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Major DepressionAka: Major Depressive Disorder, Depressive Disorder

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  1. See Also
    1. Dysthymic Disorder
    2. Seasonal Depression
    3. Atypical Depression
    4. Bipolar Disorder
    5. Suicide
    6. Athletes with Depression
    7. Antepartum Depression
    8. Postpartum Depression
  2. Epidemiology
    1. Lifetime depression Incidence: 25%
    2. Depression Prevalence: 6%
    3. Age of Peak Incidence: 55 to 65 years old
    4. Women have higher risk of depression
    5. Men have higher completed Suicide rate
    6. Family History: Twin concordance
      1. Monozygotic twins: 75%
      2. Dizygotic twins: 38%
    7. Depression is missed in elderly and nursing homes
      1. Brown (2002) J Am Geriatr Soc 50:69
  3. Risk Factors
    1. Prior episodes of depression
    2. Prior Suicide attempts
    3. Age under 40 years old
    4. Comorbid medical condition
    5. Stressful life events
    6. Family History of depression
    7. Female sex
    8. Recent childbirth
    9. Lack of social support
    10. Current Chemical Dependency or Substance Abuse
  4. Differential Diagnosis
    1. See Major Depression Differential Diagnosis
  5. Risk Factors: Medical Conditions Predisposing to Depression
    1. Alzheimer's Disease or other Dementia
    2. Cancer
    3. Chronic Fatigue Syndrome
    4. Chronic Pain Syndrome
    5. Coronary Artery Disease
    6. Crohn's Disease
    7. Medications Predisposing to Depression
    8. Diabetes Mellitus
    9. Fibromyalgia
    10. Parkinson's Disease
    11. Cerebrovascular Accident (CVA)
  6. Evaluation
    1. Evaluate for Suicide Risk
    2. Screening Tools
      1. See Depression Screening with SALSA
      2. See Depression Screening with SIG E CAPS
      3. Beck Depression Inventory
      4. Zung Self-Rating Depression Scale
      5. Hamilton Depression Scale
      6. Mazmanian Mania-Depression Mood Scale
  7. Diagnosis
    1. Major Depression Diagnosis
  8. Labs
    1. Thyroid Stimulating Hormone (TSH)
    2. Hemoglobin
    3. Consider additional lab studies
      1. Liver Function Tests
      2. Urinalysis
  9. Comorbid Conditions (Differentiate or Integrate)
    1. Major Depression
    2. Anxiety Disorder
    3. Panic Disorder
  10. Criteria: Indications for Psychiatric Consultation
    1. Serious Suicidal Ideation
    2. Psychotic symptoms with poor judgment
    3. Acute manic symptoms
    4. Bipolar depression
    5. Refractory to Antidepressant medications
    6. Refuses medications despite severe depression
    7. Inpatient psychiatric care
    8. Electroconvulsive Therapy
  11. Management
    1. See Suicide
    2. See Depression Management
    3. See Depression Medical Management
    4. See Refractory Depression Management
    5. See Depression Management Special Circumstances
  12. References
    1. (1994) DSM-IV, APA, p. 320-7
    2. Bhatia (1997) Am Fam Physician 55(5):1683
    3. Kuzel (1996) Postgrad Med 99(5):179

Depressive disorder (C0011581)

Definition (MSH)An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent.
ConceptsMental or Behavioral Dysfunction (T048)
ICD9311
MSHD003866
BasqueDEPRESIO NAHASTEAK
DanishDepressiv tilstand
DutchDepressie
EnglishDepression, DEPRESSIVE DIS, Depressive disorder, Depressive Disorders, Depressive illness, Depressive Neuroses, Depressive Neurosis
FinnishMASENTUNEISUUS
FrenchTrouble depressif
Germandepressive Stoerung
Hebrewhafraa dikonit
Hungariandepresszio
ItalianDisturbo depressivo
NorwegianDEPRESSIV TILSTAND/NEUROSE
PortuguesePerturbacoes depressivas
SpanishAlteraciones depresivas, trastornos depresivos
SwedishDEPRESSIV STORNING
Parent ConceptsDiagnosis/Diseases Component (C0497531), Psychiatric problem (C1306597), Mood Disorders (C0525045)
SourcesDXP, ICPC, ICPCBAQ, ICPCDAN, ICPCDUT, ICPCFIN, ICPCFRE, ICPCGER, ICPCHEB, ICPCHUN, ICPCITA, ICPCNOR, ICPCPOR, ICPCSPA, ICPCSWE, MEDLINEPLUS, MSH, MTH, MTHICD9, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Major Depressive Disorder (C1269683)

Definition (CSP)one or more periods of depression in the absence of history of manic or hypomanic episodes; chronic type lasts 2 or more years; melancholic type is more severe, has vegetative signs, and responds well to somatic therapy.
Definition (MSH)Marked depression appearing in the involution period and characterized by hallucinations, delusions, paranoia, and agitation.
ConceptsMental or Behavioral Dysfunction (T048)
MSHD003865
EnglishDEPRESSIVE DIS MAJOR, Major depression, MAJOR DEPRESSIVE DIS, Major Depressive Disorder, Major Depressive Disorders, MDD
Spanishdepresion mayor, trastorno depresivo mayor
Parent ConceptsAffective Disorders, Psychotic (C0001723), Endogenous depression (C0011573), Psychotic Disorders (C0033975), Depressive disorder (C0011581)
SourcesAOD, COSTAR, CSP, MSH, MTH, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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