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Diagnosing mood disorders in chronic illness is problematic. Understanding the value of individual symptoms in predicting depression is one approach to this problem. The contribution of individual symptoms to the diagnoses of major depressive disorder (MDD) was examined in 82 patients with confirmed rheumatoid arthritis (RA) and a control sample of 150 university employees. Comparisons between DSM-III and DSM-III-R rates of MDD were derived using the Inventory to Diagnose Depression (IDD). It was found that cognitive-affective symptoms such as dysphoric mood, acknowledgment of guilt, and suicidal ideation were the most efficient predictors of MDD. According to DSM-III-R criteria, 16% of the RA sample met criteria for diagnosis of MDD, while 27% of the RA sample met criteria according to the DSM-III. RA patients reported that their arthritis affected their mood at least occasionally.