Diagnosis

The diagnosis of depressions requires fulfillment of the following criteria:

1. Mood or Loss of Interest or Pleasure (Symptoms present > 2 wks)
   
            and

2. Vegetative signs present for > 2 wks
       (remembered by mnemonic “SIG-E-CAPS”)

        Major depression requires  4 of  8 vegetative signs (See chart below)
        Minor depression requires  3 of  8 vegetative signs (See chart below)

3. Symptoms must cause distress
    

4. Symptoms not due to a physiologic chorus

1. Mood

Assessment in the elderly may require the use of questions such as:

            How is your mood?
            How are your spirits?
            Are you feeling blue?

2. Vegetative signs:

Often these are revealed incidentally by the patient during the interview.  A technique the writer uses is to “jot” down “SIG E CAPS” on my notes and as the patient mentions one of the symptoms, I just notate.

 WHEN IN DOUBT about diagnosis: 

1. Get psychiatric consult.    

(If you wish to know the origins of the mnemonic (“SIG-E-CAPS”) click on it here. (This is clever but optional material and likely will never appear on boards)