- LAST REVIEWED: 08 May 2015
- LAST MODIFIED: 26 February 2013
- DOI: 10.1093/obo/9780199828340-0095
- LAST REVIEWED: 08 May 2015
- LAST MODIFIED: 26 February 2013
- DOI: 10.1093/obo/9780199828340-0095
Major Depressive Disorder (MDD) is a highly debilitating, chronic, recurrent, and prevalent disorder. This article provides an overview and references covering several key aspects of the disorder. We include discussion of epidemiology, diagnosis and assessment, developmental course and risk factors, treatment, and important associated features (behavioral, interpersonal, biological, neurological, cognitive, emotional, and suicidal behavior) of the disorder. In order to focus the scope of this article, we have chosen to focus primarily on MDD, as it is the most prevalent and well studied of the mood disorders. While depression symptoms occur along a continuum with subclinical levels occurring in the general population, and there are important correlates associated with subclinical levels of depression, we will focus on the clinical levels of depression associated with MDD for the purposes of this article.
MDD affects as many as 10–25 percent of women and 9–12 percent of men at some point in their lifetime (Murray and Lopez 1997). As Kessler and Wang 2009 reviews, the presence of subthreshold depression symptoms is estimated to be even higher, with community surveys estimating 20 percent of adults and 50 percent of children and adolescents reporting some level of recent depression symptoms. Depression is almost twice as common in women as in men, with Kessler, et al. 2003 finding a prevalence rate of 21.3 percent for women and 12.7 percent for men in the National Comorbidity Survey. In a cross-national epidemiologic survey, Weissman, et al. 1996 demonstrates that lifetime rates of MDD vary widely across countries, which may result from a variety of factors. A review of theories that might explain gender differences in depression is provided in Nolen-Hoeksema 2001. As reviewed in Boland and Keller 2009, depression is a highly chronic and recurrent disorder, with untreated episodes lasting approximately six to eight months. Approximately 75 percent of individuals diagnosed with depression have multiple episodes, with rates of recurrence tending to increase with subsequent episodes. The Diagnostic and Statistical Manual of Mental Disorders (DSM), currently in the 4th edition (American Psychiatric Association 2000), is considered the gold standard by which major depression and related mood disorders are defined and diagnosed by mental health professionals and also reviews many of the epidemiological aspects and associated features of the disorders.
American Psychiatric Association. 2000. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) provides an overview of epidemiological statistics and features associated with depression, as well as diagnostic criteria. It is considered the gold standard by which mental health disorders are diagnosed in the United States.
Boland, R. J., and M. B. Keller. 2009. Course and outcome of depression. In Handbook of depression. Edited by I. H. Gotlib and C. L. Hammen, 23–43. 2d ed. New York: Guilford.
This chapter provides an overview of data on the course and outcome of depression, including relapse and remission rates, definitions of relapse and recovery, and factors related to the course of the disorder.
Kessler, R. C., and P. S. Wang. 2009. Epidemiology of depression. In Handbook of depression. Edited by I. H. Gotlib and C. L. Hammen, 5–22. 2d ed. New York: Guilford.
This chapter provides an overview of the epidemiology of depression, including prevalence rates, clinical severity, subtypes, comorbidity, and adverse outcomes of depression.
Kessler, R. C, P. Berglund, O. Demler, et al. 2003. The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association 289:3095–3105.
Kessler and colleagues provide a review of epidemiological data from a large national sample on major depressive disorder and associated factors, including gender differences.
Murray, C. J., and A. D. Lopez. 1997. Global mortality, disability and the contribution of risk factors: Global burden of disease study. Lancet 349:1436–1442.
This article describes the Global Burden of Disease Study, which provides a standardized review of global mortality, disability, and risk factors for 107 disorders. Among psychiatric disorders, burden and disability related to depression are reviewed.
Nolen-Hoeksema, S. 2001. Gender differences in depression. Current Directions in Psychological Science 10:173–176.
This review article provides an overview of gender differences in depression, including epidemiological data and explanations for gender differences in prevalence.
Weissman, M. M., R. C. Bland, G. J. Canino, et al. 1996. Cross-national epidemiology of major depression and bipolar disorder. Journal of the American Medical Association 276:293–299.
Weissman and colleagues provide cross-national epidemiologic data on major depression as well as bipolar disorder, providing detailed statistics on prevalence, onset, comorbidity, gender, age, and other demographic features.
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