Side-by-side review

Compare two specifiers

Find the deciding clinical difference.

Ask this

Is the central pattern “anxious arousal occurring within a mood episode” or “non-reactive, biologically patterned depression”?

Anxious distress

Prominent tension, restlessness, worry, or fear accompanies the current mood episode.

Episode features

Melancholic features

Profound loss of pleasure or mood reactivity occurs with a characteristic biological and psychomotor pattern.

Episode features

Clinical focus

AAnxious arousal occurring within a mood episode

BNon-reactive, biologically patterned depression

Time course

ATracks the current depressive or manic-spectrum episode

BPersists across the depressive episode

Look for

ATension, restlessness, worry, dread, fear of losing control

BAnhedonia, non-reactivity, diurnal change, psychomotor change, guilt

Do not overcall from

ADo not infer it from insomnia or agitation alone

BSeverity alone does not establish melancholic features

Example wording

Major depressive disorder, current episode, with anxious distress

Open full guide

Example wording

Major depressive disorder, current episode, with melancholic features

Open full guide

Browse the map Build diagnostic wording

Side-by-side review

Compare two specifiers

Find the deciding clinical difference.

Ask this

Is the central pattern “anxious arousal occurring within a mood episode” or “non-reactive, biologically patterned depression”?

Anxious distress

Prominent tension, restlessness, worry, or fear accompanies the current mood episode.

Episode features

Melancholic features

Profound loss of pleasure or mood reactivity occurs with a characteristic biological and psychomotor pattern.

Episode features

Clinical focus

AAnxious arousal occurring within a mood episode

BNon-reactive, biologically patterned depression

Time course

ATracks the current depressive or manic-spectrum episode

BPersists across the depressive episode

Look for

ATension, restlessness, worry, dread, fear of losing control

BAnhedonia, non-reactivity, diurnal change, psychomotor change, guilt

Do not overcall from

ADo not infer it from insomnia or agitation alone

BSeverity alone does not establish melancholic features

Example wording

Major depressive disorder, current episode, with anxious distress

Open full guide

Example wording

Major depressive disorder, current episode, with melancholic features

Open full guide

Browse the map Build diagnostic wording