features, pathological sensitivity to perceived interpersonal rejection is a trait that has
an early onset and persists throughout most of adult life. Rejection sensitivity occurs
both when the person is and is not depressed, though it may be exacerbated during
depressive periods.
With psychotic features:  Delusions and/or hallucinations are present.
With mood-congruent psychotic features: The content of all delusions and hal-
lucinations is consistent with the typical depressive themes of personal inade-
quacy, guilt, disease, death, nihilism, or deserved punishment.
With mood-incongruent psychotic features:  The content of the delusions or hal-
lucinations does not involve typical depressive themes of personal inadequacy,
guilt, disease, death, nihilism, or deserved punishment, or the content is a mixture
of mood-incongruent and mood-congruent themes.
With catatonia:  The catatonia specifier can apply to an episode of depression if cata-
tonic features are present during most of the episode. See criteria for catatonia asso-
ciated with a mental disorder (for a description of catatonia, see the chapter
“Schizophrenia Spectrum and Other Psychotic Disorders”).
With peripartum onset:  This specifier can be applied to the current or, if full criteria
are not currently met for a major depressive episode, most recent episode of major de-
pression if onset of mood symptoms occurs during pregnancy or in the 4 weeks follow-
ing delivery.
Note:  Mood episodes can have their onset either during pregnancy or postpartum.
Although the estimates differ according to the period of follow-up after delivery, be-
tween 3% and 6% of women will experience the onset of a major depressive epi-
sode during pregnancy or in the weeks or months following delivery. Fifty percent