Depression

Naureen Rafiq, MBBS and Michael G. Kavan, PhD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A primary mood disorder characterized by a sustained feeling of sadness and/or decreased interest in all or most activities once enjoyed (anhedonia), which represents a change from p...

DIAGNOSIS

HISTORY

DSM-5 requires all of the following criteria for MDD: 
  • Criterion A: ≥5 of the following symptoms present nearly every day during the same 2-week period, with at least 1 of the 5 being ...

TREATMENT

American Psychiatric Association (APA) 2010 guidelines recommend phasic approach: acute phase (first 3 months), continuation phase (4 to 9 months), and maintenance (9 months until discontinu...

ONGOING CARE

PATIENT EDUCATION

  • Depression is a common medical illness, not a character defect.

  • Emphasize the need for long-term treatment and follow-up, which includes lifestyle changes.

  • Exercise, good s...

REFERENCES

1 Flint J, Kendler KS. The genetics of major depression. Neuron.  2014;81(3):484–503.  [View Abstract]
2 Mitchell AJ, Bird V, Rizzo M, et al. Diagnostic validity and added value of t...

SEE ALSO

Algorithms: Depressed Mood Associated with Medical Illness; Depressive Episode, Major 

CODES

ICD10

  • F32.9 Major depressive disorder, single episode, unspecified

  • F33.9 Major depressive disorder, recurrent, unspecified

  • F34.1 Dysthymic disorder

  • F32.8 Other depressive episodes

  • F33.8 Other recurre...

CLINICAL PEARLS

  • Therapeutic alliance is important to treatment success.

  • Given the high recurrence rates, long-term treatment is often necessary.

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