Core symptoms of major depressive disorder: relevance to diagnosis and treatment

Summary & key facts

Major depressive disorder (MDD) is defined without assuming a single cause and has two main symptoms: depressed mood and loss of interest or pleasure. The paper says we should also pay more attention to fatigue, sleep problems, anxiety, thinking (cognitive) problems, and sexual problems when diagnosing and judging treatment. Some standard rating scales pick up symptoms such as mood, guilt, work, interest, and psychic anxiety, and these tend to change with current treatments. But many antidepressant treatments work on a narrow set of symptoms and may leave other symptoms unchanged or worse. Symptoms can improve at different speeds—for example, mood may get better sooner than sleep problems.

Key facts:

• MDD does not assume one single cause across different groups of people with different symptom patterns.
• The two core features of a major depressive episode are "depressed mood" and "loss of interest or pleasure in nearly all activities."
• The authors recommend more attention to fatigue, sleep disturbance, anxiety, neurocognitive (thinking) problems, and sexual dysfunction in diagnosis and treatment evaluation.
• On validated Hamilton Depression Rating Scale subscales, mood, guilt, work, interest, and psychic anxiety are consistently found and are sensitive to change with existing treatments.
• A major limitation of many current antidepressant therapies is a narrow spectrum of action; associated symptoms are often unaffected or can be worsened by these treatments.
• Improvement in symptoms can happen at different rates: mood symptoms may improve earlier than others such as sleep disturbance.

Abstract

The construct of major depressive disorder makes no etiological assumptions about populations with diverse symptom clusters. “Depressed mood” and “loss of interest or pleasure in nearly all activities” are core features of a major depressive ...

Topics

Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Mental Health Research Topics Treatment of Major Depression

Categories

Health Sciences Medicine Pharmacology

Tags

Anxiety Clinical psychology Cognition Depression (economics) Dysfunctional family Economics Insomnia Macroeconomics Major depressive disorder Mood Mood disorders Neurocognitive Psychiatry Psychology Sleep disorder