Depression worldwide and the leading cause of disability in

Depression (Major Depressive Disorder) is a
common and serious medical illness that negatively affects how you feel, the
way you think and how you act. Fortunately, it is also treatable. Depression
causes feelings of sadness and/or a loss of interest in activities once
enjoyed. It can lead to a variety of emotional and physical problems and can
decrease a person’s ability to function at work and at home. Depression
symptoms can vary from mild to severe and can include feeling sad or having a
depressed mood and of course many more symptoms to follow. What is depression? Retrieved from
Where gender is concerned, one of the greatest risk factors for depression is simply
being female. Other factors include heredity and age. Studies of families and
twins have shown a genetic component in major depression and bipolar disorders.  ( Sarason & Sarason, 2002).

Women are about
two times more likely to be diagnosed with depression than men (Greenberger et
al; 2000; Kessler, 2003). This gender difference starts emerging at about age
13. (Hankin & Abramson, 2001). Low levels of estrogen are widely seen as
the culprit. Depression Research 2000 says that in any given year, about 12% of
women and 7 % men in United States are estimated to be diagnosable with
depression. Symptoms must be present for at least two weeks to be diagnosed as

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is a potentially life-threatening mood disorder that affects 1 in 6 persons in
the United States, or nearly 17.6 million Americans each year. Depressed
patients are more likely to develop type 2 diabetes and cardiovascular disease. Not
counting the effect of secondary disease states, over the next 20 years,
unipolar depression is projected to be the second leading cause of disability
worldwide and the leading cause of disability in high-income nations, including
the United States.

associated with depression is difficult to
quantify, but the seriousness of depression takes the measurable form of
completed suicide, the tenth leading
reported cause of death in the United States. The present
economic cost of depressive illness is estimated to be $30-44 billion annually
in the United States alone. In addition to considerable pain and suffering that
interfere with individual functioning, depression affects those who care about
the ill person, sometimes destroying family relationships or work dynamics
between the patient and others. Therefore, the human cost in suffering cannot
be overestimated.

to two thirds of people with depression do not realize that they have a
treatable illness and do not seek treatment. Only 50% of persons diagnosed with
major depression receive any kind of treatment, and only 20% of those
individuals receive treatment consistent with current practice guidelines of
the American Psychiatric Association (APA). More alarming, in a
large Canadian study, 48% of patients who had suicidal ideation and 24% of
those who made a suicide attempt, reported not
receiving care or even perceiving the need for care. 

Depression and Suicide. Retrieved from

Author: Louise B Andrew, MD, JD; Chief Editor: Barry E
Brenner, MD, PhD, FACEP  



Depression is one of
the most common mental disorders worldwide. There are a number of depression
subtypes, and there has been much debate about how to most accurately capture
and organize the features and subtypes of major depression. Depression is one
of the most common mental disorders worldwide, with a current prevalence
estimated between 2.1% and 7.6%.1–4 A number of depressive subtypes have
been identified, and there has been much debate about how to most accurately
describe them. The current state of designating major depression with psychotic
features (psychotic major depression, PMD) under the severity dimension is less
than optimal leading to 2 pressing issues. Firstly, should PMD be classified as
a separate subtype of major depression? Secondly, what should or could be done
to improve the current severity dimension classification?

The prevalence of
psychotic depression suggests that it is worth examining a reclassification. In
a recent study5,6 reported that in the general population in 5 European
countries, 2.4% of those surveyed met criteria for unipolar major depression,
of whom, nearly 19% also had psychotic features. Thus, this study reported a
prevalence of 0.4% of major depression with psychotic features. The percentage
of major depressives with psychotic features is consistent with estimates of
15% of major depressives reporting a lifetime history of psychosis in the
United States.7