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DSM-5 Criteria for Major Depressive Disorder

DSM-5 Criteria -MDD

Defines diagnostic criteria for major depressive disorder

DSM-5 Criteria for Major Depressive Disorder

DSM-5 Criteria -MDD

Defines diagnostic criteria for major depressive disorder

Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly due to a medical condition.
Symptoms
1. Depressed mood
Depressed most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). Note: Do not include symptoms that are clearly due to a medical condition.
2. Anhedonia
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).
3. Weight or appetite change
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. Note: Will not be assessed if entirely due to somatic treatment.
4. Insomnia or hypersomnia
Nearly every day.
5. Psychomotor agitation or retardation
Nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
6. Fatigue or loss of energy
Nearly every day.
7. Feelings of worthlessness or excessive guilt
Nearly every day (not merely self-reproach or guilt about being sick).
8. Diminished ability to think or concentrate, or indecisiveness
Nearly every day (either by subjective account or as observed by others).
9. Recurrent thoughts of death, suicidal ideation, or suicide attempt
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.
Additional Criteria
Symptoms represent a change from previous functioning?
Symptoms present nearly every day for at least the past 2 weeks?
Do the symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning?
Are the symptoms not better explained by the physiological effects of a substance (e.g., drug of abuse, medication) or another medical condition?
Is there no history of a manic or hypomanic episode?
0/9 — Negative
0/14 answered · check to select

Instructions

The DSM-5 criteria provide a structured way to diagnose Major Depressive Disorder. A clinician should assess whether the individual meets the required number of symptoms, their duration, and the level of impairment in daily functioning.

Overview
When to use
Why use
Evidences

Interpretation

Criteria

Requirement

Symptoms

≥ 5 present during the same 2-week period

Core Symptoms

Depressed mood or loss of interest/pleasure required

Duration

Symptoms present most of the day, nearly every day, for ≥ 2 weeks

Impairment

Clinically significant distress or impairment in functioning

Exclusion

Not attributable to substances, medical illness, or psychotic disorders

Regier DA et al. DSM-5 field trials in the United States and Canada, Part II: test-retest reliability of selected categorical diagnoses. Am J Psychiatry. 2013;170(1):59–70. Reports moderate interrater reliability for MDD in real-world field trials, supporting operational use while noting limitations.
https://psychiatryonline.org/doi/full/10.1176/appi.ajp.2012.12070999

Fried EI, Nesse RM. Depression sum-scores don’t add up: why analyzing specific symptoms is essential. BMC Med. 2015;13:72. Highlights heterogeneity within DSM symptom sets and variable impairment contributions of individual symptoms, relevant for interpreting DSM-5 MDD criteria in research/clinics.
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0325-4

Guo T et al. Measurement-based care versus standard care for major depression: a randomized controlled trial. Am J Psychiatry. 2015;172(10):1004–1013. Demonstrates improved outcomes when DSM-5 diagnosis is paired with standardized symptom monitoring (e.g., PHQ‑9) and algorithmic adjustments.
https://psychiatryonline.org/doi/10.1176/appi.ajp.2015.14050652

Overview
When to use
Why use
Evidences

Major Depressive Disorder (MDD) is one of the most common psychiatric conditions worldwide, with significant impact on quality of life, functioning, and overall health. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, outlines standardized criteria for diagnosing MDD.

According to DSM-5, a diagnosis requires the presence of five or more depressive symptoms during the same two-week period, representing a change from previous functioning. Importantly, at least one of the symptoms must be either depressed mood or loss of interest/pleasure (anhedonia). Other symptoms may include weight or appetite changes, sleep disturbances, psychomotor changes, fatigue, feelings of worthlessness or guilt, concentration difficulties, and recurrent thoughts of death or suicide.

Symptoms must cause clinically significant distress or impairment in social, occupational, or other areas of functioning, and they cannot be attributable to the physiological effects of a substance or another medical condition. The DSM-5 also requires that the episode is not better explained by schizoaffective disorder, schizophrenia, or other psychotic disorders, and that there has never been a manic or hypomanic episode.

Overview
When to use
Why use
Evidences

Interpretation

Criteria

Requirement

Symptoms

≥ 5 present during the same 2-week period

Core Symptoms

Depressed mood or loss of interest/pleasure required

Duration

Symptoms present most of the day, nearly every day, for ≥ 2 weeks

Impairment

Clinically significant distress or impairment in functioning

Exclusion

Not attributable to substances, medical illness, or psychotic disorders

Regier DA et al. DSM-5 field trials in the United States and Canada, Part II: test-retest reliability of selected categorical diagnoses. Am J Psychiatry. 2013;170(1):59–70. Reports moderate interrater reliability for MDD in real-world field trials, supporting operational use while noting limitations.
https://psychiatryonline.org/doi/full/10.1176/appi.ajp.2012.12070999

Fried EI, Nesse RM. Depression sum-scores don’t add up: why analyzing specific symptoms is essential. BMC Med. 2015;13:72. Highlights heterogeneity within DSM symptom sets and variable impairment contributions of individual symptoms, relevant for interpreting DSM-5 MDD criteria in research/clinics.
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0325-4

Guo T et al. Measurement-based care versus standard care for major depression: a randomized controlled trial. Am J Psychiatry. 2015;172(10):1004–1013. Demonstrates improved outcomes when DSM-5 diagnosis is paired with standardized symptom monitoring (e.g., PHQ‑9) and algorithmic adjustments.
https://psychiatryonline.org/doi/10.1176/appi.ajp.2015.14050652

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