PART D – Psychological consequences of torture on individuals 31 F32.2 Severe depressive episode without psychotic symptoms An episode of depression in which several of the above symptoms are marked and distressing, typically loss of self-esteem and ideas of worthlessness or guilt. Suicidal thoughts and acts are common and a number of “somatic” symptoms are usually present. Agitated depression Major depression Vital depression } single episode without psychotic symptoms F32.3 Severe depressive episode with psychotic symptoms An episode of depression as described in F32.2, but with the presence of hallucinations, delusions, psychomotor retardation, or stupor so severe that ordinary social activities are impossible; there may be danger to life from suicide, dehydration, or starvation. The hallucinations and delusions may or may not be mood-congruent. Single episodes of: – major depression with psychotic symptoms – psychogenic depressive psychosis – psychotic depression – reactive depressive psychosis F32.8 Other depressive episodes F32.9 Depressive episode, unspecified Under “Mood [affective] disorders (F30-F39)” see also: F30 Manic episode F31 Bipolar affective disorder F33 Recurrent depressive disorder F34 Persistent mood [affective] disorders F38 Other mood [affective] disorders NEUROTIC, STRESS-RELATED AND SOMATOFORM DISORDERS (F40F48) F43 Reaction to severe stress, and adjustment disorders This category differs from others in that it includes disorders identifiable on the basis of not only symptoms and course but also the existence of one or other of two causative influences: an exceptionally stressful life event producing an acute stress reaction, or a significant life change leading to continued unpleasant circumstances that result in an adjustment disorder. Although less severe psychosocial stress (“life events”) may precipitate the onset or contribute to the presentation of a very wide range of disorders classified elsewhere in this chapter, its etiological importance is not always clear and in each case will be found to depend on individual, often idiosyncratic, vulnerability, i.e. the life events are neither necessary nor sufficient to explain the occurrence and form of the disorder. In contrast, the disorders brought together here are thought to arise always as a direct consequence of acute severe stress or continued trauma. The stressful events or the continuing unpleasant circumstances are the primary and