Materiały źródłowe

• #1 Depression: Screening and Diagnosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/1015/p508.html

  Depression affects an estimated 8% of persons in the United States and accounts for more than $210 billion in health care costs annually. […] The U.S. Preventive Services Task Force (USPSTF) and American Academy of Family Physicians recommend screening for depression in the general adult population. […] Additionally, the USPSTF recommends screening children and adolescents 12 to 18 years of age for major depressive disorder. […] If screening is positive for possible depression, the diagnosis should be confirmed using Diagnostic and Statistical Manual of Mental Disorders, 5th ed., criteria. […] Major depression is one of the most common mental health disorders in the United States. […] The USPSTF recommends screening adolescents 12 to 18 years of age for major depressive disorder in the primary care setting.

• #2 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder (MDD) has been ranked as the third cause of the burden of disease worldwide in 2008 by WHO, which has projected that this disease will rank first by 2030. It is diagnosed when an individual has a persistently low or depressed mood, anhedonia or decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, psychomotor retardation or agitation, sleep disturbances, or suicidal thoughts. […] Per the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), an individual must have five of the above-mentioned symptoms, of which one must be a depressed mood or anhedonia causing social or occupational impairment, to be diagnosed with MDD. History of a manic or hypomanic episode must be ruled out to make a diagnosis of MDD.

• #3 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder (MDD) has been ranked as the third cause of the burden of disease worldwide in 2008 by WHO, which has projected that this disease will rank first by 2030. It is diagnosed when an individual has a persistently low or depressed mood, anhedonia or decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, psychomotor retardation or agitation, sleep disturbances, or suicidal thoughts. […] Per the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), an individual must have five of the above-mentioned symptoms, of which one must be a depressed mood or anhedonia causing social or occupational impairment, to be diagnosed with MDD. History of a manic or hypomanic episode must be ruled out to make a diagnosis of MDD.

• #4 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder is a clinical diagnosis; it is mainly diagnosed by the clinical history given by the patient and mental status examination. The clinical interview must include medical history, family history, social history, and substance use history along with the symptomatology. […] Although there is no objective testing available to diagnose depression, routine laboratory work including complete blood account with differential, comprehensive metabolic panel, thyroid-stimulating hormone, free T4, vitamin D, urinalysis, and toxicology screening is done to rule out organic or medical causes of depression. […] In primary care settings, the Patient Health Questionnaire-9 (PHQ-9), which is a self-report, standardized depression rating scale is commonly used for screening, diagnosing, and monitoring treatment response for MDD.

• #5 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder (MDD) has been ranked as the third cause of the burden of disease worldwide in 2008 by WHO, which has projected that this disease will rank first by 2030. It is diagnosed when an individual has a persistently low or depressed mood, anhedonia or decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, psychomotor retardation or agitation, sleep disturbances, or suicidal thoughts. […] Per the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), an individual must have five of the above-mentioned symptoms, of which one must be a depressed mood or anhedonia causing social or occupational impairment, to be diagnosed with MDD. History of a manic or hypomanic episode must be ruled out to make a diagnosis of MDD.

• #6 Major depressive disorder in adults: Approach to initial management – UpToDate

  https://www.uptodate.com/contents/major-depressive-disorder-in-adults-approach-to-initial-management

  Major depressive disorder (MDD) is diagnosed in patients with a history of at least one major depressive episode and no history of mania or hypomania. […] A major depressive episode is a period lasting at least two consecutive weeks, with five or more of the following symptoms: depressed mood, anhedonia, insomnia or hypersomnia, change in appetite or weight, psychomotor retardation or agitation, low energy, poor concentration, thoughts of worthlessness or guilt, and recurrent thoughts about death or suicide. […] The first step in managing individuals with MDD includes determining whether they can safely be managed as outpatients. […] The goals of initial treatment are symptom remission and restoration of baseline function. […] We generally target treatment strategies based on the severity of the patient’s depression.

• #7 Major depressive disorder – Wikipedia

  https://en.wikipedia.org/wiki/Major_depressive_disorder

  According to DSM-5, at least one of the symptoms is either depressed mood or loss of interest or pleasure. […] Major depressive disorder is classified as a mood disorder in the DSM-5. […] The diagnosis hinges on the presence of single or recurrent major depressive episodes. […] Major depressive episode is characterized by the presence of a severely depressed mood that persists for at least two weeks. […] If the person has had an episode of mania or markedly elevated mood, a diagnosis of bipolar disorder is made instead. […] Bereavement is not an exclusion criterion in the DSM-5, and it is up to the clinician to distinguish between normal reactions to a loss and MDD. […] The DSM-5 recognizes six further subtypes of MDD, called specifiers, in addition to noting the length, severity and presence of psychotic features.

• #8 Depressive Disorders – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/depressive-disorders

  Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. […] Diagnosis is based on history. […] The term depression is often used to refer to any of several depressive disorders. […] For diagnosis of major depressive disorder, ≥ 5 of the following must have been present nearly every day during the same 2-week period, and one of them must be depressed mood or loss of interest or pleasure: Depressed mood most of the day, Markedly diminished interest or pleasure in all or almost all activities for most of the day, Significant (> 5%) weight gain or loss or decreased or increased appetite, Insomnia (often sleep-maintenance insomnia) or hypersomnia, Psychomotor agitation or retardation observed by others (not self-reported), Fatigue or loss of energy, Feelings of worthlessness or excessive or inappropriate guilt, Diminished ability to think or concentrate or indecisiveness, Recurrent thoughts of death or suicide, a suicide attempt, or a specific plan for committing suicide.

• #9 Depressive Disorders – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/depressive-disorders

  Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. […] Diagnosis is based on history. […] The term depression is often used to refer to any of several depressive disorders. […] For diagnosis of major depressive disorder, ≥ 5 of the following must have been present nearly every day during the same 2-week period, and one of them must be depressed mood or loss of interest or pleasure: Depressed mood most of the day, Markedly diminished interest or pleasure in all or almost all activities for most of the day, Significant (> 5%) weight gain or loss or decreased or increased appetite, Insomnia (often sleep-maintenance insomnia) or hypersomnia, Psychomotor agitation or retardation observed by others (not self-reported), Fatigue or loss of energy, Feelings of worthlessness or excessive or inappropriate guilt, Diminished ability to think or concentrate or indecisiveness, Recurrent thoughts of death or suicide, a suicide attempt, or a specific plan for committing suicide.

• #10 Depressive Disorders – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/depressive-disorders

  Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. […] Diagnosis is based on history. […] The term depression is often used to refer to any of several depressive disorders. […] For diagnosis of major depressive disorder, ≥ 5 of the following must have been present nearly every day during the same 2-week period, and one of them must be depressed mood or loss of interest or pleasure: Depressed mood most of the day, Markedly diminished interest or pleasure in all or almost all activities for most of the day, Significant (> 5%) weight gain or loss or decreased or increased appetite, Insomnia (often sleep-maintenance insomnia) or hypersomnia, Psychomotor agitation or retardation observed by others (not self-reported), Fatigue or loss of energy, Feelings of worthlessness or excessive or inappropriate guilt, Diminished ability to think or concentrate or indecisiveness, Recurrent thoughts of death or suicide, a suicide attempt, or a specific plan for committing suicide.

• #11 Depressive Disorders – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/depressive-disorders

  Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. […] Diagnosis is based on history. […] The term depression is often used to refer to any of several depressive disorders. […] For diagnosis of major depressive disorder, ≥ 5 of the following must have been present nearly every day during the same 2-week period, and one of them must be depressed mood or loss of interest or pleasure: Depressed mood most of the day, Markedly diminished interest or pleasure in all or almost all activities for most of the day, Significant (> 5%) weight gain or loss or decreased or increased appetite, Insomnia (often sleep-maintenance insomnia) or hypersomnia, Psychomotor agitation or retardation observed by others (not self-reported), Fatigue or loss of energy, Feelings of worthlessness or excessive or inappropriate guilt, Diminished ability to think or concentrate or indecisiveness, Recurrent thoughts of death or suicide, a suicide attempt, or a specific plan for committing suicide.

• #12 Depressive Disorders – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/depressive-disorders

  Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. […] Diagnosis is based on history. […] The term depression is often used to refer to any of several depressive disorders. […] For diagnosis of major depressive disorder, ≥ 5 of the following must have been present nearly every day during the same 2-week period, and one of them must be depressed mood or loss of interest or pleasure: Depressed mood most of the day, Markedly diminished interest or pleasure in all or almost all activities for most of the day, Significant (> 5%) weight gain or loss or decreased or increased appetite, Insomnia (often sleep-maintenance insomnia) or hypersomnia, Psychomotor agitation or retardation observed by others (not self-reported), Fatigue or loss of energy, Feelings of worthlessness or excessive or inappropriate guilt, Diminished ability to think or concentrate or indecisiveness, Recurrent thoughts of death or suicide, a suicide attempt, or a specific plan for committing suicide.

• #13 Depressive Disorders – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/depressive-disorders

  Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. […] Diagnosis is based on history. […] The term depression is often used to refer to any of several depressive disorders. […] For diagnosis of major depressive disorder, ≥ 5 of the following must have been present nearly every day during the same 2-week period, and one of them must be depressed mood or loss of interest or pleasure: Depressed mood most of the day, Markedly diminished interest or pleasure in all or almost all activities for most of the day, Significant (> 5%) weight gain or loss or decreased or increased appetite, Insomnia (often sleep-maintenance insomnia) or hypersomnia, Psychomotor agitation or retardation observed by others (not self-reported), Fatigue or loss of energy, Feelings of worthlessness or excessive or inappropriate guilt, Diminished ability to think or concentrate or indecisiveness, Recurrent thoughts of death or suicide, a suicide attempt, or a specific plan for committing suicide.

• #14 Depressive Disorders – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/depressive-disorders

  Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. […] Diagnosis is based on history. […] The term depression is often used to refer to any of several depressive disorders. […] For diagnosis of major depressive disorder, ≥ 5 of the following must have been present nearly every day during the same 2-week period, and one of them must be depressed mood or loss of interest or pleasure: Depressed mood most of the day, Markedly diminished interest or pleasure in all or almost all activities for most of the day, Significant (> 5%) weight gain or loss or decreased or increased appetite, Insomnia (often sleep-maintenance insomnia) or hypersomnia, Psychomotor agitation or retardation observed by others (not self-reported), Fatigue or loss of energy, Feelings of worthlessness or excessive or inappropriate guilt, Diminished ability to think or concentrate or indecisiveness, Recurrent thoughts of death or suicide, a suicide attempt, or a specific plan for committing suicide.

• #15 Depressive Disorders – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/depressive-disorders

  Depressive disorders are characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities. […] Diagnosis is based on history. […] The term depression is often used to refer to any of several depressive disorders. […] For diagnosis of major depressive disorder, ≥ 5 of the following must have been present nearly every day during the same 2-week period, and one of them must be depressed mood or loss of interest or pleasure: Depressed mood most of the day, Markedly diminished interest or pleasure in all or almost all activities for most of the day, Significant (> 5%) weight gain or loss or decreased or increased appetite, Insomnia (often sleep-maintenance insomnia) or hypersomnia, Psychomotor agitation or retardation observed by others (not self-reported), Fatigue or loss of energy, Feelings of worthlessness or excessive or inappropriate guilt, Diminished ability to think or concentrate or indecisiveness, Recurrent thoughts of death or suicide, a suicide attempt, or a specific plan for committing suicide.

• #16 Depressive disorders: Definitions, contexts, differential diagnosis, neural correlates and clinical strategies

  https://www.neuroscigroup.us/articles/ADA-5-138.php

  The symptoms cause clinically significant distress and impairment of functioning in the social, work or other important areas (criterion B); the episode is not attributable to the physiological effects of a substance or to another medical condition (criterion C); the occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder or schizophrenia spectrum disorder and other psychotic disorders with other specification or without specification (criterion D); there has never been a manic or hypomanic episode. […] The DSM-V also encodes the hypothesis of non-suicidal self-harm. […] The self-injuring act performs different functions: the most reliable relate to a strategy of emotional regulation, a form of learned self-punishment due to a debilitating life context, and again, an attempt to exit dissociative states.

• #17 Depressive disorders: Definitions, contexts, differential diagnosis, neural correlates and clinical strategies

  https://www.neuroscigroup.us/articles/ADA-5-138.php

  The symptoms cause clinically significant distress and impairment of functioning in the social, work or other important areas (criterion B); the episode is not attributable to the physiological effects of a substance or to another medical condition (criterion C); the occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder or schizophrenia spectrum disorder and other psychotic disorders with other specification or without specification (criterion D); there has never been a manic or hypomanic episode. […] The DSM-V also encodes the hypothesis of non-suicidal self-harm. […] The self-injuring act performs different functions: the most reliable relate to a strategy of emotional regulation, a form of learned self-punishment due to a debilitating life context, and again, an attempt to exit dissociative states.

• #18 Depressive disorders: Definitions, contexts, differential diagnosis, neural correlates and clinical strategies

  https://www.neuroscigroup.us/articles/ADA-5-138.php

  The symptoms cause clinically significant distress and impairment of functioning in the social, work or other important areas (criterion B); the episode is not attributable to the physiological effects of a substance or to another medical condition (criterion C); the occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder or schizophrenia spectrum disorder and other psychotic disorders with other specification or without specification (criterion D); there has never been a manic or hypomanic episode. […] The DSM-V also encodes the hypothesis of non-suicidal self-harm. […] The self-injuring act performs different functions: the most reliable relate to a strategy of emotional regulation, a form of learned self-punishment due to a debilitating life context, and again, an attempt to exit dissociative states.

• #19 Depressive disorders: Definitions, contexts, differential diagnosis, neural correlates and clinical strategies

  https://www.neuroscigroup.us/articles/ADA-5-138.php

  The symptoms cause clinically significant distress and impairment of functioning in the social, work or other important areas (criterion B); the episode is not attributable to the physiological effects of a substance or to another medical condition (criterion C); the occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder or schizophrenia spectrum disorder and other psychotic disorders with other specification or without specification (criterion D); there has never been a manic or hypomanic episode. […] The DSM-V also encodes the hypothesis of non-suicidal self-harm. […] The self-injuring act performs different functions: the most reliable relate to a strategy of emotional regulation, a form of learned self-punishment due to a debilitating life context, and again, an attempt to exit dissociative states.

• #20 Depressive disorders: Definitions, contexts, differential diagnosis, neural correlates and clinical strategies

  https://www.neuroscigroup.us/articles/ADA-5-138.php

  The symptoms cause clinically significant distress and impairment of functioning in the social, work or other important areas (criterion B); the episode is not attributable to the physiological effects of a substance or to another medical condition (criterion C); the occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder or schizophrenia spectrum disorder and other psychotic disorders with other specification or without specification (criterion D); there has never been a manic or hypomanic episode. […] The DSM-V also encodes the hypothesis of non-suicidal self-harm. […] The self-injuring act performs different functions: the most reliable relate to a strategy of emotional regulation, a form of learned self-punishment due to a debilitating life context, and again, an attempt to exit dissociative states.

• #21 Major depressive disorder – Wikipedia

  https://en.wikipedia.org/wiki/Major_depressive_disorder

  According to DSM-5, at least one of the symptoms is either depressed mood or loss of interest or pleasure. […] Major depressive disorder is classified as a mood disorder in the DSM-5. […] The diagnosis hinges on the presence of single or recurrent major depressive episodes. […] Major depressive episode is characterized by the presence of a severely depressed mood that persists for at least two weeks. […] If the person has had an episode of mania or markedly elevated mood, a diagnosis of bipolar disorder is made instead. […] Bereavement is not an exclusion criterion in the DSM-5, and it is up to the clinician to distinguish between normal reactions to a loss and MDD. […] The DSM-5 recognizes six further subtypes of MDD, called specifiers, in addition to noting the length, severity and presence of psychotic features.

• #22 Depression (major depressive disorder) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013

  Your doctor may determine a diagnosis of depression based on: […] Your mental health professional may use the criteria for depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. […] It’s important to get an accurate diagnosis, so you can get appropriate treatment. […] Is depression the most likely cause of my symptoms? […] What kinds of tests will I need? […] What treatment is likely to work best for me?

• #23 Major depressive disorder – Wikipedia

  https://en.wikipedia.org/wiki/Major_depressive_disorder

  To confirm major depressive disorder as the most likely diagnosis, other potential diagnoses must be considered, including dysthymia, adjustment disorder with depressed mood, or bipolar disorder. […] Other disorders need to be ruled out before diagnosing major depressive disorder. […] No biological tests confirm major depression. […] In general, investigations are not repeated for a subsequent episode unless there is a medical indication.

• #24 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder is a clinical diagnosis; it is mainly diagnosed by the clinical history given by the patient and mental status examination. The clinical interview must include medical history, family history, social history, and substance use history along with the symptomatology. […] Although there is no objective testing available to diagnose depression, routine laboratory work including complete blood account with differential, comprehensive metabolic panel, thyroid-stimulating hormone, free T4, vitamin D, urinalysis, and toxicology screening is done to rule out organic or medical causes of depression. […] In primary care settings, the Patient Health Questionnaire-9 (PHQ-9), which is a self-report, standardized depression rating scale is commonly used for screening, diagnosing, and monitoring treatment response for MDD.

• #25 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder is a clinical diagnosis; it is mainly diagnosed by the clinical history given by the patient and mental status examination. The clinical interview must include medical history, family history, social history, and substance use history along with the symptomatology. […] Although there is no objective testing available to diagnose depression, routine laboratory work including complete blood account with differential, comprehensive metabolic panel, thyroid-stimulating hormone, free T4, vitamin D, urinalysis, and toxicology screening is done to rule out organic or medical causes of depression. […] In primary care settings, the Patient Health Questionnaire-9 (PHQ-9), which is a self-report, standardized depression rating scale is commonly used for screening, diagnosing, and monitoring treatment response for MDD.

• #26 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder is a clinical diagnosis; it is mainly diagnosed by the clinical history given by the patient and mental status examination. The clinical interview must include medical history, family history, social history, and substance use history along with the symptomatology. […] Although there is no objective testing available to diagnose depression, routine laboratory work including complete blood account with differential, comprehensive metabolic panel, thyroid-stimulating hormone, free T4, vitamin D, urinalysis, and toxicology screening is done to rule out organic or medical causes of depression. […] In primary care settings, the Patient Health Questionnaire-9 (PHQ-9), which is a self-report, standardized depression rating scale is commonly used for screening, diagnosing, and monitoring treatment response for MDD.

• #27 Depression Workup: Approach Considerations, Screening Tests, Laboratory Studies to Rule Out Organic Causes

  https://emedicine.medscape.com/article/286759-workup

  Depression screening tests can be valuable, with the most widely one used being the Patient Health Questionnaire-9 (PHQ-9). It is important to understand, however, that the results obtained from the use of any depression screening or rating scales do not diagnose depression and may be imperfect in any population, especially in elderly patients. […] The US Preventive Services Task Force (USPSTF) recommends screening for depression in the general adult population, including older adults and pregnant and postpartum women. It is important to understand that the results obtained from the use of any depression rating scales are imperfect in any population, especially the geriatric population. […] Depression is a clinical diagnosis, based on the history and physical findings. No diagnostic laboratory tests are available to diagnose major depressive disorder, but focused laboratory studies may be useful to exclude potential medical illnesses that may present as major depressive disorder.

• #28 Depression: Screening & Assessment | CAMH

  https://www.camh.ca/en/professionals/treating-conditions-and-disorders/depression/depression—screening-and-assessment

  SIGECAPS is a well-known mnemonic listing the symptoms of major depressive disorder, according to the DSM-5. […] Use the two-question quick screen for patients who have risk factors for major depressive disorder. Answering yes to either question indicates the need for a more detailed assessment. […] A brief questionnaire such as the free, online Patient Health Questionnaire (PHQ-9) aids diagnosis and assesses severity of the depression. As a screening tool, the PHQ-9 can assist in diagnosis, and also serve as a symptom severity tracker to help assess the effectiveness of the treatment plan. […] The PHQ can be used for diagnosis, assessing severity and monitoring treatment response.

• #29 Major depressive episode – Wikipedia

  https://en.wikipedia.org/wiki/Major_depressive_episode

  No labs are diagnostic of a depressive episode, but some labs can help rule out general medical conditions that may mimic the symptoms of a depressive episode. […] Healthcare providers may screen patients in the general population for depression using a screening tool, such as the Patient Healthcare Questionnaire-2 (PHQ-2). If the PHQ-2 screening is positive for depression, a provider may then administer the PHQ-9. […] Other disorders need to be ruled out before diagnosing major depressive episodes. Differential diagnoses include, but are not limited to: Adjustment disorder, Anxiety disorder (Generalized anxiety, PTSD, obsessive-compulsive disorder), Bipolar disorder, Bipolar II disorder, Cyclothymic disorder, Depression due to a general medical condition.

• #30 A Guide on Diagnoses of Depression | WTG

  https://williamsburgtherapygroup.com/blog/a-guide-on-diagnoses-of-depression

  A mental health professional may use a diagnostic and statistical manual (DSM-5) to diagnose depression with the help of evaluations like the Beck Depression Inventory. […] A depression diagnosis may be classified as mild or moderate depression or severe depression, depending on symptoms. […] An accurate diagnosis is essential, but also just the beginning of depression treatment. […] Treatment for depression typically involves talk therapy, prescription medications, or a combination of both. […] A mental health professional can help you develop a treatment plan that is right for you.

• #31 Depression in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/55

  Persistent depressive disorder (termed dysthymic disorder within ICD-11) is characterised by at least 2 years of a depressed mood for most of the day, for more days than not, for at least 2 years. […] Full details […] Key diagnostic factors include presence of risk factors, depressed mood, anhedonia, and functional impairment. […] Other diagnostic factors include weight change, libido changes, sleep disturbance, changes in movement, low energy, excessive guilt, poor concentration, suicidal ideation, somatic symptoms, bipolar disorder excluded, substance abuse/medication side effects excluded, medical illness excluded, and schizophrenia excluded. […] Diagnostic investigations include clinical diagnosis, metabolic panel, FBC, thyroid function tests, Patient Health Questionnaire-2 (PHQ-2), Patient Health Questionnaire-9 (PHQ-9), Edinburgh Postnatal Depression Scale, Geriatric Depression Scale, and Cornell Scale for Depression in Dementia.

• #32 Depression in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/55

  Persistent depressive disorder (termed dysthymic disorder within ICD-11) is characterised by at least 2 years of a depressed mood for most of the day, for more days than not, for at least 2 years. […] Full details […] Key diagnostic factors include presence of risk factors, depressed mood, anhedonia, and functional impairment. […] Other diagnostic factors include weight change, libido changes, sleep disturbance, changes in movement, low energy, excessive guilt, poor concentration, suicidal ideation, somatic symptoms, bipolar disorder excluded, substance abuse/medication side effects excluded, medical illness excluded, and schizophrenia excluded. […] Diagnostic investigations include clinical diagnosis, metabolic panel, FBC, thyroid function tests, Patient Health Questionnaire-2 (PHQ-2), Patient Health Questionnaire-9 (PHQ-9), Edinburgh Postnatal Depression Scale, Geriatric Depression Scale, and Cornell Scale for Depression in Dementia.

• #33 Depression in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/55

  Persistent depressive disorder (termed dysthymic disorder within ICD-11) is characterised by at least 2 years of a depressed mood for most of the day, for more days than not, for at least 2 years. […] Full details […] Key diagnostic factors include presence of risk factors, depressed mood, anhedonia, and functional impairment. […] Other diagnostic factors include weight change, libido changes, sleep disturbance, changes in movement, low energy, excessive guilt, poor concentration, suicidal ideation, somatic symptoms, bipolar disorder excluded, substance abuse/medication side effects excluded, medical illness excluded, and schizophrenia excluded. […] Diagnostic investigations include clinical diagnosis, metabolic panel, FBC, thyroid function tests, Patient Health Questionnaire-2 (PHQ-2), Patient Health Questionnaire-9 (PHQ-9), Edinburgh Postnatal Depression Scale, Geriatric Depression Scale, and Cornell Scale for Depression in Dementia.

• #34 Depression Workup: Approach Considerations, Screening Tests, Laboratory Studies to Rule Out Organic Causes

  https://emedicine.medscape.com/article/286759-workup

  Depression screening tests can be valuable, with the most widely one used being the Patient Health Questionnaire-9 (PHQ-9). It is important to understand, however, that the results obtained from the use of any depression screening or rating scales do not diagnose depression and may be imperfect in any population, especially in elderly patients. […] The US Preventive Services Task Force (USPSTF) recommends screening for depression in the general adult population, including older adults and pregnant and postpartum women. It is important to understand that the results obtained from the use of any depression rating scales are imperfect in any population, especially the geriatric population. […] Depression is a clinical diagnosis, based on the history and physical findings. No diagnostic laboratory tests are available to diagnose major depressive disorder, but focused laboratory studies may be useful to exclude potential medical illnesses that may present as major depressive disorder.

• #35 Approach to the adult patient with suspected depression – UpToDate

  https://www.uptodate.com/contents/approach-to-the-adult-patient-with-suspected-depression

  A positive test on depression screening raises the index of suspicion for major depressive disorder (MDD) but does not confirm its diagnosis. Screening tests for depression are sensitive but can lack specificity. A negative result with most depression screening instruments effectively rules out a diagnosis of major depression. However, in primary care settings, between one-half and two-thirds of „positive” depression screening tests will be false positives. […] Depressed mood is a common symptom in primary care patients that should raise the suspicion of MDD. Patients may describe feeling „sad” or „blue,” appear tearful or sad, or endorse frequent tearfulness or crying „for no reason.” Other mood symptoms that may suggest depression include decreased interest or pleasure in activities (anhedonia), anger, irritability, and anxiety.

• #36 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder is a clinical diagnosis; it is mainly diagnosed by the clinical history given by the patient and mental status examination. The clinical interview must include medical history, family history, social history, and substance use history along with the symptomatology. […] Although there is no objective testing available to diagnose depression, routine laboratory work including complete blood account with differential, comprehensive metabolic panel, thyroid-stimulating hormone, free T4, vitamin D, urinalysis, and toxicology screening is done to rule out organic or medical causes of depression. […] In primary care settings, the Patient Health Questionnaire-9 (PHQ-9), which is a self-report, standardized depression rating scale is commonly used for screening, diagnosing, and monitoring treatment response for MDD.

• #37 Major depressive disorder – Wikipedia

  https://en.wikipedia.org/wiki/Major_depressive_disorder

  To confirm major depressive disorder as the most likely diagnosis, other potential diagnoses must be considered, including dysthymia, adjustment disorder with depressed mood, or bipolar disorder. […] Other disorders need to be ruled out before diagnosing major depressive disorder. […] No biological tests confirm major depression. […] In general, investigations are not repeated for a subsequent episode unless there is a medical indication.

• #38 Depression Workup: Approach Considerations, Screening Tests, Laboratory Studies to Rule Out Organic Causes

  https://emedicine.medscape.com/article/286759-workup

  Neuroimaging can help clarify the nature of the neurologic illness that may produce psychiatric symptoms, but these studies are costly and may be of questionable value in patients without discrete neurologic deficits. Computed tomography (CT) scanning or magnetic resonance imaging (MRI) of the brain should be considered if organic brain syndrome or hypopituitarism is included in the differential diagnosis. […] Using single-photon emission computed tomography (SPECT) scanning, Tutus et al reported significant differences between the perfusion index values of untreated adolescents with depression and those of control patients. The researchers found that adolescents with major depressive disorder may have regional blood flow deficits in the left anterofrontal and left temporal cortical regions, with greater right-left perfusion asymmetry than healthy control patients.

• #39 Depression Workup: Approach Considerations, Screening Tests, Laboratory Studies to Rule Out Organic Causes

  https://emedicine.medscape.com/article/286759-workup

  Neuroimaging can help clarify the nature of the neurologic illness that may produce psychiatric symptoms, but these studies are costly and may be of questionable value in patients without discrete neurologic deficits. Computed tomography (CT) scanning or magnetic resonance imaging (MRI) of the brain should be considered if organic brain syndrome or hypopituitarism is included in the differential diagnosis. […] Using single-photon emission computed tomography (SPECT) scanning, Tutus et al reported significant differences between the perfusion index values of untreated adolescents with depression and those of control patients. The researchers found that adolescents with major depressive disorder may have regional blood flow deficits in the left anterofrontal and left temporal cortical regions, with greater right-left perfusion asymmetry than healthy control patients.

• #40 Depression Workup: Approach Considerations, Screening Tests, Laboratory Studies to Rule Out Organic Causes

  https://emedicine.medscape.com/article/286759-workup

  Neuroimaging can help clarify the nature of the neurologic illness that may produce psychiatric symptoms, but these studies are costly and may be of questionable value in patients without discrete neurologic deficits. Computed tomography (CT) scanning or magnetic resonance imaging (MRI) of the brain should be considered if organic brain syndrome or hypopituitarism is included in the differential diagnosis. […] Using single-photon emission computed tomography (SPECT) scanning, Tutus et al reported significant differences between the perfusion index values of untreated adolescents with depression and those of control patients. The researchers found that adolescents with major depressive disorder may have regional blood flow deficits in the left anterofrontal and left temporal cortical regions, with greater right-left perfusion asymmetry than healthy control patients.

• #41 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder can be managed with various treatment modalities, including pharmacological, psychotherapeutic, interventional, and lifestyle modification. The initial treatment of MDD includes medications or/and psychotherapy. […] While evaluating for MDD, it is important to rule out depressive disorder due to another medical condition, substance/medication-induced depressive disorder, dysthymia, cyclothymia, bereavement, adjustment disorder with depressed mood, bipolar disorder, schizoaffective disorder, schizophrenia, anxiety disorders, and eating disorders for the appropriate management. […] Untreated depressive episodes in major depressive disorder can last from 6 to 12 months. About two-thirds of the individuals with MDD contemplate suicide, and about 10 to 15 percent commit suicide. MDD is a chronic, recurrent illness; the recurrence rate is about 50% after the first episode, 70% after the second episode, and 90% after the third episode. […] MDD is one of the leading causes of disability worldwide. It not only causes a severe functional impairment but also adversely affects the interpersonal relationships, thus lowering the quality of life.

• #42 Major depressive disorder – Wikipedia

  https://en.wikipedia.org/wiki/Major_depressive_disorder

  To confirm major depressive disorder as the most likely diagnosis, other potential diagnoses must be considered, including dysthymia, adjustment disorder with depressed mood, or bipolar disorder. […] Other disorders need to be ruled out before diagnosing major depressive disorder. […] No biological tests confirm major depression. […] In general, investigations are not repeated for a subsequent episode unless there is a medical indication.

• #43 Differential Diagnosis of Major Depressive Disorder Versus Bipolar Disorder: Current Status and Best Clinical Practices

  https://www.psychiatrist.com/jcp/the-differential-diagnosis-of-mdd-versus-bp/

  The frequency of misdiagnosis and the challenge of differentiating MDD and BP (or distinguishing either from the multitude of psychiatric conditions with overlapping symptoms) highlight not only the importance of accurate differential diagnosis but also the need for and appropriate use of reliable diagnostic tools. […] The screening tool may suggest a preliminary diagnosis, but either a negative screen or a false positive may also point the clinician to a different pathway, particularly in the latter situation. […] The core differentiating factor between MDD and BP is the presence of a manic or hypomanic episode; in their absence, the likely diagnosis is MDD.

• #44 Major depressive episode – Wikipedia

  https://en.wikipedia.org/wiki/Major_depressive_episode

  No labs are diagnostic of a depressive episode, but some labs can help rule out general medical conditions that may mimic the symptoms of a depressive episode. […] Healthcare providers may screen patients in the general population for depression using a screening tool, such as the Patient Healthcare Questionnaire-2 (PHQ-2). If the PHQ-2 screening is positive for depression, a provider may then administer the PHQ-9. […] Other disorders need to be ruled out before diagnosing major depressive episodes. Differential diagnoses include, but are not limited to: Adjustment disorder, Anxiety disorder (Generalized anxiety, PTSD, obsessive-compulsive disorder), Bipolar disorder, Bipolar II disorder, Cyclothymic disorder, Depression due to a general medical condition.

• #45 Depression Diagnosis and Screening: What Doctors Look For

  https://www.webmd.com/depression/depression-diagnosis

  For example, if you do have depression, your doctor must determine whether you have major depression, chronic depression including dysthymia, seasonal affective disorder (SAD), bipolar disorder, or some other type of clinical depression. […] To be diagnosed with major depression, you must have a depressed mood or have lost interest or pleasure in life, plus have four of the symptoms listed above. […] The diagnostic criteria for depression are based on symptoms and how they affect your life. For example, for major depressive episodes, you would experience a depressed mood or loss of interest and pleasure in life for at least 2 weeks, plus four other symptoms, such as insomnia, fatigue, or feelings of worthlessness. […] Doctors write a depression diagnosis outlining the type of depression the patient has, such as major depressive disorder, seasonal affective disorder, or bipolar disease.

• #46 Major depressive disorder – Wikipedia

  https://en.wikipedia.org/wiki/Major_depressive_disorder

  To confirm major depressive disorder as the most likely diagnosis, other potential diagnoses must be considered, including dysthymia, adjustment disorder with depressed mood, or bipolar disorder. […] Other disorders need to be ruled out before diagnosing major depressive disorder. […] No biological tests confirm major depression. […] In general, investigations are not repeated for a subsequent episode unless there is a medical indication.

• #47 Major depressive episode – Wikipedia

  https://en.wikipedia.org/wiki/Major_depressive_episode

  No labs are diagnostic of a depressive episode, but some labs can help rule out general medical conditions that may mimic the symptoms of a depressive episode. […] Healthcare providers may screen patients in the general population for depression using a screening tool, such as the Patient Healthcare Questionnaire-2 (PHQ-2). If the PHQ-2 screening is positive for depression, a provider may then administer the PHQ-9. […] Other disorders need to be ruled out before diagnosing major depressive episodes. Differential diagnoses include, but are not limited to: Adjustment disorder, Anxiety disorder (Generalized anxiety, PTSD, obsessive-compulsive disorder), Bipolar disorder, Bipolar II disorder, Cyclothymic disorder, Depression due to a general medical condition.

• #48

  https://step2.medbullets.com/psychiatry/120619/major-depressive-disorder

  not associated with economic status or race […] incidence decreases with increasing age […] however, associated with presence of multiple medical comorbidities […] unipolar major depression (major depressive disorder) […] core symptom criteria have not changed in DSM-V […] a depressive episode must contain five or more of the above symptoms […] impairment of daily living […] medical causes has been ruled out (e.g., hypothyroidism, adrenal insufficiency, Huntington’s disease, hypercortisolism, mononucleosis, Parkinson’s disease, stroke, lupus, TBI, vitamin B12 deficiency) […] Routine outpatient screening now recommended by USPSTF […] Patient Health Questionnaire-2 (PHQ-2) can be used […] if positive, follow up with PHQ-9 […] assess for suicidal ideation, plan, and intent […] if patient has had 1 episode of major depression, pharmacotherapy can be discontinued after 6 months of no symptoms […] can be monitored using PHQ-9 (not PHQ-2) […] dementia secondary to depression […] rule out organic causes before making this diagnosis (such as a TSH level).

• #49

  https://step2.medbullets.com/psychiatry/120619/major-depressive-disorder

  not associated with economic status or race […] incidence decreases with increasing age […] however, associated with presence of multiple medical comorbidities […] unipolar major depression (major depressive disorder) […] core symptom criteria have not changed in DSM-V […] a depressive episode must contain five or more of the above symptoms […] impairment of daily living […] medical causes has been ruled out (e.g., hypothyroidism, adrenal insufficiency, Huntington’s disease, hypercortisolism, mononucleosis, Parkinson’s disease, stroke, lupus, TBI, vitamin B12 deficiency) […] Routine outpatient screening now recommended by USPSTF […] Patient Health Questionnaire-2 (PHQ-2) can be used […] if positive, follow up with PHQ-9 […] assess for suicidal ideation, plan, and intent […] if patient has had 1 episode of major depression, pharmacotherapy can be discontinued after 6 months of no symptoms […] can be monitored using PHQ-9 (not PHQ-2) […] dementia secondary to depression […] rule out organic causes before making this diagnosis (such as a TSH level).

• #50

  https://step2.medbullets.com/psychiatry/120619/major-depressive-disorder

  not associated with economic status or race […] incidence decreases with increasing age […] however, associated with presence of multiple medical comorbidities […] unipolar major depression (major depressive disorder) […] core symptom criteria have not changed in DSM-V […] a depressive episode must contain five or more of the above symptoms […] impairment of daily living […] medical causes has been ruled out (e.g., hypothyroidism, adrenal insufficiency, Huntington’s disease, hypercortisolism, mononucleosis, Parkinson’s disease, stroke, lupus, TBI, vitamin B12 deficiency) […] Routine outpatient screening now recommended by USPSTF […] Patient Health Questionnaire-2 (PHQ-2) can be used […] if positive, follow up with PHQ-9 […] assess for suicidal ideation, plan, and intent […] if patient has had 1 episode of major depression, pharmacotherapy can be discontinued after 6 months of no symptoms […] can be monitored using PHQ-9 (not PHQ-2) […] dementia secondary to depression […] rule out organic causes before making this diagnosis (such as a TSH level).

• #51

  https://step2.medbullets.com/psychiatry/120619/major-depressive-disorder

  not associated with economic status or race […] incidence decreases with increasing age […] however, associated with presence of multiple medical comorbidities […] unipolar major depression (major depressive disorder) […] core symptom criteria have not changed in DSM-V […] a depressive episode must contain five or more of the above symptoms […] impairment of daily living […] medical causes has been ruled out (e.g., hypothyroidism, adrenal insufficiency, Huntington’s disease, hypercortisolism, mononucleosis, Parkinson’s disease, stroke, lupus, TBI, vitamin B12 deficiency) […] Routine outpatient screening now recommended by USPSTF […] Patient Health Questionnaire-2 (PHQ-2) can be used […] if positive, follow up with PHQ-9 […] assess for suicidal ideation, plan, and intent […] if patient has had 1 episode of major depression, pharmacotherapy can be discontinued after 6 months of no symptoms […] can be monitored using PHQ-9 (not PHQ-2) […] dementia secondary to depression […] rule out organic causes before making this diagnosis (such as a TSH level).

• #52

  https://step2.medbullets.com/psychiatry/120619/major-depressive-disorder

  not associated with economic status or race […] incidence decreases with increasing age […] however, associated with presence of multiple medical comorbidities […] unipolar major depression (major depressive disorder) […] core symptom criteria have not changed in DSM-V […] a depressive episode must contain five or more of the above symptoms […] impairment of daily living […] medical causes has been ruled out (e.g., hypothyroidism, adrenal insufficiency, Huntington’s disease, hypercortisolism, mononucleosis, Parkinson’s disease, stroke, lupus, TBI, vitamin B12 deficiency) […] Routine outpatient screening now recommended by USPSTF […] Patient Health Questionnaire-2 (PHQ-2) can be used […] if positive, follow up with PHQ-9 […] assess for suicidal ideation, plan, and intent […] if patient has had 1 episode of major depression, pharmacotherapy can be discontinued after 6 months of no symptoms […] can be monitored using PHQ-9 (not PHQ-2) […] dementia secondary to depression […] rule out organic causes before making this diagnosis (such as a TSH level).

• #53

  https://step2.medbullets.com/psychiatry/120619/major-depressive-disorder

  not associated with economic status or race […] incidence decreases with increasing age […] however, associated with presence of multiple medical comorbidities […] unipolar major depression (major depressive disorder) […] core symptom criteria have not changed in DSM-V […] a depressive episode must contain five or more of the above symptoms […] impairment of daily living […] medical causes has been ruled out (e.g., hypothyroidism, adrenal insufficiency, Huntington’s disease, hypercortisolism, mononucleosis, Parkinson’s disease, stroke, lupus, TBI, vitamin B12 deficiency) […] Routine outpatient screening now recommended by USPSTF […] Patient Health Questionnaire-2 (PHQ-2) can be used […] if positive, follow up with PHQ-9 […] assess for suicidal ideation, plan, and intent […] if patient has had 1 episode of major depression, pharmacotherapy can be discontinued after 6 months of no symptoms […] can be monitored using PHQ-9 (not PHQ-2) […] dementia secondary to depression […] rule out organic causes before making this diagnosis (such as a TSH level).

• #54

  https://step2.medbullets.com/psychiatry/120619/major-depressive-disorder

  not associated with economic status or race […] incidence decreases with increasing age […] however, associated with presence of multiple medical comorbidities […] unipolar major depression (major depressive disorder) […] core symptom criteria have not changed in DSM-V […] a depressive episode must contain five or more of the above symptoms […] impairment of daily living […] medical causes has been ruled out (e.g., hypothyroidism, adrenal insufficiency, Huntington’s disease, hypercortisolism, mononucleosis, Parkinson’s disease, stroke, lupus, TBI, vitamin B12 deficiency) […] Routine outpatient screening now recommended by USPSTF […] Patient Health Questionnaire-2 (PHQ-2) can be used […] if positive, follow up with PHQ-9 […] assess for suicidal ideation, plan, and intent […] if patient has had 1 episode of major depression, pharmacotherapy can be discontinued after 6 months of no symptoms […] can be monitored using PHQ-9 (not PHQ-2) […] dementia secondary to depression […] rule out organic causes before making this diagnosis (such as a TSH level).

• #55

  https://step2.medbullets.com/psychiatry/120619/major-depressive-disorder

  not associated with economic status or race […] incidence decreases with increasing age […] however, associated with presence of multiple medical comorbidities […] unipolar major depression (major depressive disorder) […] core symptom criteria have not changed in DSM-V […] a depressive episode must contain five or more of the above symptoms […] impairment of daily living […] medical causes has been ruled out (e.g., hypothyroidism, adrenal insufficiency, Huntington’s disease, hypercortisolism, mononucleosis, Parkinson’s disease, stroke, lupus, TBI, vitamin B12 deficiency) […] Routine outpatient screening now recommended by USPSTF […] Patient Health Questionnaire-2 (PHQ-2) can be used […] if positive, follow up with PHQ-9 […] assess for suicidal ideation, plan, and intent […] if patient has had 1 episode of major depression, pharmacotherapy can be discontinued after 6 months of no symptoms […] can be monitored using PHQ-9 (not PHQ-2) […] dementia secondary to depression […] rule out organic causes before making this diagnosis (such as a TSH level).

• #56

  https://step2.medbullets.com/psychiatry/120619/major-depressive-disorder

  not associated with economic status or race […] incidence decreases with increasing age […] however, associated with presence of multiple medical comorbidities […] unipolar major depression (major depressive disorder) […] core symptom criteria have not changed in DSM-V […] a depressive episode must contain five or more of the above symptoms […] impairment of daily living […] medical causes has been ruled out (e.g., hypothyroidism, adrenal insufficiency, Huntington’s disease, hypercortisolism, mononucleosis, Parkinson’s disease, stroke, lupus, TBI, vitamin B12 deficiency) […] Routine outpatient screening now recommended by USPSTF […] Patient Health Questionnaire-2 (PHQ-2) can be used […] if positive, follow up with PHQ-9 […] assess for suicidal ideation, plan, and intent […] if patient has had 1 episode of major depression, pharmacotherapy can be discontinued after 6 months of no symptoms […] can be monitored using PHQ-9 (not PHQ-2) […] dementia secondary to depression […] rule out organic causes before making this diagnosis (such as a TSH level).

• #57

  https://step2.medbullets.com/psychiatry/120619/major-depressive-disorder

  not associated with economic status or race […] incidence decreases with increasing age […] however, associated with presence of multiple medical comorbidities […] unipolar major depression (major depressive disorder) […] core symptom criteria have not changed in DSM-V […] a depressive episode must contain five or more of the above symptoms […] impairment of daily living […] medical causes has been ruled out (e.g., hypothyroidism, adrenal insufficiency, Huntington’s disease, hypercortisolism, mononucleosis, Parkinson’s disease, stroke, lupus, TBI, vitamin B12 deficiency) […] Routine outpatient screening now recommended by USPSTF […] Patient Health Questionnaire-2 (PHQ-2) can be used […] if positive, follow up with PHQ-9 […] assess for suicidal ideation, plan, and intent […] if patient has had 1 episode of major depression, pharmacotherapy can be discontinued after 6 months of no symptoms […] can be monitored using PHQ-9 (not PHQ-2) […] dementia secondary to depression […] rule out organic causes before making this diagnosis (such as a TSH level).

• #58 Tests, Screening, and Criteria for Diagnosing Depression

  https://www.verywellhealth.com/how-depression-is-diagnosed-5114270

  Importantly, these symptoms cannot be the result of substance use (e.g., medication side effects or drug abuse), a physical illness, or another mental disorder. In addition, there should never have been a manic or hypomanic episode. […] No single test can definitively diagnose depression. Instead, your healthcare provider will ask about your symptoms and how long you have been experiencing them. They will use this information to see if you meet the DSM-5 diagnostic criteria for major depression.

• #59 Tests, Screening, and Criteria for Diagnosing Depression

  https://www.verywellhealth.com/how-depression-is-diagnosed-5114270

  Importantly, these symptoms cannot be the result of substance use (e.g., medication side effects or drug abuse), a physical illness, or another mental disorder. In addition, there should never have been a manic or hypomanic episode. […] No single test can definitively diagnose depression. Instead, your healthcare provider will ask about your symptoms and how long you have been experiencing them. They will use this information to see if you meet the DSM-5 diagnostic criteria for major depression.

• #60 Depression (major depressive disorder) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013

  Your doctor may determine a diagnosis of depression based on: […] Your mental health professional may use the criteria for depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. […] It’s important to get an accurate diagnosis, so you can get appropriate treatment. […] Is depression the most likely cause of my symptoms? […] What kinds of tests will I need? […] What treatment is likely to work best for me?

• #61 Major depressive disorder | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/major-depressive-disorder?lang=us

  Major depressive disorder (MDD) is the most common psychiatric disorder in both developed and developing countries. It is characterized by a persistently low mood and a reduced interest in previously pleasurable activities. […] The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes the following criteria for the diagnosis of major depressive disorder (must be present for at least 2 weeks): low mood, decreased interest in pleasurable activities (anhedonia), poor sleep, poor appetite, decreased energy, decreased libido, difficulty in concentration, psychomotor slowing, thoughts of suicide, thoughts around guilt or hopelessness. […] These symptoms must not be attributable to an organic cause or substance use. […] In the elderly, major depressive disorder can mimic early dementia as it often presents with reduced memory and psychomotor slowing. This is often termed pseudodementia.

• #62 Major depressive disorder in adults: Approach to initial management – UpToDate

  https://www.uptodate.com/contents/major-depressive-disorder-in-adults-approach-to-initial-management

  The severity of depression is determined by the degree of functional impairment and the number, frequency, intensity, and duration of the individual’s symptoms. […] For the initial treatment of most individuals with moderate major depression, we suggest treatment with either an antidepressant or in-person psychotherapy. […] For patients with severe major depression, we suggest combination therapy rather than other treatment regimens. […] ECT is an efficacious treatment for severe major depression, but relapse rates following remission are high. […] Antidepressants are typically used for moderate to severe depressive disorders given their efficacy, availability, and acceptability to patients. […] We suggest psychotherapy as an option for most individuals with MDD given that it has demonstrated efficacy for improving remission rates compared with placebo and has minimal harms.

• #63 Depression Clinical Presentation: History, Physical Examination, Major Depressive Disorder

  https://emedicine.medscape.com/article/286759-clinical

  There has never been a manic episode or a hypomanic episode. […] Depressive disorders can be rated as mild, moderate, or severe. […] The disorder can also occur with psychotic symptoms, which can be mood congruent or incongruent. […] DSM-5-TR further notes the importance of distinguishing between normal sadness and grief from a major depressive disorder. […] A diagnosis of major depressive disorder following a significant loss requires clinical judgement based on the individuals history and the cultural context for expression of grief.

• #64 Depression Clinical Presentation: History, Physical Examination, Major Depressive Disorder

  https://emedicine.medscape.com/article/286759-clinical

  There has never been a manic episode or a hypomanic episode. […] Depressive disorders can be rated as mild, moderate, or severe. […] The disorder can also occur with psychotic symptoms, which can be mood congruent or incongruent. […] DSM-5-TR further notes the importance of distinguishing between normal sadness and grief from a major depressive disorder. […] A diagnosis of major depressive disorder following a significant loss requires clinical judgement based on the individuals history and the cultural context for expression of grief.

• #65 Depressive Disorders – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/depressive-disorders

  For diagnosis of persistent depressive disorder (PDD), patients must have had a depressed mood for most of the day for more days than not for ≥ 2 years plus ≥ 2 of the following: Poor appetite or overeating, Insomnia or hypersomnia, Low energy or fatigue, Low self-esteem, Poor concentration or difficulty making decisions, Feelings of hopelessness. […] Diagnosis of depressive disorders is based on identification of the symptoms and signs and the clinical criteria described above. […] A physician should gently but directly ask patients about any thoughts and plans to harm themselves or others any previous threats of and/or attempts at suicide. […] Psychosis and catatonia indicate severe depression. […] Coexisting physical conditions, substance use disorders, and anxiety disorders may add to severity.

• #66 Major depressive disorder – Wikipedia

  https://en.wikipedia.org/wiki/Major_depressive_disorder

  According to DSM-5, at least one of the symptoms is either depressed mood or loss of interest or pleasure. […] Major depressive disorder is classified as a mood disorder in the DSM-5. […] The diagnosis hinges on the presence of single or recurrent major depressive episodes. […] Major depressive episode is characterized by the presence of a severely depressed mood that persists for at least two weeks. […] If the person has had an episode of mania or markedly elevated mood, a diagnosis of bipolar disorder is made instead. […] Bereavement is not an exclusion criterion in the DSM-5, and it is up to the clinician to distinguish between normal reactions to a loss and MDD. […] The DSM-5 recognizes six further subtypes of MDD, called specifiers, in addition to noting the length, severity and presence of psychotic features.

• #67 Major Depressive Disorder with Anxious Distress: Diagnosis & Treatment

  https://goodhealthpsych.com/blog/major-depressive-disorder-with-anxious-distress-diagnosis-and-treatment/

  Major depressive disorder is one of the most prevalent psychiatric disorders. It has a lifetime prevalence of around 12%, but this varies by age, gender, race, location, and marital status. Major depressive disorder is a serious health problem with several causes and contributing factors. It is also very likely to coexist alongside obsessive-compulsive disorder, social anxiety disorder, panic disorder, and substance abuse. […] Diagnosing MDD with anxious distress starts with a diagnosis of MDD, a subsequent diagnosis of the anxious distress specifier. […] It is important to get an accurate diagnosis because MDD anxious distress has a much worse prognosis compared to major depressive disorder on its own if it’s left untreated. There is a greater risk of the following: Poor treatment outcome, Relapse, Increased suicidal ideations. […] For these reasons, it’s essential that anyone who believes that they or someone close to them has MDD with anxious distress get a proper evaluation from a licensed mental health provider so that a multidisciplinary treatment approach can be created.

• #68 Depression Diagnosis and Screening: What Doctors Look For

  https://www.webmd.com/depression/depression-diagnosis

  For example, if you do have depression, your doctor must determine whether you have major depression, chronic depression including dysthymia, seasonal affective disorder (SAD), bipolar disorder, or some other type of clinical depression. […] To be diagnosed with major depression, you must have a depressed mood or have lost interest or pleasure in life, plus have four of the symptoms listed above. […] The diagnostic criteria for depression are based on symptoms and how they affect your life. For example, for major depressive episodes, you would experience a depressed mood or loss of interest and pleasure in life for at least 2 weeks, plus four other symptoms, such as insomnia, fatigue, or feelings of worthlessness. […] Doctors write a depression diagnosis outlining the type of depression the patient has, such as major depressive disorder, seasonal affective disorder, or bipolar disease.

• #69 Major depressive disorder – Knowledge @ AMBOSSdisclaimer

  https://www.amboss.com/us/knowledge/major-depressive-disorder/

  The presentation of depression in children may differ from adults. […] Consider using the PHQ-9 modified for adolescents to screen for depression. […] The diagnosis of MDD is the same as for adults, with two exceptions: Irritability can be noted in the assessment of mood. […] Monitor all children starting on SSRIs for suicidality. […] MDD in older adults (late-life depression) is common. […] Older patients may present atypically with irritability, anxiety, or physical symptoms as opposed to low mood. […] The choice of antidepressants is based on symptoms and comorbidities. […] Consider a tricyclic or SNRI if the patient also has neuropathic pain. […] MDD is more common in patients with cancer than in the general population. […] Actively screen for depression at time of original cancer diagnosis, regularly throughout cancer therapy, and when significant life events occur. […] Consider life expectancy when selecting treatment for depression in patients near the end of life; many antidepressants can take several weeks to have an effect.

• #70 Major depressive disorder – Knowledge @ AMBOSSdisclaimer

  https://www.amboss.com/us/knowledge/major-depressive-disorder/

  The presentation of depression in children may differ from adults. […] Consider using the PHQ-9 modified for adolescents to screen for depression. […] The diagnosis of MDD is the same as for adults, with two exceptions: Irritability can be noted in the assessment of mood. […] Monitor all children starting on SSRIs for suicidality. […] MDD in older adults (late-life depression) is common. […] Older patients may present atypically with irritability, anxiety, or physical symptoms as opposed to low mood. […] The choice of antidepressants is based on symptoms and comorbidities. […] Consider a tricyclic or SNRI if the patient also has neuropathic pain. […] MDD is more common in patients with cancer than in the general population. […] Actively screen for depression at time of original cancer diagnosis, regularly throughout cancer therapy, and when significant life events occur. […] Consider life expectancy when selecting treatment for depression in patients near the end of life; many antidepressants can take several weeks to have an effect.

• #71 Depression – Mental Health Disorders – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/mental-health-disorders/mood-disorders/depression

  Depression can make people sad and sluggish and/or lose all interest and pleasure in activities they used to enjoy. […] Doctors base the diagnosis on symptoms. […] A doctor is usually able to diagnose depression based on symptoms. Doctors use specific lists of symptoms (criteria) to diagnose the different types of depressive disorders. […] In older adults, depression may be difficult to notice, especially if they do not work or have little social interaction. […] A doctor may ask people to fill out a standardized questionnaires to help identify depression and determine how severe it is, but they cannot be used alone to diagnose depression. […] A thorough neurologic examination is done to check for Parkinson disease, which causes some of the same symptoms. […] A doctor’s evaluation, based on standard psychiatric diagnostic criteria. […] Tests to identify disorders that can cause depression. […] No test can confirm depression. However, laboratory tests may help a doctor determine whether depression is caused by a hormonal or other physical disorder.

• #72 Depression – Mental Health Disorders – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/mental-health-disorders/mood-disorders/depression

  Depression can make people sad and sluggish and/or lose all interest and pleasure in activities they used to enjoy. […] Doctors base the diagnosis on symptoms. […] A doctor is usually able to diagnose depression based on symptoms. Doctors use specific lists of symptoms (criteria) to diagnose the different types of depressive disorders. […] In older adults, depression may be difficult to notice, especially if they do not work or have little social interaction. […] A doctor may ask people to fill out a standardized questionnaires to help identify depression and determine how severe it is, but they cannot be used alone to diagnose depression. […] A thorough neurologic examination is done to check for Parkinson disease, which causes some of the same symptoms. […] A doctor’s evaluation, based on standard psychiatric diagnostic criteria. […] Tests to identify disorders that can cause depression. […] No test can confirm depression. However, laboratory tests may help a doctor determine whether depression is caused by a hormonal or other physical disorder.

• #73 Depression: Defining the ICD-10 Criteria

  https://mentalhealthcenter.com/depression-icd10-criteria/

  The presence of dementia or mental retardation does not rule out the diagnosis of a treatable depressive episode, but communication difficulties are likely to make it necessary to rely more than usual for the diagnosis upon objectively observed somatic symptoms, such as psychomotor retardation, loss of appetite and weight, and sleep disturbance. […] A severe depressive episode which meets the criteria given for severe depressive episode without psychotic symptoms and in which delusions, hallucinations, or depressive stupor are present.

• #74 Depression: Screening and Diagnosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/1015/p508.html

  Depression affects an estimated 8% of persons in the United States and accounts for more than $210 billion in health care costs annually. […] The U.S. Preventive Services Task Force (USPSTF) and American Academy of Family Physicians recommend screening for depression in the general adult population. […] Additionally, the USPSTF recommends screening children and adolescents 12 to 18 years of age for major depressive disorder. […] If screening is positive for possible depression, the diagnosis should be confirmed using Diagnostic and Statistical Manual of Mental Disorders, 5th ed., criteria. […] Major depression is one of the most common mental health disorders in the United States. […] The USPSTF recommends screening adolescents 12 to 18 years of age for major depressive disorder in the primary care setting.

• #75 Major depressive disorder – Knowledge @ AMBOSSdisclaimer

  https://www.amboss.com/us/knowledge/major-depressive-disorder/

  The presentation of depression in children may differ from adults. […] Consider using the PHQ-9 modified for adolescents to screen for depression. […] The diagnosis of MDD is the same as for adults, with two exceptions: Irritability can be noted in the assessment of mood. […] Monitor all children starting on SSRIs for suicidality. […] MDD in older adults (late-life depression) is common. […] Older patients may present atypically with irritability, anxiety, or physical symptoms as opposed to low mood. […] The choice of antidepressants is based on symptoms and comorbidities. […] Consider a tricyclic or SNRI if the patient also has neuropathic pain. […] MDD is more common in patients with cancer than in the general population. […] Actively screen for depression at time of original cancer diagnosis, regularly throughout cancer therapy, and when significant life events occur. […] Consider life expectancy when selecting treatment for depression in patients near the end of life; many antidepressants can take several weeks to have an effect.

• #76 Major depressive disorder – Knowledge @ AMBOSSdisclaimer

  https://www.amboss.com/us/knowledge/major-depressive-disorder/

  The presentation of depression in children may differ from adults. […] Consider using the PHQ-9 modified for adolescents to screen for depression. […] The diagnosis of MDD is the same as for adults, with two exceptions: Irritability can be noted in the assessment of mood. […] Monitor all children starting on SSRIs for suicidality. […] MDD in older adults (late-life depression) is common. […] Older patients may present atypically with irritability, anxiety, or physical symptoms as opposed to low mood. […] The choice of antidepressants is based on symptoms and comorbidities. […] Consider a tricyclic or SNRI if the patient also has neuropathic pain. […] MDD is more common in patients with cancer than in the general population. […] Actively screen for depression at time of original cancer diagnosis, regularly throughout cancer therapy, and when significant life events occur. […] Consider life expectancy when selecting treatment for depression in patients near the end of life; many antidepressants can take several weeks to have an effect.

• #77 Major depressive disorder – Knowledge @ AMBOSSdisclaimer

  https://www.amboss.com/us/knowledge/major-depressive-disorder/

  The presentation of depression in children may differ from adults. […] Consider using the PHQ-9 modified for adolescents to screen for depression. […] The diagnosis of MDD is the same as for adults, with two exceptions: Irritability can be noted in the assessment of mood. […] Monitor all children starting on SSRIs for suicidality. […] MDD in older adults (late-life depression) is common. […] Older patients may present atypically with irritability, anxiety, or physical symptoms as opposed to low mood. […] The choice of antidepressants is based on symptoms and comorbidities. […] Consider a tricyclic or SNRI if the patient also has neuropathic pain. […] MDD is more common in patients with cancer than in the general population. […] Actively screen for depression at time of original cancer diagnosis, regularly throughout cancer therapy, and when significant life events occur. […] Consider life expectancy when selecting treatment for depression in patients near the end of life; many antidepressants can take several weeks to have an effect.

• #78 Depression: Screening and Diagnosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/1015/p508.html

  The prevalence of depression in the postpartum period (commonly defined as the first 12 months after birth) has been estimated at 10%. […] Postpartum depression is not listed as its own diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5), but rather as a qualifier to the diagnosis of major depressive disorder. […] When screening is positive for possible depression, the diagnosis should be confirmed using DSM-5 criteria. […] A major depressive episode must not be better explained by schizoaffective disorder, schizophrenia, or schizophreniform disorder. […] It is reasonable to obtain basic laboratory testing when confirming the diagnosis of depression, especially in older patients, to exclude medical conditions that may mimic depression.

• #79 Depression: Screening and Diagnosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/1015/p508.html

  The prevalence of depression in the postpartum period (commonly defined as the first 12 months after birth) has been estimated at 10%. […] Postpartum depression is not listed as its own diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5), but rather as a qualifier to the diagnosis of major depressive disorder. […] When screening is positive for possible depression, the diagnosis should be confirmed using DSM-5 criteria. […] A major depressive episode must not be better explained by schizoaffective disorder, schizophrenia, or schizophreniform disorder. […] It is reasonable to obtain basic laboratory testing when confirming the diagnosis of depression, especially in older patients, to exclude medical conditions that may mimic depression.

• #80 Depression in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/55

  Persistent depressive disorder (termed dysthymic disorder within ICD-11) is characterised by at least 2 years of a depressed mood for most of the day, for more days than not, for at least 2 years. […] Full details […] Key diagnostic factors include presence of risk factors, depressed mood, anhedonia, and functional impairment. […] Other diagnostic factors include weight change, libido changes, sleep disturbance, changes in movement, low energy, excessive guilt, poor concentration, suicidal ideation, somatic symptoms, bipolar disorder excluded, substance abuse/medication side effects excluded, medical illness excluded, and schizophrenia excluded. […] Diagnostic investigations include clinical diagnosis, metabolic panel, FBC, thyroid function tests, Patient Health Questionnaire-2 (PHQ-2), Patient Health Questionnaire-9 (PHQ-9), Edinburgh Postnatal Depression Scale, Geriatric Depression Scale, and Cornell Scale for Depression in Dementia.

• #81 Top 8 Issues in Major Depressive Disorder

  https://www.psychiatrictimes.com/view/top-8-issues-in-major-depressive-disorder

  1. Diagnostic challenges. Diagnostic reliability has been a problem since DSM-1 and remains so through DSM-5-TR. MDD is a heterogeneous construct that limits communication, prognostic accuracy, and drug development, and it may be a key reason none of the current treatments are effective for more than about a third of those diagnosed with MDD. There are 227 possible combinations of symptoms that can meet DSM-5 criteria for MDD, and 2 different patients can be diagnosed with MDD without a single overlapping symptom. […] […] The diagnosis of MDD does not yet map very well with underlying biology or treatment outcomes. The National Institute of Mental Health (NIMH) Research Domain Criteria (RDOC) was an attempt to improve upon our current symptom based diagnostic system, but it has not been widely accepted or implemented by many clinicians. There are no easy solutions, but the quest to find a more reliable diagnosis for this all-important condition must continue. […]

• #82 Top 8 Issues in Major Depressive Disorder

  https://www.psychiatrictimes.com/view/top-8-issues-in-major-depressive-disorder

  1. Diagnostic challenges. Diagnostic reliability has been a problem since DSM-1 and remains so through DSM-5-TR. MDD is a heterogeneous construct that limits communication, prognostic accuracy, and drug development, and it may be a key reason none of the current treatments are effective for more than about a third of those diagnosed with MDD. There are 227 possible combinations of symptoms that can meet DSM-5 criteria for MDD, and 2 different patients can be diagnosed with MDD without a single overlapping symptom. […] […] The diagnosis of MDD does not yet map very well with underlying biology or treatment outcomes. The National Institute of Mental Health (NIMH) Research Domain Criteria (RDOC) was an attempt to improve upon our current symptom based diagnostic system, but it has not been widely accepted or implemented by many clinicians. There are no easy solutions, but the quest to find a more reliable diagnosis for this all-important condition must continue. […]

• #83 Approach to the adult patient with suspected depression – UpToDate

  https://www.uptodate.com/contents/approach-to-the-adult-patient-with-suspected-depression

  Symptoms of depression are common in primary care and outpatient specialty settings; their prevalence ranges from 17 to 53 percent. Most individuals with depressive symptoms will not have major depressive disorder (MDD) but will instead have a different depressive disorder or an alternative cause of depressed mood. […] Studies suggest that non-psychiatrists do not accurately diagnose depression, with both under- and overdiagnosis occurring. Underdiagnosis is common, in part because many patients with major depression do not present with depressed mood. […] The term „depression” can be used in multiple ways, which can be confusing for conversations about diagnosis. Depression can refer to a mood state, syndrome, or psychiatric disorder, as detailed in the table. In this topic, „depressed mood” denotes a mood state, and „depression” or „depressive episode” denotes a syndrome. „Depressive disorder” or „major depression” denotes a psychiatric disorder, such as major depressive disorder or premenstrual dysphoric disorder.

• #84 Differential Diagnosis of Major Depressive Disorder Versus Bipolar Disorder: Current Status and Best Clinical Practices

  https://www.psychiatrist.com/jcp/the-differential-diagnosis-of-mdd-versus-bp/

  Both over- and underdiagnosis have negative impacts, which reinforces the importance of becoming more skilled at making and reasoning through a differential diagnosis. […] The role of psychosis in differential diagnosis of MDD and BP arose several times in the focus group discussions as one of the factors that could be used in predicting subsequent BP and as a term that family members sometimes used to describe the patients behavior, a potential red flag for a diagnosis of BP. […] The prevailing view that underdiagnosis was more prevalent than overdiagnosis has changed over the last 10 to 15 years, with overdiagnosis now regarded by some as an equally significant concern, perhaps an even greater problem. […] Common reasons for overdiagnosis of BP include failure to meet a sufficient number of DSM-IV-associated B criteria symptoms for mania or hypomania, insufficient duration, and inability to identify abstinent periods in patients with substance abuse disorders.

• #85 Top 8 Issues in Major Depressive Disorder

  https://www.psychiatrictimes.com/view/top-8-issues-in-major-depressive-disorder

  The DSM relationship between bereavement and MDD has had a somewhat convoluted history. In a well-intentioned effort to avoid medicalizing ordinary grief and the subsequent over-prescription of antidepressants, the DSM-III introduced the bereavement exclusion, which cautioned against diagnosing MDD after the death of a loved one. But subsequent research suggested that major depressive syndromes following bereavement did not meaningfully differ in nature, course, or outcome from depression of equal severity in any other context, or from MDD appearing out of the blue. Disqualifying a patient from a diagnosis of MDD simply because the clinical picture emerged after the death of a loved one risks closing the door on potentially life-preserving interventions. […] […] The DSM-5 provides useful guidance on when to diagnose MDD in the post-bereavement period. For example, in bereavement-related grief not accompanied by MDD, loss and preoccupation with the deceased person are the predominant themes and self-esteem is usually preserved. In contrast, in MDD, persistent and pervasive unhappiness and the inability to enjoy anything are the predominant themes, and feelings of worthlessness and self-loathing are common. […]

• #86 Top 8 Issues in Major Depressive Disorder

  https://www.psychiatrictimes.com/view/top-8-issues-in-major-depressive-disorder

  The DSM relationship between bereavement and MDD has had a somewhat convoluted history. In a well-intentioned effort to avoid medicalizing ordinary grief and the subsequent over-prescription of antidepressants, the DSM-III introduced the bereavement exclusion, which cautioned against diagnosing MDD after the death of a loved one. But subsequent research suggested that major depressive syndromes following bereavement did not meaningfully differ in nature, course, or outcome from depression of equal severity in any other context, or from MDD appearing out of the blue. Disqualifying a patient from a diagnosis of MDD simply because the clinical picture emerged after the death of a loved one risks closing the door on potentially life-preserving interventions. […] […] The DSM-5 provides useful guidance on when to diagnose MDD in the post-bereavement period. For example, in bereavement-related grief not accompanied by MDD, loss and preoccupation with the deceased person are the predominant themes and self-esteem is usually preserved. In contrast, in MDD, persistent and pervasive unhappiness and the inability to enjoy anything are the predominant themes, and feelings of worthlessness and self-loathing are common. […]

• #87 Depression: Diagnosis | CAMH

  https://www.camh.ca/en/professionals/treating-conditions-and-disorders/depression/depression—diagnosis

  Depression shares many symptoms with other psychiatric disorders and mental health problems. […] The bereavement exclusion criterion for depression has been removed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) because grief, like reactions to other severe losses and stressors, can coexist with depression or precipitate it (American Psychiatric Association, 2013). […] Persistent depressive disorder features depressive symptoms that last for at least two continuous years, with periods of remission lasting no longer than two consecutive months. Symptoms can be subsyndromal (in the case of dysthymia or depression in partial remission) or syndromal (meeting criteria for depression for at least two years). […] Depression is often secondary to, or comorbid with, many anxiety disorders, especially generalized anxiety disorder, social anxiety disorder and panic disorder. Anxiety is common in depression, and DSM-5 has a specifier (with anxious distress) to rate the severity of anxiety in patients diagnosed with depression or bipolar disorder.

• #88 Differential Diagnosis of Major Depressive Disorder Versus Bipolar Disorder: Current Status and Best Clinical Practices

  https://www.psychiatrist.com/jcp/the-differential-diagnosis-of-mdd-versus-bp/

  Given the similarity in clinical presentation between major depressive disorder (MDD) and the depressive episodes of bipolar disorder (BP), it is inevitable that diagnostic errors will occur. […] The purpose of this article is to provide psychiatrists and primary care clinicians with a set of best practices to improve their ability to make an accurate differential diagnosis between MDD and BP while recognizing complexities related to not only psychiatric and medical comorbidities but also the evolving presentation of symptoms as the disorders progress. […] In making a differential diagnosis between MDD and BP, certainty is a rare commodity. Diagnosis is based on symptoms, but there is a degree of arbitrariness in the minimum number of features and the minimum duration necessary for a definitive diagnosis.

• #89 Diagnosis of major depressive disorder based on changes in multiple plasma neurotransmitters: a targeted metabolomics study | Translational Psychiatry

  https://www.nature.com/articles/s41398-018-0183-x

  Major depressive disorder (MDD) is a debilitating psychiatric illness. However, there is currently no objective laboratory-based diagnostic tests for this disorder. […] Currently, diagnosis of MDD primarily relies on subjective identification of symptom clusters by psychiatrists, resulting in a high rate of misdiagnosis. […] Thus, an objective diagnostic approach for MDD would be of considerable clinical value. […] Here, the applicability of a plasma-targeted metabonomic method for the diagnosis of MDD was evaluated. […] This study is the first to globally evaluate multiple neurotransmitters in MDD plasma. The altered plasma neurotransmitter metabolite profile has potential differential diagnostic value for MDD. […] The aim of this study was to examine the feasibility of an empirical laboratory-based method to diagnose MDD. […] Moreover, this biomarker panel was able to accurately diagnose blinded samples with both high sensitivity and high specificity. […] The biomarker panel in this study, involving three pathways, can discriminate depressed patients from healthy controls and BD subjects with high accuracy.

• #90 Diagnosis of major depressive disorder based on changes in multiple plasma neurotransmitters: a targeted metabolomics study | Translational Psychiatry

  https://www.nature.com/articles/s41398-018-0183-x

  Major depressive disorder (MDD) is a debilitating psychiatric illness. However, there is currently no objective laboratory-based diagnostic tests for this disorder. […] Currently, diagnosis of MDD primarily relies on subjective identification of symptom clusters by psychiatrists, resulting in a high rate of misdiagnosis. […] Thus, an objective diagnostic approach for MDD would be of considerable clinical value. […] Here, the applicability of a plasma-targeted metabonomic method for the diagnosis of MDD was evaluated. […] This study is the first to globally evaluate multiple neurotransmitters in MDD plasma. The altered plasma neurotransmitter metabolite profile has potential differential diagnostic value for MDD. […] The aim of this study was to examine the feasibility of an empirical laboratory-based method to diagnose MDD. […] Moreover, this biomarker panel was able to accurately diagnose blinded samples with both high sensitivity and high specificity. […] The biomarker panel in this study, involving three pathways, can discriminate depressed patients from healthy controls and BD subjects with high accuracy.

• #91 Depression Workup: Approach Considerations, Screening Tests, Laboratory Studies to Rule Out Organic Causes

  https://emedicine.medscape.com/article/286759-workup

  Neuroimaging can help clarify the nature of the neurologic illness that may produce psychiatric symptoms, but these studies are costly and may be of questionable value in patients without discrete neurologic deficits. Computed tomography (CT) scanning or magnetic resonance imaging (MRI) of the brain should be considered if organic brain syndrome or hypopituitarism is included in the differential diagnosis. […] Using single-photon emission computed tomography (SPECT) scanning, Tutus et al reported significant differences between the perfusion index values of untreated adolescents with depression and those of control patients. The researchers found that adolescents with major depressive disorder may have regional blood flow deficits in the left anterofrontal and left temporal cortical regions, with greater right-left perfusion asymmetry than healthy control patients.

• #92 Major depressive disorder – Wikipedia

  https://en.wikipedia.org/wiki/Major_depressive_disorder

  Major depressive disorder is believed to be caused by a combination of genetic, environmental, and psychological factors, with about 40% of the risk being genetic. […] Risk factors include a family history of the condition, major life changes, childhood traumas, environmental lead exposure, certain medications, chronic health problems, and substance use disorders. […] Diagnosis may be delayed or missed when symptoms are interpreted as „normal moodiness”. […] The most widely used criteria for diagnosing depressive conditions are found in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) and the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems (ICD). […] The most recent edition of the DSM is the Fifth Edition, Text Revision (DSM-5-TR), and the most recent edition of the ICD is the Eleventh Edition (ICD-11).

• #93 Major depressive disorder: hypothesis, mechanism, prevention and treatment | Signal Transduction and Targeted Therapy

  https://www.nature.com/articles/s41392-024-01738-y

  Major depressive disorder (MDD), a main cause of disability worldwide, is characterized by physical changes such as tiredness, weight loss, and appetite loss. The clinical symptoms of MDD include a depressed mood, loss of interest, changes in weight or appetite, and increased likelihood of committing suicide. These symptoms are also listed as the criteria for MDD in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In addition to the criteria listed in the DSM-5, the criteria reported in the International Classification of Diseases (ICD-10) are also used to guide clinical diagnosis. However, due to the lack of characteristic symptoms and objective diagnostic evidence for MDD, identification and early prevention are difficult in the clinic. […] Due to the complexity of the pathological mechanism of MDD, accurate diagnostic approaches and pharmacological therapeutic strategies are relatively limited. Several hypothesis were developed to explain MDD pathogenesis pathogenic including (i) the hypothalamic–pituitary–adrenal (HPA) axis dysfunction hypothesis, (ii) the monoamine hypothesis, (iii) the inflammatory hypothesis, (iv) the genetic and epigenetic anomaly hypothesis, (v) the structural and functional brain remodeling hypothesis, and (vi) the social psychological hypothesis. However, none of these hypotheses alone can fully explain the pathological basis of MDD, while many mechanisms proposed by these hypotheses interact with each other. In recent years, great progress has been made in identifying novel pharmacological therapies, diagnostic criteria, and nonpharmacological preventive measures for MDD, initiating related clinical trials.

• #94 Diagnosis of major depressive disorder based on changes in multiple plasma neurotransmitters: a targeted metabolomics study | Translational Psychiatry

  https://www.nature.com/articles/s41398-018-0183-x

  Major depressive disorder (MDD) is a debilitating psychiatric illness. However, there is currently no objective laboratory-based diagnostic tests for this disorder. […] Currently, diagnosis of MDD primarily relies on subjective identification of symptom clusters by psychiatrists, resulting in a high rate of misdiagnosis. […] Thus, an objective diagnostic approach for MDD would be of considerable clinical value. […] Here, the applicability of a plasma-targeted metabonomic method for the diagnosis of MDD was evaluated. […] This study is the first to globally evaluate multiple neurotransmitters in MDD plasma. The altered plasma neurotransmitter metabolite profile has potential differential diagnostic value for MDD. […] The aim of this study was to examine the feasibility of an empirical laboratory-based method to diagnose MDD. […] Moreover, this biomarker panel was able to accurately diagnose blinded samples with both high sensitivity and high specificity. […] The biomarker panel in this study, involving three pathways, can discriminate depressed patients from healthy controls and BD subjects with high accuracy.

• #95 Depression Diagnosis, Tests, & Treatments

  https://www.webmd.com/depression/understanding-depression-treatment

  Although common, depression is often ignored or wrongly diagnosed and left untreated. This can be life-threatening; major depression, in particular, has a high suicide rate. […] To diagnose depression, your doctor will ask you about your symptoms and family history. They may want you to fill out a questionnaire about your symptoms. […] As with any chronic illness, getting an early medical diagnosis and medical treatment may help make depression symptoms less intense or last a shorter time. It may also reduce the likelihood of a relapse. […] You may need to try a few antidepressants before you find one that works well for you. […] ECT is usually considered after a number of other options because it may require hospitalization and general anesthesia. […] rTMS has been used effectively at times to treat major depression and depression that does not respond to other forms of treatment (treatment-resistant depression). […] VNS is used to treat select cases of severe or recurrent chronic depression that does not respond to at least two antidepressants.

• #96 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder can be managed with various treatment modalities, including pharmacological, psychotherapeutic, interventional, and lifestyle modification. The initial treatment of MDD includes medications or/and psychotherapy. […] While evaluating for MDD, it is important to rule out depressive disorder due to another medical condition, substance/medication-induced depressive disorder, dysthymia, cyclothymia, bereavement, adjustment disorder with depressed mood, bipolar disorder, schizoaffective disorder, schizophrenia, anxiety disorders, and eating disorders for the appropriate management. […] Untreated depressive episodes in major depressive disorder can last from 6 to 12 months. About two-thirds of the individuals with MDD contemplate suicide, and about 10 to 15 percent commit suicide. MDD is a chronic, recurrent illness; the recurrence rate is about 50% after the first episode, 70% after the second episode, and 90% after the third episode. […] MDD is one of the leading causes of disability worldwide. It not only causes a severe functional impairment but also adversely affects the interpersonal relationships, thus lowering the quality of life.

• #97 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder can be managed with various treatment modalities, including pharmacological, psychotherapeutic, interventional, and lifestyle modification. The initial treatment of MDD includes medications or/and psychotherapy. […] While evaluating for MDD, it is important to rule out depressive disorder due to another medical condition, substance/medication-induced depressive disorder, dysthymia, cyclothymia, bereavement, adjustment disorder with depressed mood, bipolar disorder, schizoaffective disorder, schizophrenia, anxiety disorders, and eating disorders for the appropriate management. […] Untreated depressive episodes in major depressive disorder can last from 6 to 12 months. About two-thirds of the individuals with MDD contemplate suicide, and about 10 to 15 percent commit suicide. MDD is a chronic, recurrent illness; the recurrence rate is about 50% after the first episode, 70% after the second episode, and 90% after the third episode. […] MDD is one of the leading causes of disability worldwide. It not only causes a severe functional impairment but also adversely affects the interpersonal relationships, thus lowering the quality of life.

• #98 Major Depression – Harvard Health

  https://www.health.harvard.edu/a_to_z/major-depression-a-to-z

  If depression is not treated, it can become chronic (long-lasting). Treatment can shorten the length and severity of a depressive episode. […] There is no way to prevent major depression, but detecting it early can help. Treatment can both reduce symptoms and help to prevent the illness from returning. […] The most helpful treatment is a combination of psychotherapy and medication. […] A technique called cognitive behavioral therapy is designed to help a depressed person recognize negative thinking and teaches techniques for controlling symptoms. […] Treatment of depression has become quite sophisticated and effective. The prognosis with treatment is excellent. The intensity of symptoms and the frequency of episodes often are significantly reduced. Many people recover completely.

• #99 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder can be managed with various treatment modalities, including pharmacological, psychotherapeutic, interventional, and lifestyle modification. The initial treatment of MDD includes medications or/and psychotherapy. […] While evaluating for MDD, it is important to rule out depressive disorder due to another medical condition, substance/medication-induced depressive disorder, dysthymia, cyclothymia, bereavement, adjustment disorder with depressed mood, bipolar disorder, schizoaffective disorder, schizophrenia, anxiety disorders, and eating disorders for the appropriate management. […] Untreated depressive episodes in major depressive disorder can last from 6 to 12 months. About two-thirds of the individuals with MDD contemplate suicide, and about 10 to 15 percent commit suicide. MDD is a chronic, recurrent illness; the recurrence rate is about 50% after the first episode, 70% after the second episode, and 90% after the third episode. […] MDD is one of the leading causes of disability worldwide. It not only causes a severe functional impairment but also adversely affects the interpersonal relationships, thus lowering the quality of life.

• #100 Major Depressive Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559078/

  Major depressive disorder can be managed with various treatment modalities, including pharmacological, psychotherapeutic, interventional, and lifestyle modification. The initial treatment of MDD includes medications or/and psychotherapy. […] While evaluating for MDD, it is important to rule out depressive disorder due to another medical condition, substance/medication-induced depressive disorder, dysthymia, cyclothymia, bereavement, adjustment disorder with depressed mood, bipolar disorder, schizoaffective disorder, schizophrenia, anxiety disorders, and eating disorders for the appropriate management. […] Untreated depressive episodes in major depressive disorder can last from 6 to 12 months. About two-thirds of the individuals with MDD contemplate suicide, and about 10 to 15 percent commit suicide. MDD is a chronic, recurrent illness; the recurrence rate is about 50% after the first episode, 70% after the second episode, and 90% after the third episode. […] MDD is one of the leading causes of disability worldwide. It not only causes a severe functional impairment but also adversely affects the interpersonal relationships, thus lowering the quality of life.

• #101 MDD Diagnosis Criteria: A Comprehensive Guide

  https://mytmstherapy.com/blog/mdd-diagnosis-criteria-a-comprehensive-guide/

  Major Depressive Disorder (MDD), commonly known as depression, is a mental health condition that affects millions of people worldwide. It is characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities once enjoyed. […] The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the primary resource used by mental health professionals to diagnose MDD. The DSM-5 outlines the following MDD diagnosis criteria: […] To be diagnosed with MDD, an individual must exhibit at least five of these symptoms, with either depressed mood or anhedonia being one of them. These symptoms must be present for at least two weeks and cause significant distress or impairment in daily functioning. […] Diagnosing MDD correctly is crucial for several reasons: Accurate diagnosis helps mental health professionals develop appropriate treatment plans, including therapy, medication, and lifestyle changes.

• #102 Psychiatry.org – What Is Depression?

  https://www.psychiatry.org/patients-families/depression/what-is-depression

  Depression (major depressive disorder) is a common and serious mental disorder that negatively affects how you feel, think, act, and perceive the world. […] To diagnose depression, a healthcare professional will conduct a thorough diagnostic evaluation that includes a comprehensive interview to discuss your symptoms in addition to your personal, medical and family histories. […] Depression is among the most treatable of mental disorders. Between 70% and 90% percent of people with depression eventually respond well to treatment. […] The evaluating medical professional will take all of these factors into account as they formulate a diagnosis and recommend an individualized treatment plan.

• #103 Major Depression – Harvard Health

  https://www.health.harvard.edu/a_to_z/major-depression-a-to-z

  If depression is not treated, it can become chronic (long-lasting). Treatment can shorten the length and severity of a depressive episode. […] There is no way to prevent major depression, but detecting it early can help. Treatment can both reduce symptoms and help to prevent the illness from returning. […] The most helpful treatment is a combination of psychotherapy and medication. […] A technique called cognitive behavioral therapy is designed to help a depressed person recognize negative thinking and teaches techniques for controlling symptoms. […] Treatment of depression has become quite sophisticated and effective. The prognosis with treatment is excellent. The intensity of symptoms and the frequency of episodes often are significantly reduced. Many people recover completely.

• #104 Major Depressive Disorder (MDD) — Seattle Anxiety Specialists – Psychiatry, Psychology, and Psychotherapy

  https://seattleanxiety.com/major-depressive-disorder-mdd

  Not everyone who is depressed experiences every symptom; some experience only a few symptoms while others experience many. Symptoms tend to be severe enough to cause noticeable complications in ones day-to-day activities (e.g., work, school, social activities or personal relationships). Several persistent symptoms, in addition to low mood, are required for a diagnosis of MDD; but people with only a few, but distressing, symptoms may benefit from treatment of their subsyndromal depression. […] A stressful life event may trigger an episode of depression, but it often does not appear to present as related to a specific event. Additionally, while there is no way to prevent MDD, early detection is beneficial as treatment can both reduce symptoms and aid in preventing its reoccurrence. […] Depression, even the most severe cases, can be treated. Between 80% and 90% percent of people with depression eventually respond well to treatment with nearly all patients attaining some relief from their symptoms. Major depression is usually treated with medications, psychotherapy, with a combination of the two producing the most effective treatments in many cases. If these treatments do not reduce ones symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be undertaken.

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