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

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 criteria^b

[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