Depression is a broad and heterogeneous diagnosis. Major depressive disorder (MDD) is characterized by discrete episodes of at least 2 weeks’ duration involving changes in affect, cognition, and neurovegetative functions and inter-episode remissionsThe clinical course of MDD after the initial depressive episode varies from patient to patient. The optimal outcome for a patient with MDD is a full recovery from the major depressive episode and never becoming depressed again. However, patients with MDD in remission can experience residual symptoms, including functional and cognitive impairment, which can increase the risk of relapse. This slide deck covers the course, natural history, and prognosis of MDD.

This slide deck was developed by Professor Dr. Brenda Penninx, Amsterdam UMC, Vrije Universiteit, Department of Psychiatry, The Netherlands; and Professor Dr. Lakshmi Yatham, Department of Psychiatry, University of British Columbia, Canada, in collaboration with Cambridge (a division of Prime, Cambridge, UK).

Index for
slide deck

Introduction

Major depressive disorder (MDD) - Course, natural history and prognosis
Major depressive disorder (MDD) - Course, natural history and prognosis
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Depression
Depression

Depression can be defined based on the World Health Organization’s ICD-11 classification system or the American Psychiatric Association’s DSM-5-TR system.

References:
1.National Institute for Health and Care Excellence CG222. Depression in adults: recognition and manageme…

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Symptoms of depression
Symptoms of depression

The many symptoms of depression are varied, and can include emotional, cognitive, and physical symptoms that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.1,2

References:
1.American Psychiatric Associa…

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Diagnosis of MDD
Diagnosis of MDD

Depression can be diagnosed according to the American Psychiatric Association’s DSM-5-TR criteria, as outlined on the slide.

Reference:
1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition – text revision. © American Psy…

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MDD symptoms in DSM-5-TR
MDD symptoms in DSM-5-TR

The American Psychiatric Association (APA) describes nine depressive symptoms for diagnostic purposes, as outlined on the slide.1 At least five of these symptoms, at least one of which is ‘depressed mood’ or ‘loss of interest or pleasure’ are required during the same two-…

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The impact of the symptoms of depression on patients
The impact of the symptoms of depression on patients

As outlined on the slide, the various symptoms of depression can negatively impact a patient’s functioning, including in the areas of work or school, family life, and social life.1,2

References:
1.American Psychiatric Association. Diagnostic and Statistical Manual of Ment…

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The course of MDD
The course of MDD

The optimal outcome for a patient with major depressive disorder (MDD) is a full recovery from the major depressive episode and to never become depressed again.5 Treatment of MDD is divided into three phases, corresponding to different stages of the illness.6 Each of thes…

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Outcomes for patients with depression
Outcomes for patients with depression

The clinical course of major depressive disorder after the initial depressive episode varies from patient to patient, and whilst roughly half of patients will not go on to experience further recurrence, a minority of patients will experience unremitting depression.1,2

Ref…

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Definitions of clinical course and treatment outcomes I
Definitions of clinical course and treatment outcomes I

The terms ‘response’ and ‘remission’ have been used to mean different things in psychiatric research; the most commonly used meanings of these terms in studies of treatment outcomes in people with major depression disorder are given on the slide.1,2

References:
1.Nierenbe…

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Definitions of clinical course and treatment outcomes II
Definitions of clinical course and treatment outcomes II

MDD is a chronic disorder, most frequently characterised by relapses and recurrences.2 Relapse can be defined as an episode of MDD that occurs within 6 months of response or remission;2,3 theoretically, relapse signifies the return of a major depressive episode, rather th…

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MDD specifiers I
MDD specifiers I

Specifiers are extensions to a diagnosis that further clarify the course, severity, or special features of the disorder.

Reference:
1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition – text revision. © American Psychia…

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