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The World Health Organisation has stated that depression is a leading cause of disability worldwide and a major contributor to the global burden of disease. [5] Stephen Ilardi has described depression as a "disease of civilisation", stating "We were never designed for the sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden, frenetic pace of modern life".
Psychotic major depression (PMD), or simply psychotic depression, is the term for a major depressive episode, in particular of melancholic nature, wherein the patient experiences psychotic symptoms such as delusions or, less commonly, hallucinations. These are most commonly mood-congruent (content coincident with depressive themes). [16]
The patient is rated by a clinician on 17 to 29 items (depending on version) scored either on a 3-point or 5-point Likert-type scale. For the 17-item version, a score of 0–7 is considered to be normal while a score of 20 or higher (indicating at least moderate severity) is usually required for entry into a clinical trial. [ 11 ]
Sequenced Treatment Alternatives to Relieve Depression (STAR*D) was a collaborative study on the treatment of depression, funded by the National Institute of Mental Health. Its main focus was on the treatment of depression in patients where the first prescribed antidepressant proved inadequate.
With more chronic forms of depression, the most effective treatment is often considered to be a combination of medication and psychotherapy. [6] [9] Psychotherapy is the treatment of choice in people under 18. [8] A meta-analysis examined the effectiveness of psychotherapy for depression across ages from younger than 13 years to older than 75 ...
The Beck Depression Inventory was originally designed by psychiatrist Aaron T. Beck in 1961. [11] The Geriatric Depression Scale (GDS) is another self-administered scale, but in this case it is used for older patients, and for patients with mild to moderate dementia. Instead of presenting a five-category response set, the GDS questions are ...
Several treatment guidelines recommend pharmaceutical treatments that include either the combination of a second-generation antidepressant and atypical antipsychotic or tricyclic antidepressant monotherapy or electroconvulsive therapy (ECT) as the first-line treatment for unipolar psychotic depression.