According to DSM-5, a diagnosis of Major Depressive Disorder requires five or more symptoms present during the same two-week period. At least one of these must be:

• A Recurrent thoughts of death or suicidal ideation
• B Fatigue or loss of energy
• C Feelings of worthlessness or excessive guilt
• D Depressed mood or loss of interest or pleasure ✓

Explanation

DSM-5 mandates that at least one of the two cardinal symptoms be present: depressed mood, or anhedonia (markedly diminished interest or pleasure in activities). The remaining four symptoms are drawn from the other seven criterion items (weight change, sleep disturbance, psychomotor change, fatigue, guilt/worthlessness, concentration difficulty, suicidal ideation). Fatigue, guilt, and suicidal ideation can all contribute toward the count of five but cannot substitute for the two cardinal symptoms.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th ed.

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Written and medically reviewed by the StethoPrep medical team.