Major depressive disorder (MDD) – Definitions and Diagnosis

Major depressive disorder (MDD) - Definitions and Diagnosis

History of depression

Definition of major depressive disorder

Symptoms of depression

The impact of the symptoms of depression on patients

MDD symptoms in DSM-5-TR

DSM-5-TR criteria for MDD

The Montgomery–Åsberg Depression Rating Scale

Definitions of clinical course and treatment outcomes I

MDD is a complex, often recurrent and remitting disorder1

Residual depressive symptoms and the risk of relapse

Definitions of symptoms and signs

Definitions of epidemiological terms

Definitions of burden of disease and key epidemiological terms

Definitions of clinical course and treatment outcomes II

Diagnosis of major depressive disorder – signs and symptoms

Signs and symptoms of depression – diagnostic criteria

Levels of depression severity

Structured interviews for diagnosis of MDD

Major depressive disorder – differential diagnosis

DSM categories related to depressive disorders

Persistent depressive disorder (PDD)

Other specified depressive disorders

Other differential diagnoses

MDD specifiers I

MDD specifiers II

MDD specifiers III

MDD specifiers IV

MDD specifiers V

ICD-11 classification of depression

Common screening and rating instruments for depression

Hamilton Depression Rating Scale (HAM-D)

Montgomery–Åsberg Depression Rating Scale (MADRS)

Children Depression Rating Scale – Revised (CDRS-R)

Beck Depression Inventory (BDI-II)

Geriatric Depression Scale (GDS)

Center for Epidemiologic Studies Depression Scale (CES-D)

Patient Health Questionnaire (PHQ2 or PHQ9)

General Behavior Inventory 10-Item Depression Scale (GBI-10D)

Measuring treatment outcomes in depression

Depression severity captured in different rating scales

The course of MDD

Measurement-based care in depression

Functional, physical, and psychosocial impacts of depression

Functional impairment in depression

Physical health outcome in people with depression

Patient-reported psychopathology in patients in remission

grid_view

out of/ 51

Slide description

Full description, scroll

file_download Download slide in HQ file_downloadDownload all in HQ

Depression is a broad and heterogeneous condition. Commonly used diagnostic manuals include the World Health Organization’s ICD-11 classification system and the American Psychiatric Association’s DSM-5-TR system. Depression often has a remitting and relapsing course, and symptoms may persist between episodes. This slide deck explores fundamental concepts and definitions related to depression, including signs and symptoms, differential diagnosis, and commonly used screening and rating instruments.

This slide deck was developed by Professor Dr. Anthony Cleare, Professor of Psychopharmacology & Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, King’s College London, United Kingdom; and Professor Dr. Lakshmi Yatham, Department of Psychiatry, University of British Columbia, Canada, in collaboration with Cambridge (a division of Prime, Cambridge, UK).

file_download Download slide in HQ file_downloadDownload all in HQ

Index for
slide deck

Major depressive disorder (MDD) - Definitions and Diagnosis

Major depressive disorder (MDD) - Definitions and Diagnosis

Major depressive disorder (MDD) - Definitions and Diagnosis

file_download Download slide in HQ

History of depression

History of depression

Reference:
1. Horowitz AV, Wakefield JC, Lorenzo-Luaces L. History of depression. In: DeRubeis RJ, Strunk DR (eds). The Oxford Handbook of Mood Disorders. Oxford University Press, 2017.

file_download Download slide in HQ

Definition of major depressive disorder

Definition of major depressive disorder

Definition of major depressive disorder

file_download Download slide in HQ

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 manag…

file_download Download slide in HQ

Depression

Depression

Reference:
1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition – text revision. © American Psychiatric Association, 2022.

file_download Download slide in HQ

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 Asso…

file_download Download slide in HQ

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 M…

file_download Download slide in HQ

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-…

file_download Download slide in HQ

DSM-5-TR criteria for MDD

DSM-5-TR criteria for MDD

The Diagnostic and Statistical Manual (DSM) of Mental Disorders is published by the American Psychiatric Association and provides standard criteria for the classification of mental disorders. It is now in its fifth edition text revision, DSM-5-TR, which was published in 2…

file_download Download slide in HQ

The Montgomery–Åsberg Depression Rating Scale

The Montgomery–Åsberg Depression Rating Scale

The Montgomery–Åsberg Depression Rating Scale (MADRS), which was designed to be sensitive to the effects of antidepressants, includes ten depressive symptoms.¹ Some studies evaluating antidepressant effect have used the six-item MADRS subscale, which includes only the fol…

file_download Download slide in HQ

Definitions of clinical course and treatment outcomes I

Definitions of clinical course and treatment outcomes I

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 …

file_download Download slide in HQ

MDD is a complex, often recurrent and remitting disorder1

MDD is a complex, often recurrent and remitting disorder1

Long-term treatment of depression with antidepressants benefits many patients by (1) reducing the likelihood of relapse or recurrence and (2) increasing the amount of time spent asymptomatic between episodes.^3-5

Discontinuing antidepressant treatment in the acute phase be…

file_download Download slide in HQ

Residual depressive symptoms and the risk of relapse

Residual depressive symptoms and the risk of relapse

Reference:
1. Judd LL, Akiskal HS, Maser JD, et al. Major depressive disorder: a prospective study of residual subthreshold depressive symptoms as predictor of rapid relapse. J Affect Disord 1998; 50 (2–3): 97–108.

file_download Download slide in HQ

Definitions of symptoms and signs

Definitions of symptoms and signs

As outlined on the slide, symptoms are apparent to the patient, whereas signs are not always.¹ Diagnostic criteria for major depressive disorder cover many of the signs and symptoms of which a clinician should be aware.^2,3

References:
1. King LS. Signs and symptoms. JAMA …

file_download Download slide in HQ

Definitions of epidemiological terms

Definitions of epidemiological terms

The slide explains the difference between prevalence and incidence as key epidemiological terms. While prevalence is the proportion of persons with condition, in a given population, at a designated time, the incidence describes the number of people newly developing a cond…

file_download Download slide in HQ

Definitions of burden of disease and key epidemiological terms

Definitions of burden of disease and key epidemiological terms

This slide gives definitions for key epidemiological terms used in studies to quantify the burden of a disease. Term defined are the Burden of disease (BoD), Quality adjusted life years (QALYs), Years of life lost (YLLs), Years lived with disability (YLDs), Disability adj…

file_download Download slide in HQ

Definitions of clinical course and treatment outcomes II

Definitions of clinical course and treatment outcomes II

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.Nieren…

file_download Download slide in HQ

task_alt