Major depressive disorder

What it is

Major depressive disorder is made on counted criteria: a duration of 2 weeks or more, with 5 or more of the following, at least one of them low mood or lost interest: 1) low mood; 2) loss of interest, that is anhedonia; 3) sleep changes; 4) appetite or weight changes; 5) fatigue; 6) guilt or worthlessness; 7) reduced concentration; 8) psychomotor change; 9) suicidal ideation. Exclusion is no mania and no hypomania, and severity is written mild, moderate or severe, with or without psychosis. It is made on that list and not on whether a stressor can be found: when a patient meets the diagnostic criteria for major depressive disorder in response to a stressor, the diagnosis should be major depressive disorder and not adjustment disorder, and the adjustment disorders it is set against are 1) with depressed mood; 2) with anxiety; 3) with mixed anxiety and depression. Dysthymia, also called persistent depressive disorder, is a separate diagnosis, and if a depressive episode occurs in a patient known to have dysthymia it is clinically called double depression. Seen as a whole it is a syndrome of repeated major depressive episodes, and one of the most common psychiatric disorders, with a lifetime prevalence of 15%-25% and a greater incidence in women and in the elderly, where it is often overlooked.