DSM 5 diagnostic criteria for major depressive disorder

What are the DSM 5 diagnostic criteria for major depressive disorder?

  • 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.
    • 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)
    • 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
    • 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 of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a 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.
  • D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.
  • E. There has never been a manic episode or a hypomanic episode.

Five or more of the following symptoms must be present nearly every day during a 2-wk period:
Core symptoms (>/= 1 required for diagnosis)

  • Depressed mood most of the day
  • Anhedonia or markedly decreased interest or pleasure in almost all activities

Specify if:

  • With anxious distress
  • With mixed features
  • With melancholic features
  • With atypical features
  • With mood-congruent psychotic features
  • With mood-incongruent psychotic features
  • With catatonia
  • With peripartum onset
  • With seasonal pattern (previously called seasonal affective disorder)

Additional symptoms

  • Clinically significant weight loss or increase or decrease in appetite
  • Insomnia or hypersomnia
  • Psychomotor agitation or retardation
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Diminished ability to think or concentrate, or indecisiveness
  • Recurrent thoughts of death or suicidal ideation

Major depressive disorder (MDD), also known as clinical depression or major depression, is a mental health condition characterized by persistent feelings of sadness, loss of interest or pleasure in activities, and a range of emotional, cognitive, and physical symptoms. It is a common and serious mood disorder that can significantly impact daily functioning and quality of life.

To receive a diagnosis of major depressive disorder, these symptoms must persist for at least two weeks and significantly impair daily functioning.

Treatment for major depressive disorder typically involves a combination of psychotherapy, medication, and lifestyle changes. Psychotherapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT), helps individuals identify and change negative thought patterns and develop healthy coping strategies. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), may be prescribed to help alleviate symptoms. Lifestyle changes, including regular exercise, healthy sleep habits, and social support, are also important in managing depression.

Convergent evidence from international studies indicates that Major Depressive Disorder (MDD) is one of the most common mental disorders affecting adult populations.

In addition to being a highly disabling disorder, MDD is also a risk factor for several other NCDs (e.g., cardiovascular disease) and has been demonstrated to complicate health outcomes from conditions ranging from cardiovascular disease and diabetes to obesity.

Major depressive disorder (MDD) has been ranked as the third cause of the burden of disease worldwide in 2008 by WHO, which has projected that this disease will rank first by 2030.

Within the broader category of “non-communicable” chronic diseases (i.e., NCDs), MDD is associated with relatively higher rates of disability (e.g., impairment in role function) when compared to most other NCDs (e.g., diabetes mellitus) and is also associated with premature mortality of up to 10 years of potential years of life lost.

Summary

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides the following diagnostic criteria for major depressive disorder:

  1. Depressed Mood: The presence of a depressed mood most of the day, nearly every day, as indicated by subjective feelings or observed by others.
  2. Loss of Interest or Pleasure: A markedly diminished interest or pleasure in almost all activities most of the day, nearly every day.
  3. Significant Weight Loss or Gain: Significant weight loss or gain, or a decrease or increase in appetite nearly every day.
  4. Sleep Disturbances: Insomnia (difficulty falling asleep, staying asleep, or early morning awakening) or hypersomnia (excessive sleepiness) nearly every day.
  5. Psychomotor Changes: Observable psychomotor agitation or retardation nearly every day, as reported by others.
  6. Fatigue or Loss of Energy: Feelings of fatigue or loss of energy nearly every day.
  7. Feelings of Worthlessness or Guilt: Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
  8. Difficulty Concentrating: Diminished ability to think or concentrate, or indecisiveness, nearly every day.
  9. Recurrent Thoughts of Death: Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide.
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