Expertise Details




• Depressive disorders are characterised by persistent low mood, loss of interest and enjoyment and reduced energy. They often impair day-to-day functioning.

• Major depressive disorder is characterised by one or more major depressive episodes (i.e. at least 2 weeks of depressed mood or loss of interest accompanied by at least four additional symptoms of depression).

Clinical Features


• Depressed (dysphoric) mood is the most characteristic feature. There may be diurnal variation of the mood, the depressed mood being worst in the early morning or in the evening.

• Loss of pleasure in life, and loss of interest in oneself and others.

• Low self-esteem and ideas of hopelessness and worthlessness.

• Self-blame and feelings of excessive or inappropriate guilt.

• Psychotic features (e.g. hallucinations, delusions, etc.) may be present such a condition is known as psychotic depression.


• Sleep disturbance may occur as initial insomnia, early morning wakening or hypersomnia.

• Fatigue, headache and various other pains.

• Anorexia, weight loss or weight gain, and constipation.

• Poor concentration, psychomotor retardation and reduced libido.


1. Depressed mood most of the day, nearly every day as indicated by either subjective report (e.g. feels sad,

empty, hopeless) or observations made by others (e.g. appears tearful)

2. Markedly diminished interest or pleasure in all or almost all activities most of the day, nearly every day

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

3. Loss of energy or fatigue nearly every day

4. Loss of confidence or self-esteem

5. Recurrent thoughts of death or suicide or any suicidal behaviour

6. Diminished ability to think or concentrate or indecisiveness, nearly every day

7. Unreasonable feelings of self-reproach or excessive or inappropriate guilt, nearly every day

8. Psychomotor agitation or retardation, nearly every day

9. Insomnia or hypersomnia, nearly every day

10. Change in appetite (decrease or increase with corresponding weight change)


1. Symptoms 1 and/or 2 and any 4 others must be present for at least 2 weeks

2. Symptoms not caused by a medical condition, a substance or a bereavement



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