms (i.e., sleep disturbance) or the degree of psychomotor retardation (slowing of physical and mental processes) and job requirements. A suicide attempt may lengthen disability due to necessary medical treatment and the need for further psychological assessment. Emotionally stressful job duties may increase the length of disability. Symptoms may interfere with optimal work performance.

Medical Codes

ICD-9-CM:
300.4 - Dysthymic Disorder; Anxiety Depression, Depression with Anxiety, Depressive Reaction, Neurotic Depressive State, Reactive Depression

Treatment

Treatment usually consists of psychotherapy and/or antidepressant medications. Supportive counseling can address feelings of hopelessness. Cognitive therapy may help change the pessimistic ideas, unrealistic expectations, and overly critical self-evaluations that sustain the depressed mood, and can also help the individual distinguish between critical and minor life problems. Both cognitive behavioral therapy and interpersonal therapy are empirically based treatment strategies with demonstrated effectiveness. A number of studies have found both strategies to be as effective as antidepressant medications in the treatment of persistent depressive disorder (dysthymia). They can be delivered individually or in a group setting, and typically require 8 to 16 weekly sessions. Problem-solving therapy can help change stressful situations contributing to depression. Family and friends may benefit from counseling or a support group to help them cope with the demands of the loved one's illness.

Antidepressant medications, primarily selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants (TCAs), are often seen as the treatment of choice in the treatment of persistent depressive disorder (dysthymia). Treatment begins with a low dose and continues for up to 3 months. If there is significant improvement in symptoms, therapy should continue for as long as needed, which may be up to 2 to 3 years or for life. Approximately 55% of individuals with persistent depressive disorder (dysthymia) benefit from antidepressant medication (Halverson). Guidelines for assessing the potential of drug therapy include a positive family history and a past history of poor response to other forms of treatment. Hospitalization is generally not necessary unless there is a suicide plan or attempt.

Source: Medical Disability Advisor






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