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Signs and Symptoms of Major Depressive Disorder

DSM-IV-TR defines a major depressive disorder as the presence of at least five of the following Signs and Symptoms for at least two weeks:

depressed mood

markedly diminished interest or pleasure in almost all activities

significant weight loss or gain, or increase in or loss of appetite

physical agitation

fatigue or loss of energy

feelings of worthlessness or excessive guilt

reduced ability to think, concentrate or indecisiveness

signifi cant distress or impairment.

People who are depressed are characterized by emotional, motivational, physiological and cognitive problems. They feel low and gain no pleasure from their usual activities. They are frequently unmotivated to take voluntary action, often spending considerable time in bed or withdrawing quietly from the company of others. They may be markedly slow in their activities or speech. They generally hold negative views about themselves and marked pessimism about the present and future. They may feel out of control and unable to change their situation. Some, but by no means all, will experience suicidal thoughts or actions.

Depressed people often report confused or slow thoughts, and difficulties in retaining information or solving problems. About 5 per cent of the European population will be clinically depressed at any one time. Women are twice as likely as men to report depression: lifetime prevalence rates for women are 26 per cent compared with 12 per cent for men (Keller et al. 1984). About a quarter of depressive episodes last less than one month. Between 25 and 30 per cent of people remain depressed one year after onset, while nearly a quarter are depressed for up to two years. The typical age of onset of a fi rst episode of depression is between the ages of 24 and 29. Treatment of depressive disorders utilizes signifi cant health resources, accounting for 16 per cent of primary care consultations in one Canadian state.

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