A syndrome characterised by the presence of prominent depressive symptoms such as persistently depressed mood, loss of interest in previously enjoyable activities, or signs such as tearful and downtrodden appearance that is judged to be a direct pathophysiological consequence of a health condition not classified under mental and behavioural transtornos based on evidence from the history, physical examination, or laboratory findings. The symptoms are not accounted for by Delirium or by another mental and behavioural transtorno, and are not a psychologically mediated response to a grave medical condition (e.g., depressive symptoms in response to a life-threatening diagnosis). This category should be used in addition to the diagnosis for the presumed underlying transtorno or disease when the mood symptoms are sufficiently grave to warrant specific clinical attention.