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Major depressive disorder(MDD)

MedGen UID:
266123
Concept ID:
C1269683
Mental or Behavioral Dysfunction
Synonyms: MDD; UNIPOLAR DEPRESSION
SNOMED CT: Major depressive disorder (370143000); Major depression (370143000)
 
Genes (locations): FKBP5 (6p21.31); HTR2A (13q14.2); TPH2 (12q21.1)
 
Monarch Initiative: MONDO:0002009
OMIM®: 608516

Definition

Depression (also known as major depression or major depressive disorder) is a psychiatric disorder that affects mood, behavior, and overall health. It causes prolonged feelings of sadness, emptiness, or hopelessness, and a loss of interest in activities that were once enjoyed. People with depression may also have changes in appetite (leading to overeating or not eating enough), changes in sleeping patterns (sleeping too much or not being able to sleep), loss of energy, and difficulty concentrating. Although depression is considered primarily a mental health disorder, it can also have physical features including headaches, other unexplained aches and pains, unusually slow or fast movements, and digestive problems. To be diagnosed with depression, an individual must have signs and symptoms nearly every day for at least 2 weeks. However, the features of this condition vary widely.

Depression most commonly begins in late adolescence or early adulthood, although it can appear at any age. If untreated, episodes of depression can last for weeks, months, or years, and can go away and come back (recur). Affected individuals may have difficulty functioning in their daily lives, including at school or work. People with depression have a higher risk of substance abuse problems and dying by suicide than the general population.

Several health conditions are closely related to depression or have depression as a characteristic feature. These include dysthymia (which has long-lasting signs and symptoms that are similar to, but not as severe as, those of depression), perinatal or postpartum depression (which occurs around or following the birth of a child), seasonal affective disorder (which is triggered by the changing of the seasons), bipolar disorder (which can include both "highs," or manic episodes, and depressive episodes), and generalized anxiety disorder. In people with schizoaffective disorder, depression or another mood disorder occurs together with features of schizophrenia (a brain disorder that affects a person's thinking, sense of self, and perceptions). [from MedlinePlus Genetics]

Clinical features

From HPO
Depression
MedGen UID:
4229
Concept ID:
C0011581
Mental or Behavioral Dysfunction
Frequently experiencing feelings of being down, miserable, and/or hopeless; struggling to recover from these moods; having a pessimistic outlook on the future; feeling a pervasive sense of shame; having a low self-worth; experiencing thoughts of suicide and engaging in suicidal behavior.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVMajor depressive disorder

Professional guidelines

PubMed

Kverno KS, Mangano E
J Psychosoc Nurs Ment Health Serv 2021 Sep;59(9):7-11. Epub 2021 Sep 1 doi: 10.3928/02793695-20210816-01. PMID: 34459676
Trivedi MH
J Clin Psychiatry 2020 Mar 17;81(2) doi: 10.4088/JCP.UT17042BR1C. PMID: 32220155
Cuijpers P, Quero S, Dowrick C, Arroll B
Curr Psychiatry Rep 2019 Nov 23;21(12):129. doi: 10.1007/s11920-019-1117-x. PMID: 31760505Free PMC Article

Curated

UK NICE Guideline NG222, Depression in adults: treatment and management, 2022

Recent clinical studies

Etiology

Clayton AH, Lasser R, Parikh SV, Iosifescu DV, Jung J, Kotecha M, Forrestal F, Jonas J, Kanes SJ, Doherty J
Am J Psychiatry 2023 Sep 1;180(9):676-684. Epub 2023 May 3 doi: 10.1176/appi.ajp.20220459. PMID: 37132201
Abdoli N, Salari N, Darvishi N, Jafarpour S, Solaymani M, Mohammadi M, Shohaimi S
Neurosci Biobehav Rev 2022 Jan;132:1067-1073. Epub 2021 Nov 4 doi: 10.1016/j.neubiorev.2021.10.041. PMID: 34742925
Berger T, Lee H, Young AH, Aarsland D, Thuret S
Trends Mol Med 2020 Sep;26(9):803-818. Epub 2020 May 14 doi: 10.1016/j.molmed.2020.03.010. PMID: 32418723
Uchida S, Yamagata H, Seki T, Watanabe Y
Psychiatry Clin Neurosci 2018 Apr;72(4):212-227. Epub 2017 Dec 26 doi: 10.1111/pcn.12621. PMID: 29154458
Hirschfeld RM
J Affect Disord 2014 Dec;169 Suppl 1:S12-6. doi: 10.1016/S0165-0327(14)70004-7. PMID: 25533909

Diagnosis

Rao S, Broadbear J
Australas Psychiatry 2019 Dec;27(6):573-577. Epub 2019 Oct 1 doi: 10.1177/1039856219878643. PMID: 31573324
Pan Z, Park C, Brietzke E, Zuckerman H, Rong C, Mansur RB, Fus D, Subramaniapillai M, Lee Y, McIntyre RS
CNS Spectr 2019 Feb;24(1):22-29. Epub 2018 Nov 23 doi: 10.1017/S1092852918001207. PMID: 30468135
Murphy MJ, Peterson MJ
Sleep Med Clin 2015 Mar;10(1):17-23. Epub 2014 Dec 12 doi: 10.1016/j.jsmc.2014.11.009. PMID: 26055669Free PMC Article
Hirschfeld RM
J Affect Disord 2014 Dec;169 Suppl 1:S12-6. doi: 10.1016/S0165-0327(14)70004-7. PMID: 25533909
Uher R, Payne JL, Pavlova B, Perlis RH
Depress Anxiety 2014 Jun;31(6):459-71. Epub 2013 Nov 22 doi: 10.1002/da.22217. PMID: 24272961

Therapy

Borges-Vieira JG, Cardoso CKS
Nutr Neurosci 2023 Mar;26(3):187-207. Epub 2022 Feb 14 doi: 10.1080/1028415X.2022.2031494. PMID: 35156551
Do A, Li VW, Huang S, Michalak EE, Tam EM, Chakrabarty T, Yatham LN, Lam RW
Can J Psychiatry 2022 Oct;67(10):745-754. Epub 2022 May 6 doi: 10.1177/07067437221097903. PMID: 35522196Free PMC Article
Kaur Gill A, Bansal Y, Bhandari R, Kaur S, Kaur J, Singh R, Kuhad A, Kuhad A
Drugs Today (Barc) 2019 Jul;55(7):423-437. doi: 10.1358/dot.2019.55.7.2958474. PMID: 31347611
Kraus C, Kadriu B, Lanzenberger R, Zarate CA Jr, Kasper S
Transl Psychiatry 2019 Apr 3;9(1):127. doi: 10.1038/s41398-019-0460-3. PMID: 30944309Free PMC Article
Penders TM, Stanciu CN, Schoemann AM, Ninan PT, Bloch R, Saeed SA
Prim Care Companion CNS Disord 2016 Oct 20;18(5) doi: 10.4088/PCC.15r01906. PMID: 27835725

Prognosis

Ebert DD, Buntrock C, Mortier P, Auerbach R, Weisel KK, Kessler RC, Cuijpers P, Green JG, Kiekens G, Nock MK, Demyttenaere K, Bruffaerts R
Depress Anxiety 2019 Apr;36(4):294-304. Epub 2018 Dec 6 doi: 10.1002/da.22867. PMID: 30521136Free PMC Article
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators
Lancet 2017 Sep 16;390(10100):1211-1259. doi: 10.1016/S0140-6736(17)32154-2. PMID: 28919117Free PMC Article
Hirst KP, Moutier CY
Am Fam Physician 2010 Oct 15;82(8):926-33. PMID: 20949886
Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T
Obstet Gynecol 2005 Nov;106(5 Pt 1):1071-83. doi: 10.1097/01.AOG.0000183597.31630.db. PMID: 16260528
Babyak M, Blumenthal JA, Herman S, Khatri P, Doraiswamy M, Moore K, Craighead WE, Baldewicz TT, Krishnan KR
Psychosom Med 2000 Sep-Oct;62(5):633-8. doi: 10.1097/00006842-200009000-00006. PMID: 11020092

Clinical prediction guides

Pinna M, Manchia M, Oppo R, Scano F, Pillai G, Loche AP, Salis P, Minnai GP
Neurosci Lett 2018 Mar 16;669:32-42. Epub 2016 Oct 25 doi: 10.1016/j.neulet.2016.10.047. PMID: 27793702
Luking KR, Pagliaccio D, Luby JL, Barch DM
Trends Cogn Sci 2016 Jun;20(6):456-468. Epub 2016 Apr 27 doi: 10.1016/j.tics.2016.04.002. PMID: 27131776Free PMC Article
Elderon L, Whooley MA
Prog Cardiovasc Dis 2013 May-Jun;55(6):511-23. Epub 2013 Apr 11 doi: 10.1016/j.pcad.2013.03.010. PMID: 23621961
Vöhringer PA, Ghaemi SN
Clin Ther 2011 Dec;33(12):B49-61. Epub 2011 Dec 2 doi: 10.1016/j.clinthera.2011.11.019. PMID: 22136980Free PMC Article
Papakostas GI, Fava M
Dialogues Clin Neurosci 2008;10(4):439-51. doi: 10.31887/DCNS.2008.10.4/gipapakostas. PMID: 19170401Free PMC Article

Recent systematic reviews

COVID-19 Mental Disorders Collaborators
Lancet 2021 Nov 6;398(10312):1700-1712. Epub 2021 Oct 8 doi: 10.1016/S0140-6736(21)02143-7. PMID: 34634250Free PMC Article
Nikolova VL, Smith MRB, Hall LJ, Cleare AJ, Stone JM, Young AH
JAMA Psychiatry 2021 Dec 1;78(12):1343-1354. doi: 10.1001/jamapsychiatry.2021.2573. PMID: 34524405Free PMC Article
Oliva V, Lippi M, Paci R, Del Fabro L, Delvecchio G, Brambilla P, De Ronchi D, Fanelli G, Serretti A
Prog Neuropsychopharmacol Biol Psychiatry 2021 Jul 13;109:110266. Epub 2021 Feb 5 doi: 10.1016/j.pnpbp.2021.110266. PMID: 33549697
Sanada K, Nakajima S, Kurokawa S, Barceló-Soler A, Ikuse D, Hirata A, Yoshizawa A, Tomizawa Y, Salas-Valero M, Noda Y, Mimura M, Iwanami A, Kishimoto T
J Affect Disord 2020 Apr 1;266:1-13. Epub 2020 Jan 23 doi: 10.1016/j.jad.2020.01.102. PMID: 32056863
Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, Leucht S, Ruhe HG, Turner EH, Higgins JPT, Egger M, Takeshima N, Hayasaka Y, Imai H, Shinohara K, Tajika A, Ioannidis JPA, Geddes JR
Lancet 2018 Apr 7;391(10128):1357-1366. Epub 2018 Feb 21 doi: 10.1016/S0140-6736(17)32802-7. PMID: 29477251Free PMC Article

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    • NICE, 2022
      UK NICE Guideline NG222, Depression in adults: treatment and management, 2022

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