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==Overview==
Based on the duration of symptoms, timing, and the presumed etiologies, depressive disorders are classified into 7 subtypes: major depressive disorder, persistent depressive disorder (or dysthymia), premenstrual dysphoric disorder, substance/medication-induced depressive disorder,  depressive disorder due to another medical condition, other specified depressive disorder, and unspecified depressive disorder.


==Classification==
==Classification==
The diagnostic category major depressive disorder appears in the [[Diagnostic and Statistical Manual of Mental Disorders]] of the [[American Psychiatric Association]].  The term is generally not used in countries which instead use the [[ICD-10]] system, but the diagnosis of a depressive episode is very similar to an episode of major depression. Clinical depression also usually refers to acute or chronic depression severe enough to need treatment. Minor depression is a less-used term for a subclinical depression that does not meet the criteria for major depression but where there are at least two symptoms present for two weeks.
*The common feature of all depressive disorders is the presence of dysphoric mood (i.e., sad, empty, or irritable mood), with accompanying somatic and cognitive symptoms that significantly affect the functional capacity of the individuals. Depressive disorders may be classified according to the duration, timing, and presumed etiologies into the following subtypes: <ref>{{cite book | last = LastName | first = FirstName | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association,American Psychiatric Association | location = Arlington, VA Washington, D.C | year = 2013 | isbn = 978-0-89042-554-1 }}</ref>
 
**'''Major depressive disorder:''' is characterized by single or discrete episodes of depressed mood (most of the day) and/or anhedonia and at least four other depressive symptoms that last at least for 2 weeks. All symptoms must be present nearly every day, except for thoughts of death or suicidal ideation/attempts.  
====Major Depression====
**'''Persistent depressive disorder (or dysthymia):''' Dysthymia is mild, chronic depression that lasts at least 2 years in adults and 1 year in children, and on most days, patients experience depressed mood for most of the day and at least two other symptoms of depression.
Major depression is a severely depressed mood that persists for at least two weeks. Episodes may be isolated or recurrent and categorized as mild, major, or severe. If the patient has already had an episode of [[mania]] or [[hypomania|markedly elevated mood]], a diagnosis of [[bipolar disorder]] is usually made instead. Depression without periods of elation or mania is therefore sometimes referred to as unipolar depression because the mood remains at one emotional state or "pole." The diagnosis usually excludes cases where the symptoms are a normal result of [[bereavement]], though it is possible for normal bereavement to turn into a depressive episode.
**'''Premenstrual dysphoric disorder:'''
 
**'''Substance/medication-induced depressive disorder:''' This condition is characterized by a depressed mood that is due to a substance, for example, alcohol or medications (e.g. barbiturates).
Diagnosticians recognize several possible subtypes of major depression: <ref name="pmid18729608">{{cite journal| author=Klein DN| title=Classification of depressive disorders in the DSM-V: proposal for a two-dimension system. | journal=J Abnorm Psychol | year= 2008 | volume= 117 | issue= 3 | pages= 552-60 | pmid=18729608 | doi=10.1037/0021-843X.117.3.552 | pmc=3057920 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18729608  }} </ref> <ref name="pmid30333763">{{cite journal| author=Tolentino JC, Schmidt SL| title=DSM-5 Criteria and Depression Severity: Implications for Clinical Practice. | journal=Front Psychiatry | year= 2018 | volume= 9 | issue=  | pages= 450 | pmid=30333763 | doi=10.3389/fpsyt.2018.00450 | pmc=6176119 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30333763  }} </ref>  
**'''Depressive disorder due to another medical condition:'''This condition is characterized by a depressed mood secondary to a medical disorder such as Hypothyroidism, or Cushing's syndrome.
 
**'''Other specified depressive disorder:''' This diagnostic category includes two subtypes:
*[[Melancholic depression|Depression with melancholic features]] – [[Melancholia]] is characterized by a loss of pleasure ([[anhedonia]]) in most or all activities, a failure of reactivity to pleasurable [[stimuli]], a quality of depressed mood more pronounced than that of [[grief]] or loss, a worsening of symptoms in the morning hours, early morning waking, [[psychomotor]] retardation, excessive weight loss (not to be confused with [[Anorexia Nervosa]]), or excessive guilt.  
***1) Recurrent depressive episode: depression that lasts 2-13 days and occurs at least once a month
 
***2) short-duration depressive episode: a depressed mood lasting 4-14 days, and is nonrecurrent
*[[Atypical depression|Depression with atypical features]] – Atypical depression is characterized by mood reactivity (paradoxical anhedonia) and positivity, significant [[weight gain]] or increased appetite ("comfort eating")
**'''Unspecified depressive disorder:''' This diagnostic category includes 4 major subtypes:
 
***1) Melancholia: a severe form of depression characterized by anhedonia, hopelessness, and psychomotor retardation
*[[Psychotic depression|Depression with Psychotic Features]] – Some people with major depressive or manic episodes may experience psychotic features. They may be presented with [[hallucination]]s or [[delusion]]s that are either mood-congruent (content coincident with depressive themes) or non-mood-congruent (content not coincident with depressive themes). It is clinically more common to encounter a delusional system as an adjunct to depression than to encounter hallucinations, whether visual or auditory.
***2) Atypical depression: is characterized by weight gain and hypersomnia
 
***3) Peripartum depression (previously called postpartum depression): The onset of symptoms is around parturition or within 4 weeks postpartum. These patients commonly have psychotic symptoms.  
It is possible for a person to have a combination of these subtypes. For instance, someone may experience the loss of pleasure in activities observed in melancholic depression in conjunction with the over-eating and weight gain common in cases of atypical depression.
***4) Seasonal pattern (previously called seasonal affective disorder [SAD]): Patients with a seasonal pattern to their depressive symptoms tend to experience a depressed mood during a particular season, most commonly winter. These patients may preferentially respond to light therapy.  
 
**'''Disruptive mood dysregulation disorder:''' This disorder is characterized by frequent episodes of temper tantrums, persistent irritability, and angry mood in children 6-12 years of age.
====Other Disorders Featuring Depressed Mood====
* [[Dysthymia]] is a chronic, mild depression in which a person suffers from a depressive mood almost daily over a span of at least two years without episodes of major depression. The symptoms are not as severe as those for major depression, although people with dysthymia are vulnerable to co-occurring episodes of major depression (sometimes referred to as "double depression").
 
* [[Bipolar disorder]] is an episodic illness characterized by alternating states of [[mania]], [[hypomania]] and depression. In the United States, bipolar disorder was previously called "manic depression", but this term is no longer favored by the medical community.
 
* [[Postnatal depression]] or postpartum depression is a form of clinical depression that occurs after [[childbirth]]. Postnatal depression primarily occurs in women, less commonly in men, with similar symptoms and treatment methods as clinical depression. Postnatal depression generally lasts only a few weeks with proper diagnosis and treatment.
 
* Recurrent brief depression (RBD) is distinguished from clinical depression primarily by differences in duration. Patients with RBD have depressive episodes about once per month, with individual episodes lasting less than two weeks and typically less than 2–3 days. Diagnosis of RBD requires that the episodes occur over the span of at least one year and, in female patients, independently of the [[menstrual cycle]]. People with clinical depression can develop RBD, and vice versa, with both illnesses having similar risks.


==References==
==References==

Latest revision as of 16:14, 3 May 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Based on the duration of symptoms, timing, and the presumed etiologies, depressive disorders are classified into 7 subtypes: major depressive disorder, persistent depressive disorder (or dysthymia), premenstrual dysphoric disorder, substance/medication-induced depressive disorder, depressive disorder due to another medical condition, other specified depressive disorder, and unspecified depressive disorder.

Classification

  • The common feature of all depressive disorders is the presence of dysphoric mood (i.e., sad, empty, or irritable mood), with accompanying somatic and cognitive symptoms that significantly affect the functional capacity of the individuals. Depressive disorders may be classified according to the duration, timing, and presumed etiologies into the following subtypes: [1]
    • Major depressive disorder: is characterized by single or discrete episodes of depressed mood (most of the day) and/or anhedonia and at least four other depressive symptoms that last at least for 2 weeks. All symptoms must be present nearly every day, except for thoughts of death or suicidal ideation/attempts.
    • Persistent depressive disorder (or dysthymia): Dysthymia is mild, chronic depression that lasts at least 2 years in adults and 1 year in children, and on most days, patients experience depressed mood for most of the day and at least two other symptoms of depression.
    • Premenstrual dysphoric disorder:
    • Substance/medication-induced depressive disorder: This condition is characterized by a depressed mood that is due to a substance, for example, alcohol or medications (e.g. barbiturates).
    • Depressive disorder due to another medical condition:This condition is characterized by a depressed mood secondary to a medical disorder such as Hypothyroidism, or Cushing's syndrome.
    • Other specified depressive disorder: This diagnostic category includes two subtypes:
      • 1) Recurrent depressive episode: depression that lasts 2-13 days and occurs at least once a month
      • 2) short-duration depressive episode: a depressed mood lasting 4-14 days, and is nonrecurrent
    • Unspecified depressive disorder: This diagnostic category includes 4 major subtypes:
      • 1) Melancholia: a severe form of depression characterized by anhedonia, hopelessness, and psychomotor retardation
      • 2) Atypical depression: is characterized by weight gain and hypersomnia
      • 3) Peripartum depression (previously called postpartum depression): The onset of symptoms is around parturition or within 4 weeks postpartum. These patients commonly have psychotic symptoms.
      • 4) Seasonal pattern (previously called seasonal affective disorder [SAD]): Patients with a seasonal pattern to their depressive symptoms tend to experience a depressed mood during a particular season, most commonly winter. These patients may preferentially respond to light therapy.
    • Disruptive mood dysregulation disorder: This disorder is characterized by frequent episodes of temper tantrums, persistent irritability, and angry mood in children 6-12 years of age.

References

  1. ↑ LastName, FirstName (2013). Diagnostic and statistical manual of mental disorders : DSM-5. Arlington, VA Washington, D.C: American Psychiatric Association,American Psychiatric Association. ISBN 978-0-89042-554-1.

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