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Symptoms of Major Depressive Disorder
Terms in this set (12)
A symptoms relating to mood (affective)
Depressed mood most of the day, nearly every day, as indicated by subjective report, e.g. feels empty, hopeless, sad. or observation made by others, e.g. appears tearful. This may include irritability in children and adolescents.
A symptom relating to interests and pleasure
Marked disinterest or pleasure in all or almost all activities most of the day, nearly every day as indicated by subjective report or observation
A symptom relating to weight and appetite (Physical/Somatic)
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. In children consider failure to make expected weight gain.
A symptom relating to sleep
Hypersomnia or insomnia
A symptom relating to movement
Psychomotor agitation or retardation nearly every day observable to pothers not merely subjective feelings of restlessness or being slowed down
A symptom relating to energy levels
fatigue or loss of energy nearly every day
A set of symptoms relating to self-concept/self esteem
Feelings of worthlessness or excessive or inappropriate guilt which may be delusional nearly every day not merely self reproach or guilt about being sick
A cognitive symptom relating to thinking
Diminished ability to think or concentrate or indecisiveness nearly every day either by subjective account or as observed by others
A symptom relating to death/suicide
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
Curation and number of symptoms necessary to make a diagnosis
5 or more present during the same 2 week period representing a change from previous functioning, at least one of the symptoms must be depressed mood or loss of interest or pleasure
What needs ruling out before making a diagnosis
Another medical condition as a cause of the symptoms.
Significant loss (e.g. bereavement, financial ruin, losses from natural disaster, a serious medical illness being diagnosed or disability).
Any psychotic disorders
Evidence of mania or hypomania, so long as this not drug related.
Changes relating to the bereavement clause (DSM4)
DSM5 acknowledges that reactions similar to MDD can happen following significant loss caused by bereavement but also by financial ruin, natural disasters, a serious medical illness being diagnosed or disability. Practitioners are advised to exercise clinical judgement regarding individual circumstances - a diagnosis may or may not be appropriate and should not be ruled out automatically if treatment would be beneficial. There is guidance about detecting the difference between "normal" grief reactions and MDD and practitioners are advised to think about cultural differences in the experiences of loss as research of grief may have Western bias.
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