Mental Depression
Major Depressive Disorder (Unipolar Depression)
Major depressive disorder (MDD) is the DSM-IV term for serious
depression that is accompanied by neurovegetative symptoms. Lifetime risk
of developing major depression is estimated to be one in four for women
and one in eight for men. Dysphoric mood typically dominates the clinical
picture and is persistent. Major depression is characterized by a change
in functioning that last for at least 2 weeks and at least one of the
symptoms is either depressed mood or anhedonia, and the presence of four
or more of the following symptoms is required:
• depressed mood
• anhedonia
• significant change in appetite and weight
• insomnia or hypersomnia
• psychomotor agitation or retardation nearly every day
• fatigue or loss of energy nearly every day
• feelings of worthlessness or excessive and/or inappropriate
guilt
• trouble concentrating
• recurrent thoughts of death or suicide ideation
The onset of the illness is variable. Symptoms usually develop over weeks
to months, but they may develop suddenly. Situational factors surrounding
the onset of the illness have no bearing on the diagnosis. Historically,
distinctions were made between endogenous and reactive depression,
but an identifiable precipitant is no longer considered pertinent with respect
to diagnosis. At least half of all patients have recurrent episodes. A family
history of a major affective disorder (major depression or bipolar disorder)
is common. The relationship between alcoholism and depression remains controversial.
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