Diagnostic Criteria for Major Depressive Disorder*

A.

The patient has depressed mood (e.g., sad or empty feeling) or loss of interest or pleasure most of the time for 2 or more weeks plus 4 or more of the following symptoms:

Sleep

Insomnia or hypersomnia nearly every day

Interest

Markedly diminished interest or pleasure in nearly all activities most of the time

Guilt

Excessive or inappropriate feelings of guilt or worthlessness most of the time

Energy

Loss of energy or fatigue most of the time

Concentration

Diminished ability to think or concentrate; indecisiveness most of the time

Appetite

Increase or decrease in appetite

Psychomotor

Observed psychomotor agitation or retardation

Suicide

Recurrent thoughts of death or suicidal ideation

B.

The symptoms do not meet criteria for mixed episode (major depressive episode and 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 (e.g., a drug of abuse, a medication) or a general medical condition

E.

The symptoms are not better accounted for by bereavement

*Adapted from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV).