Types of depression

Depressive disorders exhibit different phenotypes with variations in the number of symptoms, their severity, and persistence according to DSM-IV6 and ICD-107 classifications.

6.03.1.1.1.1.1 Major depression disorder This manifests as a combination of symptoms (Table 1).

6.03.1.1.1.1.2 Dysthymia This is a less severe form of depression involving long-term, chronic symptoms that do not disable but keep individuals from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.

6.03.1.1.1.1.3 Bipolar affective disorder BPAD, also called manic-depressive illness, is not nearly as prevalent as other forms of depressive disorder. BPAD is characterized by cycling mood changes: severe highs (mania) and lows (depression). These mood switches can be dramatic and rapid, but more often they are gradual. In the depressed cycle, individuals can have any or all of the symptoms of a depressive disorder. In the manic cycle, they may be overactive, over

Table 1 Classification of depressive states

Classification used DSM-IV" (code)

lCD-10b (code)

in guideline

Major depression

Major depressive episode, single episode, or recurrent (296)

Depressive episode - severe (F32.2), moderate (F32.1), or mild with at least five symptomsc (F32.0)

Recurrent depressive disorder current episode severe (F33.2), moderate (F33.1), or mild with at least five symptomsc (F33.0)

Recurrent depressive disorder current episode severe (F33.2), moderate (F33.1), or mild with at least five symptomsc (F33.0)

Dysthymia

Dysthymia (300.4)

Dysthymia (F34.1)

Dysthymia

Dysthymia (300.4)

Dysthymia (F34.1)

Reprinted by permission of Sage Publications Ltd from Anderson, I. M.; Nutt, D. J.; Deakin, J. F. W. J. Psychopharmacol. 2000, 14, 3-20. Copyright (© British Association for Psychopharmacology, 2000). a Fourth Revision of the American Psychiatric Association's Diagnostic and Statistics Manual.6 bTenth Revision of the International Classification of Diseases.7

c For a list of symptoms, see the abridged DSM-IV criteria in Table 2. Must include at least two of (1) depressed mood, (2) loss of interest or pleasure, (3) decreased energy or increased fatigability.

talkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, an individual in a manic phase may feel elated and full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, can worsen to a psychotic state.

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