1. Persistent sad or empty mood, either by patient’s report or by observation of others. In children and adolescents, this can be irritable mood.
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (again, as either reported by the patient or as observed by others).
3. Significant change in appetite or body weight.
4. Difficulty sleeping or oversleeping (“insomnia” or “hypersomnia”).
5. Physical slowing or agitation as observed by others.
6. Fatigue or loss of energy.
7. Feelings of worthlessness or inappropriate guilt.
8. Difficulty thinking or concentrating, or indecisiveness (again, as either reported by the patient or as observed by others).
9. Recurrent thoughts of death or suicide.
