definiens: I ' ) • [ lliJ I 38 . DEPRESSION is defined as persistent depressed mood, anhedonia, or vegetative signs 38.0 sufficient to interfere with daily functioning . Depression can impair cognitive function or alter a person 's self - report of his / her behavior . However, it is typically not possible for an examiner to know whether altered performance on cognitive assessment ( or other portions of the UHDRS ) was adversely affected by depression . Therefore, rather than rating whether depression affected the UHDRS, examiners should just consider the question more simply : Does the examiner believe that the participant is showing signs of depression ? ( 0 = No, 1 = Yes ) INSTRUCTIONS : Items 39 and 40 are used to indicate that the examiner believes that a clinical evaluation or clinical follow up is warranted to assess the need for pharmacotherapy for depression or for irritability . The examiner 's opinion could have arisen in the course of administering the UHDRS ( or some portion ), or as a result of contact with the subject or an informant at the time of the visit Thus, if a subject is on medications for depression and/or irritability, and appears to be responding well to the current treatments, the examiner is unlikely to feel that a clinical evaluation or follow up is warranted at this time . If the subject is having difficulty that, in the examiner 's opinion might warrant initiating, adding to, or changing pharmacotherapy, the appropriate item(s ) should be answered · yes " . Regardless of who the examiner is and regardless of the examiner 's area of expertise, these items can be used to express the examiner 's view that a clinical evaluation or follow up is recommended