Criteria for Melancholic Features Specifier
(cautionary statement)
Specify if:
With Melancholic Features (can be applied to the current or most recent Major Depressive Episode
in Major Depressive Disorder and to a Major Depressive Episode in
Bipolar I or Bipolar II Disorder
only if it is the most recent type of mood episode)
A. Either of the following, occurring during the most severe period of the current episode:
(1) loss of pleasure in all, or almost all, activities
(2) lack of reactivity to usually pleasurable stimuli (does not feel much better, even temporarily, when something good happens)
B. Three (or more) of the following:
(1) distinct quality of depressed mood (i.e., the depressed mood is experienced as distinctly different from the kind of feeling experienced after the death of a loved one)
(2) depression regularly worse in the morning
(3) early
morning awakening (at least 2 hours before usual time of awakening)
(4) marked psychomotor
retardation or agitation
(5) significant anorexia or weight loss
(6) excessive or inappropriate guilt
Reprinted with permission from the Diagnostic
and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American
Psychiatric Association
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