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O'Connor EA, Whitlock EP, Gaynes B, et al. Screening for Depression in Adults and Older Adults in Primary Care: An Updated Systematic Review [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2009 Dec. (Evidence Syntheses, No. 75.)

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Screening for Depression in Adults and Older Adults in Primary Care: An Updated Systematic Review [Internet].

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Table 1Primary DSM-IV depression disorders, criteria for adults²

Depressive Diagnoses	Symptoms
*Major Depressive Episode:* - 5 or more depressive symptoms for ≥ 2 weeks - Must have either depressed mood or loss of interest/pleasure - Symptoms must cause significant distress or impairment - No manic or hypomanic behavior *Minor Depressive Episode:^ - 2–4 depressive symptoms for ≥2 weeks - Must have either depressed mood or loss of interest or pleasure - Symptoms must cause significant distress or impairment - No manic or hypomanic behavior	Depressed Mood Markedly diminished interest or pleasure in most or all activities Significant weight loss (or poor appetite) or weight gain Insomnia or hypersomnia Psychomotor retardation Fatigue or loss of energy Feelings of worthlessness or excessive or inappropriate guilt Diminished ability to think or concentrate, or indecisiveness Recurrent thoughts of death (not just fear of dying), or suicidal ideation, plan, or attempt
*Dysthymic Disorder* - Depressed mood for most of the time for at least two years - Presence of 2 or more of symptoms of dysthymia - Never without symptoms for 2 months or more over 2 year period - Symptoms must cause clinically significant distress or impairment - No major depressive disorder in first two years, no manic, hypomanic, or mixed episodes.	Significant weight loss (or poor appetite) or weight gain Insomnia or hypersomnia Fatigue or loss of energy Low self-esteem Diminished ability to think or concentrate, or indecisiveness Feelings of hopelessness

Depressive Diagnoses

Symptoms

Major Depressive Episode:

- 5 or more depressive symptoms for ≥ 2 weeks
- Must have either depressed mood or loss of interest/pleasure
- Symptoms must cause significant distress or impairment
- No manic or hypomanic behavior

Minor Depressive Episode:^*

- 2–4 depressive symptoms for ≥2 weeks
- Must have either depressed mood or loss of interest or pleasure
- Symptoms must cause significant distress or impairment
- No manic or hypomanic behavior

Depressed Mood
Markedly diminished interest or pleasure in most or all activities
Significant weight loss (or poor appetite) or weight gain
Insomnia or hypersomnia
Psychomotor retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive or inappropriate guilt
Diminished ability to think or concentrate, or indecisiveness
Recurrent thoughts of death (not just fear of dying), or suicidal ideation, plan, or attempt

Dysthymic Disorder

- Depressed mood for most of the time for at least two years
- Presence of 2 or more of symptoms of dysthymia
- Never without symptoms for 2 months or more over 2 year period
- Symptoms must cause clinically significant distress or impairment
- No major depressive disorder in first two years, no manic, hypomanic, or mixed episodes.

Significant weight loss (or poor appetite) or weight gain
Insomnia or hypersomnia
Fatigue or loss of energy
Low self-esteem
Diminished ability to think or concentrate, or indecisiveness
Feelings of hopelessness

*: not a formal diagnosis but considered a research category requiring further study

From: 1, Introduction

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O'Connor EA, Whitlock EP, Gaynes B, et al. Screening for Depression in Adults and Older Adults in Primary Care: An Updated Systematic Review [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2009 Dec. (Evidence Syntheses, No. 75.) Table 1, Primary DSM-IV depression disorders, criteria for adults.
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