Criteria for Severity/Psychotic/Remission Specifiers for current (or most recent) Major Depressive Episode
(cautionary statement)
Note: Code in fifth digit. Can be applied to the most recent Major Depressive Episode
in Major Depressive Disorder and to a Major Depressive Episode in
Bipolar I or II Disorder only if it is the most recent type of
mood episode.
.x1--Mild: Few, if any, symptoms in excess of those required to make the diagnosis and
symptoms result in only minor impairment in occupational functioning or in usual social activities or relationships with others.
.x2--Moderate: Symptoms or functional impairment between "mild" and "severe."
.x3--Severe Without Psychotic Features: Several symptoms in excess of those required to make the diagnosis, and symptoms markedly interfere with occupational functioning or with usual social activities or relationships with others.
.x4--Severe With Psychotic Features: Delusions or
hallucinations. If possible, specify whether the
psychotic features are mood-congruent
or mood-incongruent:
Mood-Congruent Psychotic Features: Delusions or hallucinations whose content is entirely consistent with the typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment.
Mood-Incongruent Psychotic Features: Delusions or hallucinations whose content does not involve typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment. Included are such symptoms as
persecutory delusions (not directly related to depressive themes),
thought insertion, thought
broadcasting, and delusions of control.
.x5--In Partial Remission: Symptoms of a Major Depressive Episode are present but full criteria are not met, or there is a period without any significant symptoms of a Major Depressive Episode lasting less than 2 months following the end of the Major Depressive Episode. (If the Major Depressive Episode was superimposed on
Dysthymic Disorder, the diagnosis of Dysthymic Disorder alone is given once the full criteria for a Major Depressive Episode are no longer met.)
.x6--In Full Remission: During the past 2 months, no significant signs
or symptoms of the disturbance were present.
.x0--Unspecified.
Reprinted with permission from the Diagnostic
and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American
Psychiatric Association
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