Assessing depression and its severity


The following guidance is taken directly from NICE guidelines13:

The assessment of depression is based on the criteria in DSM-IV. Assessment should include the number and severity of symptoms, duration of the current episode, and course of illness.

The diagnosis of depression should not be based on a symptom count alone and is merely the first step in consideration of the individual's particular circumstances. Previous guidelines included basing the diagnosis of depression on the criteria in ICD-1. These are not included in the current guidelines as the evidence base for treatments nearly always use DSM-IV.

Key symptoms:

  • persistent sadness or low mood; and/or
  • marked loss of interests or pleasure.

At least one of these, most days, most of the time for at least 2 weeks.

If any of above present, ask about associated symptoms:

  • disturbed sleep (decreased or increased compared to usual)
  • decreased or increased appetite and/or weight
  • fatigue or loss of energy
  • agitation or slowing of movements
  • poor concentration or indecisiveness
  • feelings of worthlessness or excessive or inappropriate guilt
  • suicidal thoughts or acts.

Then ask about duration and associated disability, past and family history of mood disorders, and availability of social support



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