DSM-5 criteria for major depressive disorder

Depressed mood most of the day, nearly every day

Markedly diminished interest or pleasure (anhedonia)

Significant weight/appetite change

Insomnia or hypersomnia nearly every day

Psychomotor agitation or retardation (observable)

Fatigue or loss of energy

Feelings of worthlessness or excessive/inappropriate guilt

Diminished concentration or indecisiveness

Recurrent thoughts of death or suicidal ideation

Symptoms present during the same 2-week period

Cause clinically significant distress or functional impairment

Not attributable to a substance, medical condition, or another disorder

Result0 of 9 symptoms

Criteria not met: need >=5 symptoms including depressed mood or anhedonia.

Core symptom present: No

When to use

Structured confirmation of DSM-5 major depressive episode criteria during a clinical interview.

Formula

Criteria A: >=5 of 9 symptoms in the same 2-week period, at least one being depressed mood or anhedonia. Plus distress/impairment (B) and exclusion of substance/medical/other causes (C).

Pearls and pitfalls

A diagnosis also requires that the episode is not better explained by another disorder and there has never been a manic or hypomanic episode.

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. 2013.