(GP)

Overview

• Can describe both a mood and an illness
• Major Depressive Disorder → episodic mood disorder primarily characterised by depressed mood and anhedonia lasting for at least 2 weeks
• F>M (2:1), peak age of onset in 3rd decade of life
• Affects 5-10% of patients in the primary care setting
• 1 in 5 nursing home residents without dementia are diagnosed with depression
• Aetiology → lack of monoamines (serotonin, noradrenaline, dopamine) play role in pathophysiology
• Risk Factors → female, recent childbirth, stress, trauma, co-existing medical conditions, personal or family hx of depression

Making Diagnosis

Clinical Features:

• Major Criteria
  • Depressed Mood → most of the day, nearly every day, for period of 2 weeks
  • Anhedonia → diminished interest or pleasure in all activities for 2 weeks
• Other Criteria
  • Sleep Disturbance (insomnia or hypersomnia)
  • Guilt/Worthlessness
  • Fatigue
  • Diminished Concentration or Cognition
  • Weight Change (due to appetite change)
  • Agitation (change in activity)
  • Suicidal Ideation

<aside> 💡 Diagnosis of MDD (≥5/9 criteria met) ⇒ Depressed Mood OR Anhedonia + 4 other symptoms of depression (for min. 2 weeks)

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Investigations: