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.
- 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