Unifying Concepts

Diagnostic Criteria for Major Depression

In major depression, the person’s mood is described as depressed, sad, hopeless, discouraged, or “down in the dumps”.

Diagnostic Criteria for Major Depression (American Psychiatric Association)

  • Period of at least 2 wk during which five or more symptoms have been present (at least one of the symptoms is either depressed mood or loss of interest or pleasure in nearly all activities).
  • Changes in appetite or decrease or increase in weight, insomnia or hypersomnia, and psychomotor agitation or retardation; decreased energy; feelings of worthlessness or guilt; difficulty in thinking, concentrating, or making decisions; recurrent thoughts of death or suicidal ideation, plans, or attempts.
  • Symptoms are either new or worse than before the depressive episode, and they persist for most of the day, nearly every day, for at least 2 consecutive wk.
  • Episode accompanied by clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • Symptoms are not due to bereavement or to direct physiological effect of medication, general medical condition, or substance abuse



  1. Diagnostic and statistical manual of mental disorders, 4th ed. rev.: DSM-IV-R. Washington, DC: American Psychiatric Association, 2000.
  2. Frye MA. Clinical practice. Bipolar disorder–a focus on depression. N Engl J Med. 2011 Jan 6;364(1):51-9. [Medline]


Created: Jan 12, 2011.

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