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DSM-IV-TR Diagnostic Criteria for a Major Depressive Episode
The American Psychiatric Association diagnosis depression using
the following criteria.
A. For a diagnosis of major depression, at least five of the following symptoms
must be present for 2 weeks or more, and must represent a change from a previous
functioning. Furthermore, at least one symptom must be (1) depressed mood or (2)
loss of interest or pleasure. (Note: Do not include mood-incongruent delusions
or hallucinations, or symptoms that are due to a general medical condition.)
• Depressed mood most of the day, nearly every day. (Note: In children and
adolescents, can be irritable mood.)
• Loss of interest or pleasure in all or almost all activities.
• Significant weight loss or weight gain without dieting or decrease or increase
in appetite (Note: In children, consider failure to make expected weight gains.)
• 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, recurrent suicidal ideation, a suicide attempt,
or a specific suicide plan.
B. The symptoms do not meet the criteria for a Mixed Episode (ie, an episode in
which criteria are met for a Major Depressive Episode and a Manic Episode).
C. The symptoms cause clinically significant distress or impairment in
social, occupational, or other important areas of functioning.
D. The symptoms are not due to the direct physiological effects of a
substance (eg, drug abuse, medication) or a general condition (eg,
hypothyroidism).
E. Major depression should not be diagnosed in the context of
bereavement (ie, after the loss of a loved one), unless the symptoms
persist for longer than 2 months, or are characterized by marked
functional impairment, morbid preoccupation with worthlessness, suicidal
ideation, psychotic symptoms, or psychomotor retardation | 
