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Major Depressive Disorder
Patients with this disorder have had one or more
Major Depressive Episodes, but have never had a manic episode, mixed episode, or
hypomanic episode.
Criteria for a Major Depressive Episode
- Five or more of the following symptoms have been present during the same
2-week period and represent a change from previous functioning; at least one
of the symptoms is either (1) depressed mood or (2) loss of interest or
pleasure.
- depressed mood most of the day, nearly every day, as indicated by either
subjective report (e.g., feels sad or empty) or by observation made by
others
e.g., "appears tearful").
- markedly diminished interest or pleasure in all, or almost all, activities
most of
the day nearly every day (as indicated by either subjective account or
observation made by others).
- significant weight loss while not dieting or weight gain (i.e., a change
of more
then 5% of body weight in a month), or a decrease or increase in appetite
nearly
every day.
- insomnia or hypersomnia nearly every day.
- psychomotor agitation or retardation nearly every day (observable by
others, not merely subjective feelings of restlessness or being slowed
down).
6. fatique or loss of energy nearly every day.
7. feelings of worthlessness or excessive or
inappropriate guilt (which may be
delusional) nearly every day
(not merely self-reproach or guilt about being sick).
8. diminished ability to think or concentrate,
or indecisiveness, nearly every day
(either by subjective
account or as observed by others).
9. recurrent thoughts of death (not just fear
of dying), recurrent suicidal ideation
without a specific plan,
or a suicide attempt or a specific plan for committing
suicide.
B. The symptoms do not meet the criteria
for a "mixed episode".
C. The symptoms cause clinically significant
distress or impairment in social, occupational,
or other important areas of
functioning.
D. The symptoms are not due to the direct
physiological effects of a substance
abuse or a general
medical condition (e.g., hypothyroidism).
E. The symptoms are not better accounted
for by bereavement, (i.e., after the loss of a
loved one).
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