A. Depressed mood is present for most of the day, for more days than it is not present, and depression has been present for at least two years.
B. Presence of at least two of the following:
1. Poor appetite or overeating.
2. Insomnia or hypersomnia.
3. Low energy or fatigue.
4. Low self-esteem.
5. Poor concentration or difficulty making decisions.
C. Over the two-year period, the patient has never been without symptoms for more than two months consecutively.
D. No major depressive episode has occurred during the first two years of the disturbance.
E. No manic, hypomanic or mixed episode, or evidence of cyclothymia is present.
F. Symptoms do not occur with a chronic psychotic disorder.
G. Symptoms are not due to substance use or a general medical condition.
H. Symptoms cause significant social or occupational dysfunction or marked subjective distress.
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