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MDD Diagnosis
DSM #5 TR Criteria, Differentials and Important Questions
| Term | Definition |
|---|---|
| Criteria A 1 - Depressed Mood | Frequency: most of the day nearly everyday Subjective report (feeling sad, empty or hopeless) Observation (appears tearful) Children/Adolescents: Irritable mood |
| Criteria A 2 - Anhedonia | Significantly diminished interest/pleasure in all/almost all activities Frequency: most of the day nearly everyday Subjective or Observational indications |
| Criteria A 3 - Weight Fluctuations | Change in 5% of body weight (loss or gain) Timeline: 1 month Decrease/Increase in appetite Frequency: nearly everyday Children: Indication: failure to meet expected weight gain |
| Criteria A 4 - Sleep Disturbances | Insomnia/hypersomnia Frequency: nearly every day |
| Criteria A 5 - Psychomotor Agitation/Retardation | Frequency: nearly every day Caveat: must be observable by others (not merely self report) |
| Criteria A 6 - Fatigue | Frequency: nearly every day |
| Criteria A 7 - Worthlessness/Guilt | Inappropriate guilt (potentially delusional) Frequency: nearly everyday Caveat: not self reproach |
| Criteria A 8 - Concentration Issues/ Indecisiveness | Frequency: nearly every day Subjective or Observational reports |
| Criteria A 9 - Recurrent Thoughts of Death | Beyond fear of dying Suicidal ideation with or without a plan Suicide attempt |
| Criteria B - Distress/Impairment | Affected Areas: social, occupational, & other important functioning |
| Criteria C - No Substance/Medical Issue | Not explainable by substance use or medical condition |
| Criteria D - No Psychotic Disorder | Not explainable by another mental health issue Particularly: Schizoaffective Schizophrenia Schizophreniform Delusional |
| Criteria E - No Mania/Hypomania | No experiences of bipolar symptoms unless they are explained by substance use or medical conditions |
| Note # 1 | Responses to significant loss can resemble a depressive episode (criterion A), clinical expertise is required to determine if the depressive symptoms are more severe than normal for such situations |
| Note # 2 | Criterion A - C = A major depressive episode |
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Alexa3926
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