Depressive Disorders

Depressive Disorders

  • Depression is the oldest and one of the most frequently diagnosed psychiatric illnesses.
  • Transient symptoms are normal, healthy responses to everyday disappointments in life.
  • Pathological depression occurs when adaptation is ineffective.
  • Depression is an alteration in mood/affect that is expressed by feelings of sadness, despair, and pessimism.

Epidemiology

  • 6.7% of persons aged 18 or older had at least one major depressive episode in the previous year.
  • Gender prevalence
    • Depression is more prevalent in women than in men by about 2 to 1.
  • Age and gender
    • Lifetime prevalence of depressive disorders is higher in those aged 45 years or younger.
  • Social class
    • There is an inverse relationship between social class and the report of depressive symptoms.
  • Race and culture
    • No consistent relationship between race and affective disorder has been reported.
    • Problems have been encountered in reviewing racial comparisons.
  • Marital status
    • Single and divorced people are more likely to experience depression than are married persons or persons with a close interpersonal relationship (differences occur in various age groups).
  • Seasonal interaction
    • There is evidence that supports a seasonal decrease in social interactions during Fall and Winter seasons which may result in the development of Seasonal Affective Disorder (SAD)

Types of Depressive Disorders

  • Major depressive disorder
    • Characterized by depressed mood
    • Loss of interest or pleasure in usual activities
    • Symptoms present for at least 2 weeks
    • No history of manic behavior
    • Cannot be attributed to use of substances or another medical condition
  • Persistent depressive disorder (dysthymia)
    • Sad or “down in the dumps”
    • No evidence of psychotic symptoms
    • Essential feature is a chronically depressed mood for
      • Most of the day
      • More days than not
      • At least 2 years
  • Premenstrual dysphoric disorder
    • Depressed mood
    • Anxiety
    • Mood swings
    • Decreased interest in activities
    • Symptoms begin during the week prior to menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week post-menses.
  • Substance- or medication-induced depressive disorder
    • Considered to be the direct result of physiological effects of a substance
  • Depressive disorder associated with another medical condition
    • Attributable to the direct physiological effects of a general medical condition

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