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DSM-IV - Minor Depressive Disorder


[From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text rev. Washington, DC: American Psychiatric Association; copyright 2000.] ...

  1. A mood disturbance, defined as follows:
    1. at least two (but less than five) 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 (a) or (b):
      1. depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
      2. 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. 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: In children, consider failure to make expected weight gains.
      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 or inappropriate guilt (which may be delusional) 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 (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
    2. the symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
    3. 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.g., hypothyroidism)
    4. the symptoms are not better accounted for by bereavement (i.e., a normal reaction to the death of a loved one)
  2. There has never been a major depressive episode, and criteria are not met for dysthymic disorder.
  3. There has never been a manic episode, a mixed episode, or a hypomanic episode, and criteria are not met for cyclothymic disorder. Note: This exclusion does not apply if all of the manic-, mixed-, or hypomanic-like episodes are substance or treatment induced.
  4. The mood disturbance does not occur exclusively during schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, or psychotic disorder not otherwise specified.

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