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Table 1 Clinical manifestations and diagnostic criteria of TCM-based subtypes of MDD

From: Blood and urinary metabolomic evidence validating traditional Chinese medicine diagnostic classification of major depressive disorder

  Liver Qi Stagnation (LQS) Heart and Spleen Deficiency (HSD)
Mood symptom characters Depressed mood with frustration, nervousness, and/or irritability Depressed mood with excessive pensiveness, suspicion, and/or timorousness
Somatic symptoms A. Frequently sighing (0 = absent, 1 = slight, 2 = mild, 3 = moderate, 4 = severe)
B. Chest distension and/or hypochondriac pain (0 = absent, 1 = slight, 2 = mild, 3 = moderate, 4 = severe)
C. Abdominal bloating (0 = absent, 1 = slight, 2 = mild, 3 = moderate, 4 = severe)
D. Decreased appetite (0 = absent, 1 = mild, 2 = moderate, 3 = severe)
E. Loose stool (0 = absent, 1 = mild, 2 = moderate, 3 = severe)
F. Breast tenderness (0 = absent, 1 = slight, 2 = mild, 3 = moderate, 4 = severe)
G. Irregular menstruation (0 = normal, 1 = seldom, 2 = sometimes, 3 = frequent)a
H. Menstrual pain (0 = absent, 1 = mild, 2 = moderate, 3 = severe)a
A. Palpitation (0 = normal, 1 = seldom, 2 = sometimes, 3 = most times, 4 = all times)
B. Forgetfulness (0 = absent, 1 = slight, 2 = mild, 3 = moderate, 4 = severe)
C. Insomnia or dream-disturbed sleep (0 = absent, 1 = sometimes, 3 = most times)
D. Decreased appetite (0 = absent, 1 = slight, 2 = mild, 3 = moderate, 4 = severe)
E. Abdominal fullness (0 = absent, 1 = sometimes, 3 = most times)
F. Loose stool or dysfunctional diarrhea (0 = absent, 1 = slight, 2 = mild, 3 = moderate, 4 = severe)
G. Pale and sallow complexion (0 = normal, 1 = slightly apparent, 2 = mildly apparent; 3 = moderately apparent, 4 = very apparent)
H. Tiredness (0 = absent, 1 = mild, 2 = moderate, 3 = severe)
Tongue and pulse I. Red tongue body with thin and white coating (0 = normal, 1 = mildly apparent, 2 = moderately apparent, 3 = very apparent)
J. Wiry pulse (0 = normal, 1 = slightly apparent, 2 = mildly apparent; 3 = moderately apparent, 4 = very apparent)
I. Pale and tender or watery tongue body with white coating (0 = normal, 1 = slightly apparent, 2 = mildly apparent; 3 = moderately apparent, 4 = very apparent)
J. Weak and thin pulse (0 = normal, 1 = slightly apparent, 2 = mildly apparent; 3 = moderately apparent, 4 = very apparent)
Diagnostic criteriab [1]. Must have A, B, I, and J; at least one of D and E; and at least one of F, G, and H for women
[2]. Total score of physical symptoms and tongue and pulse signs is not less than 10
[1]. Must have at least two of A, B and C; at least two of D, E and F; at least one of G and H; I and J
[2]. Total score of physical symptoms and tongue and pulse signs is not less than 10
  1. The diagnostic criteria are modified based on Ref. [7, 9, 10]
  2. a F, G, and H items are only applied for women
  3. b Those who fail to meet either LQS or HSD subtype are classified as Other Subtypes