DSM-5-TR: major depressive episode

For Criterion A.3, failure to make expected weight gain should be considered when diagnosing children.¹ Criterion A.7 should not be fulfilled based on self-reproach or guilt about being sick.¹

Major depressive episodes are common in bipolar I disorder, but are not required for a diagnosis.¹ Response to a significant loss (e.g., bereavement, financial, losses from a natural disaster) may include some of the symptoms listed in Criterion A, resembling a depressive episode.¹ These symptoms may be understandable or considered appropriate to the loss; however, the presence of a major depressive episode in addition to the normal response to a significant loss should also be carefully considered.¹ In this situation, a clinical judgement should be made, based on the patient’s history and cultural norms.¹

Reference:
1. American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition, text revision. Washington DC: APA; 2022.