Last reviewed: November 2017
Last updated: November  2017

Introduction

Conditions relevant to Depression (Overview)

Condition
Description

Major depressive disorder is characterised by at least 5 symptoms during the same 2-week period and may be further categorised as mild, moderate, or severe, based on number of symptoms and degree of functional impairment. Psychotic features (e.g., hallucinations or paranoia) may be present in severe depression. [1]

Depression in children and adolescents may have a more insidious onset than in adults. It may be characterised more by irritability than sadness, and it often occurs in association with other conditions such as anxiety. [2] [3]

Disruptive mood dysregulation disorder

Disruptive mood dysregulation disorder is a category of depressive disorders first diagnosed at 6 to 18 years of age, with age of onset before 10 years. It is characterised by the DSM-5 as severe and persistent irritability or angry mood nearly every day, and severe and recurrent temper outbursts on average 3 or more times per week for at least 1 year. [1]

Common form of depression, but lasting longer than acute major depressive disorder. The DSM-5 developed new diagnostic criteria for persistent depressive disorder that included both chronic major depressive disorder and the previous category of dysthymic disorder (dysthymia), or chronic low-grade depression. The DSM-5 included specifiers to identify different pathways to the diagnosis of persistent depressive disorder and various presentations based on severity and clinical characteristics.

The DSM-5 does not recognise postpartum depression as a separate diagnosis; rather, patients must meet the criteria for a major depressive episode and the criteria for the peripartum-onset specifier. The definition is, therefore, a major depressive episode with an onset in pregnancy or within 4 weeks of delivery. [1]

Characteristics of postpartum depression may include guilt about the depressive symptoms, ambivalent feelings toward the infant, impaired bonding, and obsessive ruminations, including intrusive thoughts about harming the infant. Postpartum depression should be distinguished from postpartum blues ('baby blues'), in which the symptoms generally resolve within 2 weeks.

Premenstrual syndrome (PMS) is characterised by cyclical physical and behavioural symptoms occurring in the luteal phase of the menstrual cycle (the period between ovulation and onset of menstruation). Premenstrual dysphoric disorder (PMDD) is a more severe variant that includes at least 1 affective symptom. Depression may coexist with PMS or PMDD in up to 50% of cases. A diagnosis of PMS or PMDD may predate a diagnosis of depression. [4]

Seasonal affective disorder (SAD) is a subtype of major depression, occurring with seasonal change. SAD occurs more commonly in high latitudes. Lifetime estimates for depressive and bipolar disorders with a seasonal pattern average between 0.4% and 2.9% in US, Canadian, and UK community studies. [5] [6] [7] Some estimates may be as high 9.7%. [8] However, these differences are probably due to differences in the sampling and diagnostic criteria used.

Bipolar affective disorder is marked by alternating mood elevation (mania or hypomania) and depression.

Bipolar disorder, type I: at least one manic or mixed episode.

Bipolar disorder, type II: has never had a full manic episode; at least one hypomanic episode and at least one major depressive episode. [1]

Bipolar disorder in children

The DSM-5 does not distinguish in its definition between bipolar disorders in adults and children. [1] The prevalence in children is lower than in adults, though the disease can be more severe and the cycles between mania and depression much quicker.

Suicide is an important causes of death globally. In people aged 15 to 44 years, self-inflicted injury is the fourth-leading cause of death and the sixth-leading cause of ill health and disability worldwide, making suicide a significant public health concern. Suicide risk management refers to the identification, assessment, and treatment of a person exhibiting suicidal behaviour (includes death by suicide, suicide attempt, and suicidal ideation).

Contributors

Authors

BMJ Publishing Group

Disclosures

This overview has been compiled using the information in existing sub-topics.

Use of this content is subject to our disclaimer