Psychotic Depression - Diagnostic Criteria

Diagnostic Criteria

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a widely used manual for diagnosing mental disorders, patients who show at least six of the following symptoms in a period of two weeks may be diagnosed with PMD. In order to qualify for a PMD diagnosis, patients need to report either (1) or (3), and (11), along with three or four other symptoms (for a total of six). These symptoms also must be different from how patients felt or behaved at a previous time.

1. depressed mood most of the day nearly every day
2. noticeably increased or decreased sex drive
3. loss of interest or pleasure in all, or almost all, activities most of the day nearly every day
4. significant weight loss or weight gain, OR decrease or increase in appetite nearly every day
5. insomnia OR hypersomnia (sleeping excessively) nearly everyday
6. psychomotor agitation (moving more quickly) OR retardation (moving more slowly) nearly every day, so much that other people notice
7. fatigue OR loss of energy nearly every day
8. feelings of worthlessness OR excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
9. diminished ability to think or concentrate, OR indecisiveness, nearly every day
10. recurrent thoughts of death (not just fear of dying), recurrent ideas about suicide without a specific plan, or a suicide attempt or specific plan for committing suicide
11. delusions or hallucinations
12. increased and intense daydreaming

The symptoms cannot meet criteria for a Mixed Episode (diagnosed by a clinician) or be due to the effects of a substance or physical illness. The symptoms also must cause distress or impairment in functioning.