Table 2—

Diagnostic and Statistical Manual of Mental Disorders diagnostic 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
 Depressed mood for 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)#
 Markedly diminished interest or pleasure in all, or almost all, activities for 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 (e.g. a change of >5% of body weight in 1 month), or 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)
 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)
 Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observation by others)
 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
  • #: at least one of these symptoms should be present. Symptoms that are clearly due to a general medical condition should not be included. Reproduced from 18 with permission from the publisher.