Depression - classification
Affective disorder (affective = external expression of emotional state
· Major depressive disorder (mdd) in the dsm-iv. criteria include
· depressed mood most of the day, almost every day
· markedly diminished interest in all or nearly all activities all day or almost all day
· significant weight loss when not dieting or weight gain
· insomnia or hyposomnia – almost every day
· psychomotor agitation or retardation
· fatigue or loss of energy almost every day
· feelings of worthlessness or exessive or inappropriate guilt (may be delusional)
· diminished ability to concentrate, indecisiveness
· recurrent thoughts of death, suicidal idealation
· cause significant distress in social or occupational functioning
· are not due to medical condition or effects of a substance
· are not better accounted for by bereavement
Also dysthimic disorder.
· fewer milder symptoms more than two years
· low self esteem, low energy, pessimism other symptoms
· MDD is a universal disorder found in all countries sampled by smith and weissman
· in europe, depression varies from 4.9% to 7.4%. Blazer et al found us rates of depression to be 4.9%. dysthimic disorder = a further 2-4%. most common mental disorder.
· depression on the increase in young people
· more common in women than men, ratio 2:1. could be due to biological and psychosocial reasons.
· Longitudinal studies – e.g coryell et al, most depressive disorders disappear within 4 to 6 months regardless of treatments
· WHO – thornicroft and sartorious found that only a third of people showed normal functioning