Table 1

DSM-IV symptoms of major depressive disorder and Endicott substitute symptoms (Endicott criteria)

DSM-IV symptomsEndicott substitute symptoms
Depressed mood most of the day*
Marked diminished interest or pleasure in all, or almost all, activities most of the day (Anhedonia)*
Weight loss or gain (>5% body weight in a month)/change in appetiteDepressed appearance
Insomnia or hypersomniaSocial withdrawal or decreased talkativeness
Psychomotor agitation or retardation
Fatigue or loss of energyBrooding, self-pity or pessimism
Feeling of worthlessness or excessive or inappropriate guilt
Diminished ability to think or concentrate, indecisivenessLack of reactivity; cannot be cheered up
Recurrent thoughts of death, or suicidal ideation or planning, or a suicide attempt
  • *One of these symptoms must be present for a diagnosis of major depressive disorder. Each symptom must also meet severity criteria of ‘most of the day’ or ‘nearly every day” with a duration of greater than 2 weeks. The symptoms must cause clinically significant distress or impairment. They are not due to a physiological effect of a medication or general medical condition, and must not be accounted for bereavement.