Page 79 - Depression in adults: treatment and management

Depression in adults: treatment and management (NG222)

• significant changes in appetite or weight

• psychomotor agitation or retardation

• reduced energy or fatigue

In DSM-5 depression is defined as the presence of 5 or more symptoms from a list of 8 symptoms,

during the same 2-week period and where at least 1 of the symptoms is depressed mood or loss of
interest or pleasure. The 8 symptoms are:

• depressed mood most of the day, nearly every day

• markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly

every day

• significant weight loss when not dieting, or weight gain, or decrease or increase in appetite

nearly every day

• a slowing down of thought and a reduction of physical movement (observable by others, not

merely subjective feelings of restlessness or being slowed down)

• fatigue or loss of energy nearly every day

• feelings of worthlessness or excessive or inappropriate guilt nearly every day

• diminished ability to think or concentrate, or indecisiveness, nearly every day

• recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide

attempt or a specific plan for committing suicide.

In this guideline the term 'people with depression' is used. This includes people with a clinical

diagnosis of depression and those who feel themselves to be experiencing depression or depressive
symptoms, and recognises that people experience, describe and label their experiences of
depression in very individual ways.

Less severe depression Less severe depression

Less severe depression encompasses subthreshold and mild depression, and in this guideline was
defined as depression scoring less than 16 on the PHQ-9 scale.

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