Calculators & Tools

Major Depressive Episode

DSM-5 criteria - symptoms in the same 2-week period, a change from previous function.

1 What is the Major Depressive Episode?

The Major Depressive Episode is a psychosocial scoring tool used in paediatric practice. DSM-5 criteria - symptoms in the same 2-week period, a change from previous function. It scores 9 criteria and interprets the total across 2 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in psychosocial
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 9 criteria: Depressed mood most of the day, nearly every day (children/adolescents: can be irritable mood); Markedly diminished interest or pleasure in almost all activities; Significant weight change or appetite change (children: failure to make expected weight gain); Insomnia or hypersomnia nearly every day; Psychomotor agitation or retardation observable by others; Fatigue or loss of energy nearly every day; Feelings of worthlessness or excessive/inappropriate guilt; Diminished ability to think or concentrate; indecisiveness; Recurrent thoughts of death, suicidal ideation, or a suicide attempt/plan. Totals are then banded: any score - Below threshold: fewer than 5 symptoms in the same 2-week period; 5 criteria met or more - Threshold met: ≥5 symptoms over the same 2 weeks - and at least ONE must be depressed mood or loss of interest. Assess suicide risk now and arrange mental-health review.
  • DSM-5 threshold: 5 or more of the 9 criteria listed.
  • A diagnosis also requires clinically significant distress or impairment, the required duration, and exclusion of substance use or another condition. Screening aid only - not a diagnosis.
  • At least one of the first two criteria (depressed mood / anhedonia) must be present.
  • Always ask directly about suicidal ideation and safety, regardless of total.

4 Frequently asked questions

How many criteria does the Major Depressive Episode use?

9. They are Depressed mood most of the day, nearly every day (children/adolescents: can be irritable mood); Markedly diminished interest or pleasure in almost all activities; Significant weight change or appetite change (children: failure to make expected weight gain); Insomnia or hypersomnia nearly every day; Psychomotor agitation or retardation observable by others; Fatigue or loss of energy nearly every day; and others.

What do the bands of the Major Depressive Episode mean?

The total is interpreted as: any score - Below threshold: fewer than 5 symptoms in the same 2-week period; 5 criteria met or more - Threshold met: ≥5 symptoms over the same 2 weeks - and at least ONE must be depressed mood or loss of interest. Assess suicide risk now and arrange mental-health review.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

DSM-5 threshold: 5 or more of the 9 criteria listed.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.