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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

Lam RW, Kennedy SH, Adams C, Bahji A, Beaulieu S, Bhat V, Blier P, Blumberger DM, Brietzke E, Chakrabarty T, Do A, Frey BN, Giacobbe P, Gratzer D, Grigoriadis S, Habert J, Ishrat Husain M, Ismail Z, McGirr A, McIntyre RS, Michalak EE, Müller DJ, Parikh SV, Quilty LS, Ravindran AV, Ravindran N, Renaud J, Rosenblat JD, Samaan Z, Saraf G, Schade K, Schaffer A, Sinyor M, Soares CN, Swainson J, Taylor VH, Tourjman SV, Uher R, van Ameringen M, Vazquez G, Vigod S, Voineskos D, Yatham LN, Milev RV
Can J Psychiatry 2024 Sep;69(9):641-687. Epub 2024 May 6 doi: 10.1177/07067437241245384. PMID: 38711351Free PMC Article
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
Tourjman SV, Buck G, Jutras-Aswad D, Khullar A, McInerney S, Saraf G, Pinto JV, Potvin S, Poulin MJ, Frey BN, Kennedy SH, Lam RW, MacQueen G, Milev R, Parikh SV, Ravindran A, McIntyre RS, Schaffer A, Taylor VH, van Ameringen M, Yatham LN, Beaulieu S
Can J Psychiatry 2023 May;68(5):299-311. Epub 2022 Jun 16 doi: 10.1177/07067437221099769. PMID: 35711159Free PMC Article
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
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

Bschor T, Nagel L, Unger J, Schwarzer G, Baethge C
JAMA Psychiatry 2024 Aug 1;81(8):757-768. doi: 10.1001/jamapsychiatry.2024.0994. PMID: 38809560Free PMC Article
Neuteboom D, Zantvoord JB, Goya-Maldonado R, Wilkening J, Dols A, van Exel E, Lok A, de Haan L, Scheepstra KWF
Psychiatry Res 2023 Sep;327:115429. Epub 2023 Aug 21 doi: 10.1016/j.psychres.2023.115429. PMID: 37625365
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

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
Ferrari AJ, Somerville AJ, Baxter AJ, Norman R, Patten SB, Vos T, Whiteford HA
Psychol Med 2013 Mar;43(3):471-81. Epub 2012 Jul 25 doi: 10.1017/S0033291712001511. PMID: 22831756
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

Koch C, Wilhelm M, Salzmann S, Rief W, Euteneuer F
Psychol Med 2019 Sep;49(12):1948-1957. Epub 2019 Jun 26 doi: 10.1017/S0033291719001351. PMID: 31239003
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
Leuchter AF, Cook IA, Hamilton SP, Narr KL, Toga A, Hunter AM, Faull K, Whitelegge J, Andrews AM, Loo J, Way B, Nelson SF, Horvath S, Lebowitz BD
Curr Psychiatry Rep 2010 Dec;12(6):553-62. doi: 10.1007/s11920-010-0160-4. PMID: 20963521Free PMC Article

Recent systematic reviews

Haikazian S, Chen-Li DCJ, Johnson DE, Fancy F, Levinta A, Husain MI, Mansur RB, McIntyre RS, Rosenblat JD
Psychiatry Res 2023 Nov;329:115531. Epub 2023 Oct 11 doi: 10.1016/j.psychres.2023.115531. PMID: 37844352
Alli SR, Gorbovskaya I, Liu JCW, Kolla NJ, Brown L, Müller DJ
Int J Mol Sci 2022 Apr 19;23(9) doi: 10.3390/ijms23094494. PMID: 35562885Free PMC Article
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
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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