Depression
Basics
Description
A primary mood disorder characterized by a sustained feeling of sadness and/or decreased interest in all or most activities once enjoyed (anhedonia), which represents a change from previous functioning
Epidemiology
Incidence
- In the United States, 8.1% of adults age ≥20 years experienced depression in a given 2-week period between 2013 and 2016.
- 19.2% lifetime risk of having major depressive disorder (MDD)
Prevalence
- Non-Hispanic Asian adults had the lowest prevalence of depression (3.1%) compared with Hispanic (8.2%), non-Hispanic white (7.9%), and non-Hispanic black (9.2%) adults. This pattern was observed among both men and women.
- Among all race and Hispanic-origin groups (except non-Hispanic Asian), men had a significantly lower prevalence of depression compared with women.
- Prevalence decreases with increasing levels of family income for both men and women.
- Predominant age: low risk before early teens but highest prevalence in teens and young adults
Etiology and Pathophysiology
There are diverse theories regarding the pathophysiology; none proven
Genetics
Multiple gene loci place a person at increased risk when faced with environmental stressor; twin studies suggest 37% concordance.
Risk Factors
- Female > male (2:1)
- Severity of first episode
- Persistent sleep disturbances
- Presence of chronic disease(s), recent myocardial infarction (MI), cardiovascular accident (CVA)
- Strong family history (depression, bipolar, suicide, substance abuse), spouse with depression
- Childhood trauma/maltreatment
- Substance abuse and dependence, domestic abuse/violence
- Losses, stressors, unemployment
- Single, divorced, or unhappily married
Commonly Associated Conditions
- Bipolar disorder, cyclothymic disorder, grief reaction, anxiety disorders, somatoform disorders, schizophrenia/schizoaffective disorders
- Medical comorbidity
- Substance abuse
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Citation
Domino, Frank J., et al., editors. "Depression." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688564/all/Depression.
Depression. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688564/all/Depression. Accessed June 9, 2023.
Depression. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688564/all/Depression
Depression [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 June 09]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688564/all/Depression.
* Article titles in AMA citation format should be in sentence-case
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