Major Depressive Episode

DSM-IV-TR Criteria for Major Depression

Major Depressive Episode

Five or more of the following symptoms present during the same two-week

period and representing a change from previous functioning:

• depressed mood or loss of interest or pleasure (at least one); does not

include symptoms clearly due to a general medical condition, moodincongruent

delusions, or hallucinations

depressed mood or loss of interest or pleasure (at least one); does not

include symptoms clearly due to a general medical condition, moodincongruent

delusions, or hallucinations

• depressed mood most of the day, nearly every day, as indicated by either

subjective report or observation made by others; in children and adolescents,

can be irritable mood

depressed mood most of the day, nearly every day, as indicated by either

subjective report or observation made by others; in children and adolescents,

can be irritable mood

• 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

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 (when not dieting) or weight gain or decrease/

increase in appetite nearly every day; in children, consider failure to

make expected weight gains

significant weight loss (when not dieting) or weight gain or decrease/

increase in appetite nearly every day; in children, consider failure to

make expected weight gains

• insomnia or hypersomnia 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

psychomotor agitation or retardation nearly every day observable by

others, not merely subjective feelings of restlessness or being slowed

down

• fatigue or loss of energy nearly every day

fatigue or loss of energy nearly every day

• feelings of worthlessness or excessive or inappropriate guilt (which may

be delusional) nearly every day, not merely self-reproach or guilt about

being sick

feelings of worthlessness or excessive or inappropriate guilt (which may

be delusional) nearly every day, not merely self-reproach or guilt about

being sick

• diminished ability to think or concentrate, or indecisiveness, nearly every

day, either by subjective account or as observed by others

diminished ability to think or concentrate, or indecisiveness, nearly every

day, either by subjective account or as observed by others

• recurrent thoughts of death (not just fear of dying), recurrent suicidal

ideation without a specific plan, or suicide attempt or specific plan for

committing suicide

Criteria for Mixed Episode not met

Symptoms cause clinically significant distress or impairment in social, occupational,

or other important areas of functioning

Symptoms not due to direct physiological effects of a substance or general

medical condition

Symptoms not better accounted for by bereavement, persist for longer than

two months, or characterized by marked functional impairment, morbid preoccupation

with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor

retardation

Major Depressive Disorder, Single Episode (DSM code 296.2x)

Presence of single Major Depressive Episode

Major Depressive Episode not better accounted for by Schizoaffective Disorder

and not superimposed on Schizophrenia, Schizophreniform Disorder,

Delusional Disorder, or Psychotic Disorder Not Otherwise Specified

No Manic Episodes, Mixed Episodes, or Hypomanic Episodes, unless all

manic-like, mixed-like, or hypomanic-like episodes are substance- or treatmentinduced

or due to direct physiological effects of a general medical condition

Specify for current or most recent episode: Severity/Psychotic/Remission

Specifiers; Chronic; with Catatonic Features; with Melancholic Features; with

Atypical Features; with Postpartum Onset

Major Depressive Disorder, Recurrent (DSM code 296.3x)

Presence of two or more Major Depressive Episodes; with an interval of at

least two consecutive months in which criteria not met for Major Depressive

Episode

Major Depressive Episodes not better accounted for by Schizoaffective Disorder