II. Diagnosis: Criteria to diagnose Major Depression

  1. Symptoms lasting at least 2 weeks, with each symptom persisting for most of each day, nearly everyday
    1. A total of 5 positive symptoms are required for diagnosis of Major Depression
    2. At least 1 of the following two major symptoms (most of each day, nearly everyday)
      1. Depressed mood
        1. Patient reports they feel sad, empty or helpless (or others observe this, e.g. crying)
        2. Irritable mood meets criteria in adolescents and children
      2. Reduction in pleasure or interest
        1. Diminished pleasure or participation in all or nearly all activities
    3. At least 4 (or 3 if both major symptoms present) of the following (most of each day, nearly everyday)
      1. Unintentional Weight Loss or weight gain
        1. Significant unintended weight change (e.g. >5%) or appetite change
      2. Insomnia or Hypersomnia
      3. Psychomotor Agitation or retardation
        1. Restlessness or slowed so significantly as to be recognized by others
      4. Fatigue or loss of energy
      5. Sense of worthlessness, or excessive or inappropriate guilt
      6. Decreased concentration or indecisiveness
      7. Recurrent thoughts of death or Suicidality (with or without a plan)
  2. Significantly impaired social and occupation function
  3. Symptoms do not meet criteria for other diagnosis that better explains symptoms
    1. No history of non-drug induced mania or Hypomania
    2. No mixed Bipolar Disorder
    3. No schizoaffective disorder or Schizophrenia
    4. No Delusional disorder
  4. Not due to significant acute loss that would better explain symptoms
    1. Not due to Bereavement, financial ruin or natural disaster
    2. Major Depression may be diagnosed if criteria met beyond the acute stressors
  5. No secondary causes
    1. Not caused by general medical illness (e.g. Hypothyroidism)
    2. Not a result of medication use
    3. Not a result of Alcohol Abuse or Drug Abuse

III. Diagnosis: Cluster 1 (Physical, neurovegetative symptoms)

  1. Sleep Disturbance
  2. Appetite or weight change
  3. Attention or concentration problem
  4. Energy level change or Fatigue
  5. Psychomotor disturbance

IV. Diagnosis: Cluster 2 (Psychologic, psychosocial symptoms)

  1. Depressed mood
  2. Reduction in pleasure or interest
  3. Feelings of guilt
  4. Suicidal thoughts

V. References

  1. (2013) DSM-V, APA, Washington, D.C.
  2. (2000) DSM-IV, APA, Washington, D.C.

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