http://www.psychnet-uk.com/dsm_iv/major_depression.htm
80 to 90% of individuals with Major Depressive Disorder also have anxiety symptoms (e.g., anxiety, obsessive preoccupations, panic attacks, phobias, and excessive health concerns).
Mortality: Up to 15% of patients with severe Major Depressive Disorder die by suicide. Over age 55, there is a fourfold increase in death rate.
Premorbid History: 10-25% of patients with Major Depressive Disorder have preexisting Dysthymic Disorder. These "double depressions" (i.e., Dysthymia + Major Depressive Disorder) have a poorer prognosis.
Gender: Males and females are equally affected by Major Depressive Disorder prior to puberty. After puberty, this disorder is twice as common in females as in males. The highest rates for this disorder are in the 25- to 44-year-old age group.
Prevalence: The lifetime risk for Major Depressive Disorder is 10% to 25% for women and from 5% to 12% for men. At any point in time, 5% to 9% of women and 2% to 3% of men suffer from this disorder. Prevalence is unrelated to ethnicity, education, income, or marital status.
Onset: Average age at onset is 25, but this disorder may begin at any age.
Psychological stress: Stress appears to play a prominent role in triggering the first 1-2 episodes of this disorder, but not in subsequent episodes.
Duration: An average episode lasts about 9 months.
Course: Course is variable. Some people have isolated episodes that are separated by many years, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older. About 20% of individuals with this disorder have a chronic course.
Recurrence: The risk of recurrence is about 70% at 5 year follow up and at least 80% at 8 year follow-up. After the first episode of Major Depressive Disorder, there is a 50%-60% chance of having a second episode, and a 5-10% chance of having a Manic Episode (i.e., developing Bipolar I Disorder). After the second episode, there is a 70% chance of having a third. After the third episode, there a 90% chance of having a fourth.
The greater number of previous episodes is an important risk factor for recurrence.
Poor Outcome: Poor outcome or chronicity in Major Depressive Disorder is associated with the following:
Inadequate treatment
Severe initial symptoms
Early age of onset
Greater number of previous episodes
Only partial recovery after one year
Having another severe mental disorder (e.g. Alcohol Dependency, Cocaine Dependency)
Severe chronic medical illness
Family dysfunction
Familial Pattern And Genetics: There is strong evidence that major depression is, in part, a genetic disorder:
Individuals who have parents or siblings with Major Depressive Disorder have a 1.5-3 times higher risk of developing this disorder.
Friday, May 2, 2008
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