Major Depressive Episode: A Systematic Review
Depression is an enduring and often debilitating mental health disorder that is characterized by low mood, loss of interest or pleasure in activities, decreased energy, sleep disturbances, and feelings of worthlessness and guilt (American Psychiatric Association, 2013). Major depressive episode (MDE) is the most severe form of depression, and it can be difficult to diagnose and treat. This systematic review aims to summarize the current research and evidence on MDE diagnosis and treatment.
The prevalence of MDE is estimated to be 3.3% in the United States (Kessler et al., 2003). Of those who experience an MDE, about half will experience a recurrent episode (Kessler et al., 2003). Diagnosis of MDE requires that five or more depressive symptoms are present for at least two weeks, and at least one of the symptoms is either depressed mood or loss of pleasure in activities (American Psychiatric Association, 2013). The most commonly used diagnostic tool for MDE is the Structured Clinical Interview for DSM-IV (SCID-IV). The SCID-IV is a semi-structured interview that assesses symptoms and criteria for MDE (First et al., 1996).
The most common treatment for MDE is antidepressant medication and psychotherapy. Antidepressants have been found to be effective in managing depressive symptoms (Keller et al., 2002). Commonly prescribed antidepressants include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Psychotherapy has also been found to be effective in managing symptoms of MDE, and types of psychotherapy used include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and psychodynamic therapy (Mischoulon & Amsterdam, 2002).
In summary, MDE is a severe form of depression that is difficult to diagnose and treat. Diagnosis is made using the SCID-IV and requires that five or more depressive symptoms are present for at least two weeks. The primary treatments for MDE are antidepressant medications and psychotherapy.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Association.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Washington, DC: American Psychiatric Press.
Keller, M. B., McCullough, J. P., Klein, D. N., Arnow, B., Dunner, D. L., Gelenberg, A. J., … & Markowitz, J. C. (2002). A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression. New England Journal of Medicine, 346(8), 594-602.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2003). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 60(5), 593-602.
Mischoulon, D., & Amsterdam, J. D. (2002). Psychotherapy for depression. In G. T. O’Connor & J. E. Fisher (Eds.), A Guide to Treatments that Work (2nd ed., pp. 217-242). New York, NY: Oxford University Press.