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Major Depressive Disorder Diagnosis and Symptoms

Major Depressive Disorder Diagnosis

Information related to the Major Depressive Disorder Diagnosis follow below. While some of these depression symptoms may be recognized by family, teachers, legal and medical professionals, and others, only properly trained mental health professionals (psychologists, psychiatrists, professional counselors etc.) can or should even attempt to make a mental health diagnosis. A multitude of factors are considered in addition to the symptoms in making a proper diagnosis, including medical and psychological testing considerations. This information is for information purposes only and should never replace the judgment and comprehensive assessment of a trained mental health clinician.

Major Depressive Disorder diagnostic criteria:

A. Five (or more) of the following symptoms have been present during the same 2 week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly attributable to another medical condition.

1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)
2. 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).
3. Significant weight loss when not dieting or weight gain (e.g., A change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
9. Recurrent thoughts of death (not just fear dying), recurrent suicidal ideation without a specific plan, or suicide attempt or specific plan for committing suicide.

B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The episode is not attributable to the physiological effects of a substance or to another medical condition.

Note: Criteria A-C represent a major depressive episode.
Note: Responses to a significant loss (e.g., bereavement, financial ruin, losses from a natural disaster, a serious medical illness or disability) may include the feelings of intense sadness, rumination about the loss, insomnia, poor appetite, and weight loss noted in criteria a, which may resemble a depressive episode. Although such symptoms may be understandable or considered appropriate to the loss, the presence of major depressive episode in addition to normal response to a significant loss should also be carefully considered. This decision inevitably requires the exercise of clinical judgment based on individual’s history and cultural norms for the expression of distress in the context of loss.

D. The occurrence of the major depressive episode is not better explained by seasonal affective disorder, schizophrenia, schizophrenic form disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.

E. There has never been a manic episode or hypomanic episode.

Note: This exclusion does not apply if all the manic -like or hypomanic-like episodes are substance -induced or are attributable to the physiological effects of another medical condition.

Severity/Course Specifier, Single Episode, Recurrent Episode

Mild 296. 21 (F32.0) 296. 31 (F33.0)
Moderate 296. 22 (F32.1) 296. 32 (F33.1)
Severe 296. 23 (F32.2) 296. 33 (F33.2)
With psychotic features 296. 24 (F32.3) 296. 34 (F 33.3)
In partial remission 296. 25 (F 32.4) 296. 35 (F 33.41)
In full remission 296. 26 (F32.5) 296. 36 (F 33.42)
Unspecified 296.20 (F 32.9) 296.30 (F 33.9)


With anxious distress
With mixed features
With melancholic features
With atypical features
With mood congruent psychotic features
With mood-incongruent psychotic features
With catatonia Coding note: Use additional code 293.89 (F06.1).
With peripartum onset
With seasonal pattern

Diagnostic Criterion for Major Depressive Disorder from the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition American Psychological Association

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