Side-by-side review

Compare two specifiers

Find the deciding clinical difference.

Ask this

Is the central pattern “non-reactive, biologically patterned depression” or “delusions or hallucinations within a mood episode”?

Melancholic features

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

Episode features

Psychotic features

Delusions or hallucinations occur during a severe mood episode and require explicit risk and diagnostic review.

Episode features

Clinical focus

ANon-reactive, biologically patterned depression

BDelusions or hallucinations within a mood episode

Time course

APersists across the depressive episode

BMapped directly against mood-episode onset and remission

Look for

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

BConviction, perceptual disturbance, behavioural impact, congruence

Do not overcall from

ASeverity alone does not establish melancholic features

BSevere guilt, rumination, or intrusive thoughts are not automatically psychotic

Example wording

Major depressive disorder, current episode, with melancholic features

Open full guide

Example wording

Major depressive disorder, current episode, severe with psychotic 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 “non-reactive, biologically patterned depression” or “delusions or hallucinations within a mood episode”?

Melancholic features

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

Episode features

Psychotic features

Delusions or hallucinations occur during a severe mood episode and require explicit risk and diagnostic review.

Episode features

Clinical focus

ANon-reactive, biologically patterned depression

BDelusions or hallucinations within a mood episode

Time course

APersists across the depressive episode

BMapped directly against mood-episode onset and remission

Look for

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

BConviction, perceptual disturbance, behavioural impact, congruence

Do not overcall from

ASeverity alone does not establish melancholic features

BSevere guilt, rumination, or intrusive thoughts are not automatically psychotic

Example wording

Major depressive disorder, current episode, with melancholic features

Open full guide

Example wording

Major depressive disorder, current episode, severe with psychotic features

Open full guide

Browse the map Build diagnostic wording