Brief Description and Diagnostic Criteria

Depression is an imprecisely used term both in public circles and in the mental health community. It may refer to brief feelings of sadness or to a mood disturbance manifesting profound despair that persists over time. In the latter sense, depression represents the key symptoms of a psychiatric mood disorder. 

Depressed mood is the hallmark symptom of MDD, but it is neither required nor sufficient for the diagnosis of major depression. In addition to depressed mood, the key symptoms of a major depressive episode include anhedonia, changes in sleep or appetite, psychomotor retardation or agitation, poor concentration or indecisiveness, and recurrent thoughts of death or suicide. The DSM-IV definition of major depression requires that five or more of these symptoms be present for at least 2 weeks in the absence of an identifiable cause such as medication, medical illness, or the death of a loved one. Refer to Table 3.2 for the DSM-IV criteria for MDD. 

TABLE 3.2. Diagnostic Criteria for Major Depressive Disorder 

At least five of the following symptoms are present most of the day nearly every day for 2 weeks and are different from the patient s usual mood. One of the five symptoms must be either depressed mood or anhedonia. 

Depressed mood acknowledged by the patient or witnessed by others 

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