1. Descriptions of symptoms and features

ICD-11 criteria

• ICD-11 for Major Depressive Episode (MDE)

  • ICD-11 defines MDE → in category of Mood (Affective) Disorder)

  • To diagnose MDE → at least 5 symptoms = MUST be present → during 2-week period → including at least 1 of the following:

    1. Depressed mood → most of the day/nearly everyday

    2. Loss of interest/pleasure → anhedonia

  • Additional symptoms include:

    • Significant weight loss/gain → decrease/increase in appetite

    • Insomnia/hypersomnia → lack/excessive sleep

    • Psychomotor agitation/retardation → relentless/slowed movements

    • Fatigue/loss of energy

    • Feelings of worthlessness/excessive guilt

    • Diminished ability to think/concentrate → indecisiveness

    • Suicidal thoughts/attempts

• Symptoms → must cause clinically significant stress OR impairment in social/occupation/other important areas of functioning

  • Symptoms → should not be better explained → by substance use/medical conditions

• Duration specified = at least 2 weeks → episode can be categorized → based on severity → i.e. mild/moderate/severe

DSM-5 criteria

• According to DSM-5 → diagnosed Major Depressive Disorder (MDD)

  • At least 5 of the following symptoms = must be present → during 2 weeks + represent change from previous functioning:

    • Depressed mood → most/nearly everyday

    • Markedly diminished interest/pleasure → anhedonia

    • Significant weight loss/gain → decrease/increase in appetite

    • Insomnia/hypersomnia → lack/excessive sleep

    • Psychomotor agitation/retardation → relentless/slowed movements

    • Fatigue/loss of energy

    • Feelings of worthlessness/excessive guilt

    • Diminished ability to think/concentrate → indecisiveness

    • Thoughts of death + suicidal ideation/attempt

• Symptoms → must cause clinically significant distress/impairment → social/occupational, etc. → of functioning

• Episode = not attributable → to physiological effects of substance → i.e. drug use/medication

• Symptoms = not better explained → by another mental disorder → e.g. BPD + schizophrenia

Emotional symptoms

• Persistent low mood → feelings of sadness/hopelessness/emptiness → that lasts most of the day

• Loss of interest/pleasure → anhedonia

Cognitive symptoms

• Negative thoughts → constant feelings of worthlessness/guilt + negative view of oneself + others + the future

  • Blame themselves → for events out of their control

  • Lack of self-confidence

• Difficulty concentrating → struggling to focus/make decisions → due to mental fatigue/negative thinking

• Thoughts of deaths/suicide → people with depression = may experience recurring thoughts of death/suicide → as a way of escaping their emotional pain

Behavioural symptoms

• Social withdrawal → avoiding social interactions/isolating oneself from friends + family

• Decreased activity → reduction in ability/desire → to engage in physical activities

• Fatigue + reduced energy levels → knock-on effect → when individuals withdraw from work + social life

• Signs of psychomotor retardation → agitation/slowing down → can manifest as restlessness/noticeable decrease → in movement/speech

Physical symptoms

• Changes in sleep patterns → insomnia/hypersomnia

• Appetite changes + significant weight loss/gain

• Persistent tiredness → even after adequate rest

Key features

• More persistent in women → than in men

• Divorced/separated people → 27%

• Single → 20%

• Stable relationship → 16%

• More likely to report depression → in lower-income households

• Age group @ risk = 50-54