Document ID: chunk:federal_register_of_legislation:F2024L00045:reg:7:p1
Version: federal_register_of_legislation:F2024L00045
Segment Type: reg
Provision Reference: reg 7 (pt 1/5)
Character Range: 1703–4943

7               Kind of injury, disease or death to which this Statement of Principles relates
(1)          This Statement of Principles is about depressive disorder and death from depressive disorder.
Meaning of depressive disorder
(2)          For the purposes of this Statement of Principles, depressive disorder means:
(a)          major depressive disorder; or
(b)          major depressive episode; or
(c)          persistent depressive disorder (including dysthymia); or
(d)          depressive disorder due to another medical condition; or
(e)          substance/medication-induced depressive disorder; or
(f)           premenstrual dysphoric disorder; or
(g)          other specified depressive disorder or unspecified depressive disorder; where:
(3)          major depressive disorder meets the following criteria (derived from DSM-5-TR):
(a)          Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either depressed mood or loss of interest or pleasure.
(i)            Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful).
   Note: In children and adolescents, can be irritable mood.
(ii)         Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
(iii)       Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
(iv)        Insomnia or hypersomnia nearly every day.
(v)          Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
(vi)        Fatigue or loss of energy nearly every day.
(vii)     Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
(viii)   Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
(ix)        Recurrent thoughts of death (not just fear of dying); recurrent suicidal ideation without a specific plan; a specific suicide plan; or a suicide attempt.
(b)          The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
(c)          The episode is not attributable to the physiological effects of a substance or another medical condition.
(d)          At least one major depressive episode is not better explained by schizoaffective disorder and is not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.
(e)          There has never been a manic episode or a hypomanic episode.
Note: This exclusion does not apply if all of the manic-like or hypomanic-like episodes are substance-induced or are attributable to the physiological effects of