Medicine (MD/DO)
Mood Disorders
SIG E CAPS for Major Depressive Disorder (MDD)

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SIG E CAPS for Major Depressive Disorder (MDD)

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SIG E CAPS for Major Depressive Disorder (MDD)

E-cigarette caps with Major Depressed-emo
Major Depressive Disorder (MDD) is a psychiatric disorder that can be diagnosed by establishing the occurrence of one or more major depressive episodes (MDEs) in a patient. SIG E CAPS is a mnemonic to remember 8 criteria that may accompany a depressed mood that are used by a clinician to assess the presence of an episode. Five of the nine following criteria, the 9th being depressed mood, must be present for at least 2 weeks to be considered an MDE, and at least 1 of these criteria must be either a depressed mood or anhedonia. Experiencing an MDE is a high-risk factor for suicidal later in life, especially if hospitalization is required.
Sleep Problems
Broken Snooze-alarm

Patients complain of varying sleep disturbances with a depressive episode, which may include insomnia (inability to fall asleep and/or stay asleep) and hypersomnia (excessive sleepiness).

Interest Deficit
Interests in the Trash

When somebody states they no longer have interest or take pleasure in activities they enjoyed in the past, this is called anhedonia. This is an important criterion because either anhedonia or a depressed mood must be present along with a minimum of four other symptoms to diagnose an MDE.

Guilt or Worthlessness
Guilty-gavel and Empty-pockets

People with MDD may express feelings of guilt or regret about their own or someone else’s actions or feelings. They may feel there is no way to rectify past events, and thus feel hopeless or worthless.

Energy Loss or Fatigue
Dead-battery with Sleepy-guy

When asked to describe their energy levels throughout the day, patients may endorse low or nonexistent levels. They may feel fatigued despite obtaining adequate or excessive amounts of sleep.

Concentration Difficulty
Difficulty using Concentration

Patients with MDD may be unable to carry out their daily work or school tasks due to an inability to focus or difficulty making decisions.

Appetite Changes
Nutritional-plate with Delta-sign

Appetite changes go full spectrum in major depression; patients gain weight rapidly from excessive eating or they lose weight unintentionally from poor appetite or a disinterest in food. These changes can be quantified by determining if there is a > 5% change in weight in a month.

Psychomotor Retardation or Agitation
Brain-motor and Agitation

Examples of psychomotor retardation include slowed or decreased speech and movements; examples of psychomotor agitation include constantly fidgeting with clothes or objects, pacing back and forth, and handwringing. Either of these manifestations must be observed by a third-party to meet this criterion.

Suicidal Ideation
Suicide-bridge Idea

During an MDE, patients may become preoccupied with recurrent thoughts about death and self-harm. Any form of a suicide attempt reported by a patient, regardless of actual lethality, meets criteria and must be taken seriously. Although an suicidal attempt does not need to be made to meet this criterion, recurrent suicidal thoughts are enough.

5 Symptoms Including Depressed Mood or Anhedonia for 2 Weeks
(5) Hand Sx with Depressed-emo in (2) Tutu on Weekly-newspaper

Psychiatric diseases are classified by clinicians according to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the most recent edition of which is the DSM-V. The DSM-V states that for the diagnosis of major depression to be fulfilled, 5 of the SIG E CAPS criteria must be present for a minimum of 2 weeks; one of which must be depressed mood or anhedonia.


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