“…Secondary symptoms include significant appetite change, weight loss, or both, sleep disturbance, psychomotor agitation or retardation, fatigue or energy loss, feelings of worthlessness or guilt, attention or concentration difficulties, and recurrent thoughts of death or suicide. Of these diagnostic symptoms, dysphonic mood, appetite and sleep change, and thoughts of death are most common, while loss of interest in activities and psychomotor change appear to be less common [1].…”