accompanying depressive symptoms will result in underdiagnosis. Sadness may be de-
nied at first but may be elicit ed through interview or inferred from facial expression and
demeanor. With individuals wh o focus on a somatic complaint, clinicians should de-
termine whether the distress from that comp laint is associated with specific depressive
symptoms. Fatigue and sleep disturbance are present in a high propor tion of cases; psy-
chomotor disturbances are much less common but are indicative of greater overall sever-
ity, as is the presence of delu sional or near-delusional guilt.Severity/course specifier Single episode Recurrent episode*
Mild (p. 188) 296.21 (F32.0) 296.31 (F33.0)
Moderate (p. 188) 296.22 (F32.1) 296.32 (F33.1)
Severe (p. 188) 296.23 (F32.2) 296.33 (F33.2)
With psychotic features** (p. 186) 296.24 (F32.3) 296.34 (F33.3)
In partial remission (p. 188) 296.25 (F32.4) 296.35 (F33.41)
In full remission (p. 188) 296.26 (F32.5) 296.36 (F33.42)
Unspecified 296.20 (F32.9) 296.30 (F33.9)
*For an episode to be considered recurrent, there must be an interval  of at least 2 consecutive months
between separate episodes in which criteria are no t met for a major depressive episode. The defini-