- F33
- Mood Disorders
Recurrent Depressive Disorder (F33)
DSM-5-TR: Major Depressive Disorder, Recurrent
ICD-10-AM and DSM-5-TR may classify conditions differently. Refer to APA and WHO for complete diagnostic criteria.
Key Facts
- ICD-10 RangeF30-F39
- Subcodes7 subcodes
- Australian PrevalenceA significant contributor to disability burden in Australia. Many individuals with depression experience recurrence — approximately 50% after a first episode, rising to 80-90% after three or more.
- Global PrevalenceRecurrent depression accounts for a large proportion of the global depression burden. The WHO ranks depression as a leading cause of disability worldwide.
- Duration RequirementIndividual episodes: at least two weeks. Requires ≥2 episodes separated by at least 2 months of remission.
Overview
Recurrent depressive disorder is characterised by repeated episodes of depression, without any history of independent episodes of mood elevation and increased energy (mania). Each episode typically lasts from a few weeks to months. Between episodes, the individual may return to full functioning, though some people develop persistent low-grade symptoms.
Diagnostic Criteria (ICD-10)
Core Features
- Repeated episodes of depression meeting F32 criteria
- No history of independent manic or hypomanic episodes
- Episodes typically last weeks to months
- Recovery between episodes is common but not universal
Duration Individual episodes: at least two weeks. Requires ≥2 episodes separated by at least 2 months of remission.
Severity Specifiers
- Current episode mild (F33.0)
- Current episode moderate (F33.1)
- Current episode severe without psychosis (F33.2)
- Current episode severe with psychosis (F33.3)
- Currently in remission (F33.4)
Exclusion Criteria
- Any history of mania or hypomania (use F31)
- Single depressive episode (use F32)
ICD-10-AM Subcodes
| Code | Name | Description |
|---|---|---|
| F33.0 | Recurrent depressive disorder, current episode mild | Currently experiencing a mild depressive episode with a history of at least two prior episodes. |
| F33.1 | Recurrent depressive disorder, current episode moderate | Currently moderate depression with history of recurrence. |
| F33.2 | Recurrent depressive disorder, current episode severe without psychotic symptoms | Currently severe depression without psychotic features, with recurrent history. |
| F33.3 | Recurrent depressive disorder, current episode severe with psychotic symptoms | Currently severe depression with psychotic features, with recurrent history. |
| F33.4 | Recurrent depressive disorder, currently in remission | History of two or more depressive episodes but currently asymptomatic. |
| F33.8 | Other recurrent depressive disorders | Other specified patterns of recurrent depression. |
| F33.9 | Recurrent depressive disorder, unspecified | Recurrent depression where current severity is unspecified. |
Classification Boundaries
Includes
- Recurrent episodes of depressive reaction
- Recurrent episodes of psychogenic depression
- Recurrent episodes of reactive depression
- Seasonal depressive disorder
- Recurrent depressive disorder NOS
Excludes1 (coded elsewhere)
- Single depressive episode (F32)
- Bipolar affective disorder (F31)
Australian Clinical Context
Recurrent depression is a significant contributor to disability burden in Australia. Long-term management often involves maintenance antidepressant therapy and psychological interventions. The RANZCP guidelines recommend considering long-term prophylactic treatment after two or more episodes, particularly if episodes were severe or closely spaced.
Medicare (MBS) Pathways
Better Access to Mental Health Care
The primary Medicare pathway for mental health treatment in Australia. Requires a GP Mental Health Treatment Plan (MHTP) referral. Available for any clinically diagnosed mental disorder.
10 individual + 10 group sessions per calendar year
| Provider Type | MBS Items | Session Type |
|---|---|---|
| Clinical Psychologist | 80000–80025 | Psychological therapy (higher rebate) |
| Registered Psychologist | 80100–80123 | Focused psychological strategies |
| Occupational Therapist | 80125–80145 | Focused psychological strategies |
| Social Worker | 80150–80175 | Focused psychological strategies |
| Psychiatrist | 291, 296–299, 300–308 | Psychiatric consultation |
GP referral items: 2700, 2701, 2715, 2717
Eligibility: Any clinically diagnosed mental disorder as defined by WHO ICD-10 Chapter V. Requires a GP or psychiatrist referral.
Exclusions:
- Intellectual disability (use Complex Neurodevelopmental Disorder pathway or specialist referral)
- Dementia and organic mental disorders (use specialist referral pathway)
- Tobacco use disorder
Grounded Scribe suggests the right MBS item codes from your recording so you can claim accurately without re-keying.
Reference information sourced from MBS Online (mbsonline.gov.au). Item availability, rebates, and eligibility criteria may change. This is not billing advice — always verify current items before claiming. Last verified: April 2026.
Clinical Documentation Notes
Careful history-taking is essential to exclude any prior manic or hypomanic episodes, which would reclassify the diagnosis to F31. Document the number, timing, and severity of prior episodes. Maintenance treatment decisions should follow RANZCP guidelines on prophylaxis duration.
Related Assessment Tools
Other validated instruments commonly used alongside the Recurrent Depressive Disorder (F33).
- PHQ-9
DepressionA 9-item screening tool for depression severity that maps onto the DSM-IV and DSM-5 criteriaCalculate → - DASS-21
StressA 21-item self-report measure of depression, anxiety, and stress with three 7-item subscalesCalculate → - CORE-10
Clinical OutcomesA 10-item measure of psychological distress for monitoring clinical outcomes in therapyCalculate → - CORE-OM
Clinical OutcomesA 34-item pan-theoretical measure of psychological global distress covering four domains: subjective well-being, problems/symptoms, life functioning, and risk/harm.Calculate → - CES-D-R
DepressionA 20-item measure of depression symptoms based on DSM-5 criteria, revision of the original NIMH CES-DCalculate →
Related Diagnostic Codes
ICD-10-AM diagnostic codes commonly associated with the Recurrent Depressive Disorder (F33).
Frequently Asked Questions
How many episodes qualify as "recurrent"?
A minimum of two depressive episodes is required for a diagnosis of recurrent depressive disorder (F33). The episodes should be separated by at least two months without significant depressive symptoms.
Should I always use F33 after a second episode?
Yes, once a person has experienced two or more discrete depressive episodes (separated by a period of at least partial remission), subsequent coding should use F33 rather than F32, with the appropriate severity specifier.
References
- World Health Organization. ICD-10-AM.
- RANZCP. Clinical Practice Guidelines for Mood Disorders.
- American Psychiatric Association. DSM-5-TR. 2022.
This tool calculates scores based on published guidelines for professional reference. It does not provide clinical diagnoses. Scores are provided as reference information only and should be interpreted by a qualified practitioner in the context of a comprehensive assessment.
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