Table 2 Frequently mentioned aspects of depression in Nepali youth and global populations compared to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), criteria

Loneliness: not meeting with friends, staying silent, wanting to be alone (9/9; 100%)

– not included in DSM-5 –

Social isolation/ loneliness (52%)

Low mood: sad all the time (7/9; 78%)

Depressed mood

Depressed mood/ sadness (68%)

Negative self-appraisals: hopelessness, self-doubt, not able to meet other’s expectations (6/9; 67%)

Worthlessness or excessive or inappropriate guilt

Worthlessness / guilt (32%)

Suicidality (5/9; 56%)

Recurrent thoughts of death; suicidal ideation or attempt

Suicidal thoughts (44%)

Anhedonia: ‘can’t laugh like others’; not wanting to do things that one previously liked (5/9; 56%)

Diminished interest or pleasure in activities

Loss of interest (38%)

Irritability and anger: irritated by small things, aggression towards others; angry outbursts (5/9; 56%)

Irritable mood (included as an alternative to depressed mood for children and adolescents in DSM-5)

Anger (36%)

Crying a lot (4/9, 44%)

– not included in DSM-5 –

Crying a lot (46%)

Sleep disturbance: sleepiness throughout the day; (4/9; 44%)

Insomnia or hypersomnia

Problems with sleep (63%)

Stress or Tension (3/9, 33%)

– not included in DSM-5 –

– not reported –

Thinking too much (3/9, 33%)

– not included in DSM-5 –

Thinking too much (39%)

Appetite: loss of appetite (2/9; 22%)

Weight loss or weight gain; decrease or increase in appetite

Appetite/ weight problems (50%)

Chronic Fatigue: low energy to do things (2/9; 22%)

Fatigue or loss of energy

Fatigue/ loss of energy (63%)

Headaches (1/9; 11%)

– not included in DSM-5 –

Headaches (45%)

– not reported –

Diminished ability to think or concentrate; indecisiveness

– not reported –

– not reported –

Psychomotor agitation or retardation

– not reported –