Depression Criteria Mnemonic

Mnemonic: DEPRESSION

Major symptoms

1. Depressed mood
2. Energy loss or fatigue
3. Pleasure loss or anhedonia

Minor symptoms

1. Retardation or agitation (psychomotor)
2. Eating and weight change (at least 5% in the last month)
3. Sleep changed – insomnia or hypersomnia
4. Suicidial ideation or behavior
5. I‘m a failure (Loss of confidence or self-esteem)
6. Only me to blame (guilt)
7. No concentration, Indecisiveness or inability to think

Alternative mnemonic: SIGECAPS

1. Sad/depressed mood
2. Interest reduced/anhedonia
3. Guilt/worthlessness
4. Energy reduced/easy fatiguability
5. Concentration reduced (pseudodementia)
6. Appetite (weight change >5% in a month)
7. Psychomotor retardation/agitation
8. Suicidal thoughts or acts
9. Sleeping disturbances

Criteria for Major Depressive Disorder

1. Duration: ≥2 weeks, most of the day, nearly every day
2. Organic causes must be excluded: not attributable to the abuse of psychoactive substances or to an organic mental disorder.
3. ICD-11 criteria vs DSM-V criteria: While ICD-10 criteria recognizes loss of energy or fatigue as a major or key symptoms, DSM-V and ICD-11 doesn’t recognize it as a key symptom. Hence, DSM-V has only 2 key symptoms.
   • “Loss of confidence or reduced self-esteem” is there in ICD-10/11 criteria (total 10 symptoms) but not there in DSM-V criteria (total 9 symptoms).
   • Diagnosis by DSM-V and ICD-11: ≥5 symptoms with ≥1 of the 2 key symptoms – “S” or “I” symptoms from SIGECAPS or “D” or “P” symptoms from DEPRESSION mnemonic
   • Diagnosis by ICD-10: ≥2 of the 3 key symptoms – “S”, “I” or “E” symptoms from SIGECAPS or “D”, “E” or “P” symptoms from DEPRESSION mnemonic + ≥2 of other symptoms

Grading of Depression

Unlike in the ICD-10, grading of depression into mild, moderate and severe is not based on the sum of the symptoms, but also takes into account their intensity and the degree of functional impairment in addition to the number of symptoms.

Dr. Sulabh Kumar Shrestha, MS Orthopedics

He is the section editor of Orthopedics in Epomedicine. He searches for and share simpler ways to make complicated medical topics simple. He also loves writing poetry, listening and playing music. He is currently pursuing Fellowship in Hip, Pelvi-acetabulum and Arthroplasty at B&B Hospital.