As defined by DSM-IV-TR, the diagnosis of major depression
can be made on the basis of the presence of 5 of 9
depressive symptoms. In addition to the current symptomatology,
an adequate assessment also includes personal or family
history of past depressive episodes, history of suicidality, and
history of substance abuse, as all of these can influence prognosis
for the current episode of depression (Table 2). Also
important are past treatment trials and response (to guide
current treatment), and assessment of current suicidal ideation
and imminent risk of self-harm (to guide location of
treatment, inpatient versus outpatient). Cognitive status
should be assessed with the Mini-Mental State Examination
(MMSE), given the high likelihood of comorbid depression
and cognitive dysfunction.