Diagnostic and Statistical Manual of Mental Disorders (DSM) and Depressive Symptoms Description

DSM-IV Criteria for Major Depressive Disorder

Major depression is a syndrome with well-defined clinical features. Essential features of a major depressive episode include 5 or more of the following symptoms over a 2 week period. One symptom must include either depressed mood or a marked loss of interest or pleasure for at least two consecutive weeks.

Note: The symptoms may be defined by subjective or objective description.

Depressed mood most of the day, nearly every day (e.g., feels sad, empty or appears tearful)
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
Significant weight loss (change of more than 5%)
Insomnia or hypersomnia nearly every day
Psychomotor agitation or retardation nearly every day
Fatigue or loss of energy
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day
Recurrent thoughts of death (not just fear of dying)
The symptoms do not meet the criteria for a mixed episode
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas or functioning
The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism)
The symptoms are not better accounted for by bereavement, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation
Postpartum onset specifier: Onset of episode within 4 weeks postpartum

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