Major DepressionMajor Depression

By Mr Daniel HanssonBy Mr Daniel Hansson

Major DepressionMajor Depression

SymptomsSymptoms PrevalencePrevalence EtiologyEtiology EvaluationEvaluation ConclusionConclusion

Symptoms (DSM-IV-TR)Symptoms (DSM-IV-TR)

Affective:Affective: Feelings of guilt and sadness, lack of Feelings of guilt and sadness, lack of enjoyment or pleasure in familiar activities or enjoyment or pleasure in familiar activities or companycompany

Behavioural: Behavioural: Passivity, lack of initiativePassivity, lack of initiative Cognitive: Cognitive: Frequent negative thoughts, faulty Frequent negative thoughts, faulty

attribution of blame, low self esteem, suicidal attribution of blame, low self esteem, suicidal thoughts, irrational hopelessness, difficulties in thoughts, irrational hopelessness, difficulties in concentration and inability to make decisionsconcentration and inability to make decisions

Somatic: Somatic: Loss of energy, insomnia, or Loss of energy, insomnia, or hypersomnia, weight loss/gain, diminished sex hypersomnia, weight loss/gain, diminished sex drivedrive

SymptomsSymptoms

One or two major One or two major depressive episodesdepressive episodes

At least two weeks of At least two weeks of depressed mood or depressed mood or loss of interest loss of interest accompanied with at accompanied with at least four additional least four additional symptoms of symptoms of depressiondepression

PrevalencePrevalence

Life time prevalence for the disorder:Life time prevalence for the disorder: Women – Women – 10-25% Men – 5-12%10-25% Men – 5-12%

The average age to have the first major The average age to have the first major depression:depression: Mid 20s Mid 20s

The The onset ageonset age is decreasing is decreasing One episode:One episode: 60 % of a second 60 % of a second Two or three episodes:Two or three episodes: 70-90 % of a following 70-90 % of a following

episodeepisode One year after diagnosis:One year after diagnosis: 40 % are free of 40 % are free of

symptoms, 20 % have some symptoms, 40 % symptoms, 20 % have some symptoms, 40 % meet full criteria of the disordermeet full criteria of the disorder

PrevalencePrevalence

More common in individualistic than collectivistic More common in individualistic than collectivistic culturescultures

Seattle, Washington:Seattle, Washington: 6.3 % 6.3 % China: China: 4 %4 % Verona, Italy: Verona, Italy: 4.7 %4.7 % Groningen, Germany: Groningen, Germany: 15.9 %15.9 % Manchester, United Kingdom: Manchester, United Kingdom: 16.9 %16.9 % Ankara, Turkey: Ankara, Turkey: 11.6 %11.6 % Nagasaki, Japan:Nagasaki, Japan: 2.6 % 2.6 %

EtiologyEtiology

BiologicalBiological CognitiveCognitive SocioculturalSociocultural

BiologicalBiological

Genetic and Genetic and biochemical factors in biochemical factors in depressiondepression

E.g. Caspi (2003), E.g. Caspi (2003), Lykken & Tellegen Lykken & Tellegen (1996)(1996)

CognitiveCognitive

A depressed mood may lead to depressed A depressed mood may lead to depressed thoughtsthoughts

Depressed cognitions, cognitive distortions, Depressed cognitions, cognitive distortions, and irrational beliefs produce disturbances and irrational beliefs produce disturbances in moodin mood

E.g. Goldapple (2004), Lyon & Woods E.g. Goldapple (2004), Lyon & Woods (1991)(1991)

SocioculturalSociocultural

Social and cultural Social and cultural factors affect the factors affect the prevalence and prevalence and manifestation of the manifestation of the disorderdisorder

E.g. Harris (1978), E.g. Harris (1978), Cutrona, Wallace, & Cutrona, Wallace, & Wesner (2006)Wesner (2006)

EvaluationEvaluation

+Can be used for therapy+Can be used for therapy

+Supporting research+Supporting research

-Methodological problems with research-Methodological problems with research

-Simplistic: Each perspective emphasizes one -Simplistic: Each perspective emphasizes one factorfactor

ConclusionConclusion

An interactionistic explanation of major An interactionistic explanation of major depressive disorder is preferable, e.g. the depressive disorder is preferable, e.g. the diathesis-stress model or the diathesis-stress model or the biopsychosocial modelbiopsychosocial model