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The USMLE frequently confuses us in the differentiation of Dysthymia and Major Depressive Disorder.
In order to diagnose Major Depression at least 5 of the following clinical features should be present for at least two weeks.
The mnemonic is SIGECAPS

  • Sleep disturbance (increased or decreased)
  • Interest reduced (not enjoying anything)
  • Guilt sensation and worthilessness
  • Energy loss and fatigue
  • Concentration problems
  • Appetite problem (increased or decreased)
  • Psychomotor agitation or retardation
  • Suicidility
These are usually accompanied by anhedonia, loss of sexual drive, and numbness of mood
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