Major Depression By Mr Daniel Hansson Major Depression Symptoms Prevalence Etiology Evaluation Conclusion Symptoms (DSM-IV-TR) Affective: Feelings of guilt and sadness, lack of enjoyment or pleasure in familiar activities or company Behavioural: Passivity, lack of initiative Cognitive: Frequent negative thoughts, faulty attribution of blame, low self esteem, suicidal thoughts, irrational hopelessness, difficulties in concentration and inability to make decisions Somatic: Loss of energy, insomnia, or hypersomnia, weight loss/gain, diminished sex drive Symptoms One or two major depressive episodes At least two weeks of depressed mood or loss of interest accompanied with at least four additional symptoms of depression Prevalence Life time prevalence for the disorder: Women – 10-25% Men – 5-12% The average age to have the first major depression: Mid 20s The onset age is decreasing One episode: 60 % of a second Two or three episodes: 70-90 % of a following episode One year after diagnosis: 40 % are free of symptoms, 20 % have some symptoms, 40 % meet full criteria of the disorder Prevalence More common in individualistic than collectivistic cultures Seattle, Washington: 6.3 % China: 4 % Verona, Italy: 4.7 % Groningen, Germany: 15.9 % Manchester, United Kingdom: 16.9 % Ankara, Turkey: 11.6 % Nagasaki, Japan: 2.6 % Etiology Biological Cognitive Sociocultural Biological Genetic and biochemical factors in depression E.g. Caspi (2003), Lykken & Tellegen (1996) Cognitive A depressed mood may lead to depressed thoughts Depressed cognitions, cognitive distortions, and irrational beliefs produce disturbances in mood E.g. Goldapple (2004), Lyon & Woods (1991) Sociocultural Social and cultural factors affect the prevalence and manifestation of the disorder E.g. Harris (1978), Cutrona, Wallace, & Wesner (2006) Evaluation +Can be used for therapy +Supporting research -Methodological problems with research -Simplistic: Each perspective emphasizes one factor Conclusion An interactionistic explanation of major depressive disorder is preferable, e.g. the diathesis-stress model or the biopsychosocial model