'Having no feelings': an interesting presentation

The Diagnostic and Statistical Manual of Mental Disorders the American Psychiatric Association – 5^th Edition (DSM-5) is a world leading diagnostic system. For the diagnosis of Major Depressive Disorder (MDD) to be reached, at least 5 defined symptoms from a list of 9 must be present, and one of these must be 'depressed mood' or 'loss of interest or pleasure'.

Additional symptoms of MDD listed in DSM-5 (but not among the 9 most common and accepted is 'Having no feelings'.

In this letter we describe psychological test results of an adult with a successful private and professional life, admitted to hospital with acute, severe MDD. All identifying data has been removed and we have written permission to use the following details for educational purposes. The patient completed a visual analogue scale (VAS6) which examines items taken from the 6-item Hamilton Depression Rating Scale.