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Criteria A 5+ 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.
1. Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others.
Note: in children/adolescents can be irritable mood
2. Markedly diminished interest or
pleasure in all, or almost all, activities most of the day, nearly every day (indicated by subjective account or observation).
3. Significant weight loss or weight gain (not dieting), or decrease or increase in appetite nearly every day.
Note: in children, consider failure to make expected weight gain.
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation/retardation nearly every day (can be observed by others).
6. Fatigue or loss of energy nearly every day.
7.
Feelings of worthlessness or excessive or inappropriate guilt (may be delusional) nearly every day.
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
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.
Criteria B The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Criteria C The episode is not attributable to the physiological effects of a substance or to another medical condition.
Note: Criteria A-C represent a major depressive episode
Note: Important to distinguish grief (e.g. loss of loved one) from a major depressive episode
Criteria D The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.
Criteria E There has never been a manic episode or hypomanic episode
Note: This exclusion does not apply if all of the manic-like or hypomanic-like episodes are substance-induced or are attributable to the physiological effects of another medical condition.
Criteria (A) Distinct period of abnormally and persistently elevated, expansive or irritable mood lasting at least ONE WEEK and present most of day, nearly everyday (or any duration of hospitalization is necessary)
Criteria (B) During mood disturbance or increased energy or activity, THREE or more Sx (4 if the mood is only irritable) are present to significant degree and represent a noticeable change from usual Bx- (1) Inflated self-esteem or grandiosity, (2) Decreased need for sleep, (3) More talkative than usual or pressure to keep talking, (4) Flight of ideas or subjective experience that thoughts are racing, (5) Distractibility, (6) Increase in goal directed activity (Socially, work, school, or sexual) or psychomotor agitation (purposeless non-goal directed activity)
Criteria (C) Causes significant impairment in functioning or necessary hospitalization
Criteria (D) Not attributable to physiological effects of substances or medical condition
With anxious distress, With mixed features, With Rapid Cycling, With melancholic features, With Atypical features, With mood-congruent psychotic features, With mood-incongruent psychotic features, With catatonia, With peripartum onset, With seasonal pattern
SPECIFY Course: In partial remission or In full remission
SPECIFY severity: mild, moderate, severe
Criteria (A) Period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least FOUR consecutive days and present most days, nearly every day
Criteria (B) During mood disturbance or increased energy or activity, THREE or more Sx (4 if the mood is only irritable) are present to significant degree and represent a noticeable change from usual Bx: (1) Inflated self-esteem or grandiosity (2) Decreased need for sleep (3) More talkative than usual or pressure to keep talking (4) Flight of ideas or subjective experience that thoughts are racing (5) Distractibility (6) Increase in goal directed activity (Socially, work, school, or sexual) or psychomotor agitation (purposeless non-goal directed activity) (7) Excessive involvement in activities that have high potential for painful consequences (unrestricted buying sprees, sexual indiscretions, or foolish business investments)
Criteria (C) Episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic
Criteria (D) Disturbance in mood and the change in functioning are observable by others
Criteria (E) Episode not severe enough to cause impairment or hospitalization. If any psychotic features, episode is by definition manic
Criteria (F) Not attributable to effects of substance