Symptoms are not due to the effects of psychoactive substances or organic disease. There is clinically significant distress or impaired functioning in important areas of life (e.g., work, school). Psychomotor changes (observed by others).Diminished concentration, cognition, and ability to make decisions ( pseudodementia ).Feelings of worthlessness or disproportionate guilt.
Sleep disturbance ( insomnia or hypersomnia ). Depressed mood for most of the day, almost every day (in children, can manifest with irritability). First-line treatment mainly consists of SSRIs (e.g., citalopram) and SNRIs (e.g., venlafaxine).ĭiagnostic criteria for major depressive disorder (according to DSM-5)įive or more of the nine symptoms listed below, for at least 2 weeks, with at least one of the symptoms being depressed mood or anhedonia Treatment is multifaceted and often requires pharmacotherapy, psychotherapy, and lifestyle changes. In elderly patients, MDD can also manifest with memory loss and other symptoms seen in dementia, referred to as pseudodementia. There are various subtypes of MDD characterized by additional symptoms or occurrence in specific conditions, such as atypical depression (additionally characterized by, e.g., weight gain and increased appetite), psychotic depression (with additional psychotic features such as hallucinations and delusions), and peripartum depression (which occurs during or shortly after pregnancy). Other symptoms of MDD include sleep disturbance, loss of appetite, and thoughts of suicide. Reduced levels of neurotransmitters ( serotonin, noradrenaline, dopamine) are believed to be the pathophysiological basis in most cases. 
The etiology is multifactorial, including both biological and psychological factors. The peak age of onset is the 3 rd decade. Women have a higher risk of developing MDD than men. Major depressive disorder (MDD) is an episodic mood disorder primarily characterized by depressed mood and anhedonia lasting for at least 2 weeks.
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