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Features of MDD (see diagnostic criteria for major depressive disorder).Major depression accompanied by psychotic symptoms.Major depressive disorder with psychotic features MAO inhibitors can be effective although not commonly prescribed due to their side effects.Interpersonal rejection sensitivity that leads to social and occupational impairment.Leaden paralysis (legs and arms feel heavy).Two or more of the following features are present:.Mood reactivity: brightening of mood in response to positive events, which is usually not the case in classical MDD.Major depressive disorder with atypical features

Light therapy has been shown to improve symptoms.

Patients present with typical symptoms of MDD alongside atypical ones, such as weight gain and requiring more sleep.

Symptoms must be present for ≥ 2 consecutive years and for the majority of years in a lifetime.

Occurs in a yearly, season-specific pattern (commonly in fall or winter).

Major depressive disorder with seasonal pattern ( seasonal affective disorder, winter depression) “ DICES GAPS” ( D or I must be present for diagnosis): D epressed mood (can present as irritability in children), Interest loss ( anhedonia), Concentration (poor concentration or difficulty making decisions), Energy (low energy or fatigue), Sleep ( insomnia or hypersomnia), Guilt (low self-esteem), Appetite (decreased appetite or overeating), Psychomotor agitation or retardation, and S uicidal ideation are the features of the major depressive disorder. For a diagnosis of major depressive disorder, the following two criteria must also be present: the symptoms are not due to another psychiatric disorder AND there is no history of a manic or hypomanic episode. The presence of symptoms from criteria A to C constitutes a major depressive episode. Depressive episodes are considered recurrent when there is a gap of at least two months between episodes during which the criteria for MDD are not met. There is no history of a manic or hypomanic episode.Ī to E refer to a single depressive episode. Symptoms are not due to another psychiatric disorder. Symptoms are not due to the effects of psychoactive substances or organic disease. There is clinically significant distress or impaired functioning in important areas of life (e.g., work, school).

Psychomotor changes (observed by others).

Diminished concentration, cognition, and ability to make decisions ( pseudodementia ).

Feelings of worthlessness or disproportionate guilt.Sleep disturbance ( insomnia or hypersomnia ).Depressed mood for most of the day, almost every day (in children, can manifest with irritability).First-line treatment mainly consists of SSRIs (e.g., citalopram) and SNRIs (e.g., venlafaxine).ĭiagnostic criteria for major depressive disorder (according to DSM-5)įive or more of the nine symptoms listed below, for at least 2 weeks, with at least one of the symptoms being depressed mood or anhedonia

Treatment is multifaceted and often requires pharmacotherapy, psychotherapy, and lifestyle changes. In elderly patients, MDD can also manifest with memory loss and other symptoms seen in dementia, referred to as pseudodementia. There are various subtypes of MDD characterized by additional symptoms or occurrence in specific conditions, such as atypical depression (additionally characterized by, e.g., weight gain and increased appetite), psychotic depression (with additional psychotic features such as hallucinations and delusions), and peripartum depression (which occurs during or shortly after pregnancy). Other symptoms of MDD include sleep disturbance, loss of appetite, and thoughts of suicide. Reduced levels of neurotransmitters ( serotonin, noradrenaline, dopamine) are believed to be the pathophysiological basis in most cases. The etiology is multifactorial, including both biological and psychological factors. The peak age of onset is the 3 rd decade. Women have a higher risk of developing MDD than men. Major depressive disorder (MDD) is an episodic mood disorder primarily characterized by depressed mood and anhedonia lasting for at least 2 weeks.