Diagnostic Criteria for Major Depressive Disorder and Depressive Episodes DSM-IV Criteria for Major Depressive Disorder (MDD):
- Depressed mood or a loss of interest or pleasure in daily activities for more than two weeks.
- Mood represents a change from the person’s baseline.
- Impaired function: social, occupational, educational.
Specific symptoms, at least 5 of these 9, present nearly every day:
1. Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
2. Decreased interest or pleasure in most activities, most of each day
3. Significant weight change (5%) or change in appetite
4. Change in sleep: Insomnia or hypersomnia
5. Change in activity: Psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate guilt
8. Concentration: diminished ability to think or concentrate, or more indecisiveness
9. Suicidality: Thoughts of death or suicide, or has suicide plan
DSM – V proposed (not yet adopted) anxiety symptoms that may indicate depression: irrational worry, preoccupation with unpleasant worries, trouble relaxing, feeling tense, fear that something awful might happen. Screen for conditions that may mimic or co exist with Major Depressive Disorder:
- Substance abuse causing depressed mood (eg. drugs, alcohol, medications)
- Medical illness causing depressed mood
- Other psychiatric disorders: mania, hypomania, bipolar, schizoaffective, schizophrenia, etc.
- Bereavement unless sx persist for > two months or show marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.