Major depressive disorder

Phonetic exercise: major [‘meid3ə ], depression [di’pre∫ n], disorder [dis‘ : də,        diz‘ : də ], recurrent [ri‘kΛ rə nt, ri‘kə: rə nt], experiences [ik’spiə riə nsiz], abuse          [(n) ə ’bju: s, (v) ə ’bju: z], isolation [, aisə ’lei∫ n], withdrawal [wið ’dr : ə l], behavior [bi‘heivjə ], behavioral [bi‘heivjə rə l], abnormalities [, æ bn : ‘mæ lə tiz], psychotherapy [, saikə u‘θ erə pi], cognitive [‘k gnə tiv], encompassing [in’kΛ mpə siŋ ], accompanied [ə ‘kΛ mpə nid], pleasure, [‘ple3ə ], events [i’vents], adverse [‘æ dvə: s, æ d‘və: s ], spouse [spaus], syndrome [‘sindrə um], estrogen [‘i: strə d3ə n], current [‘kΛ rə nt, ‘kə: rə nt], circumstances [‘sə: kə mstə nsiz, ‘sə: kə mstæ nsiz], exposure [iks‘pə u3ə ], hyperthyroidism [, haipə ‘θ air idizm], electrolytes [i’lektrə lait], unconscious [Λ n’k n∫ ə s]

Make a report on major depressive disorder according to the plan below:

Definition: recurrent depressive disorder, clinical depression, major depression, unipolar depression, or unipolar disorder); a mental disorder characterized by low mood accompanied by low self-esteem and by loss of interest or pleasure in normally enjoyable activities.

Causes: stressful life events, adverse events, negative thoughts composed of cognitive errors, early maternal loss, lack of a confiding relationship, responsibility for the care of several young children at home, unemployment, changes in relationships with a spouse or adult children, inability to realize full potentials, poverty and social isolation, depression, severe marital conflict or divorce, death of a parent, or other disturbances in parenting, social rejection, absence of social support, neighborhood social disorders, adverse conditions at work, particularly demanding jobs with little scope for decision-making, alcoholism or excessive alcohol consumption, withdrawal syndrome; low serotonin levels, abnormalities in the biological clock, low levels of estrogen, etc.

Epidemiology (prevalence): Depression is a major cause of morbidity worldwide. Lifetime prevalence varies widely, from 3% in Japan to 17% in the US.

Evaluation: History: a personal medical history, a medication history, a history of current circumstances, a biographical history, a family history, a family history of depression, a history of biological and psychological factors, a history of exposure to toxins, a social history, an occupational history, an environmental history, a neurological status history, a psychiatric history, a history of declining cognitive function, a history of self-reported experiences of the person, a history of abnormalities in behavior reported by family members, friends or co-workers, a history of alcohol consumption, etc.

Physical examination: observation, percussion, palpation and auscultation.

Instrumental investigations: a selected investigations to rule out other causes of symptoms: blood tests measuring TSH and thyroxine to exclude hypothyroidism; basic electrolytes and serum calcium to rule out a metabolic disturbance; and a full blood count including ESR to rule out a systemic infection or chronic disease; a CT scan to exclude brain pathology in those with psychotic, rapid-onset or otherwise unusual symptoms; cognitive testing and brain imaging can help distinguish depression from dementia. .

Management: psychotherapy, medications, and electroconvulsive therapy; physical exercises, etc.

Psychotherapy: cognitive behavioral therapy (CBT) that teaches clients to challenge self-defeating; interpersonal therapy, or family therapy; psychoanalysis, which emphasizes the resolution of unconscious mental conflicts; logotherapy, etc.

Medication therapy: antidepressants; selective serotonin reuptake inhibitors (SSRIs), etc.

Electroconvulsive therapy (ECT): for cases of severe major depression which have not responded to antidepressant medication or, less often, psychotherapy or supportive interventions.

Deep brain stimulation: a neurosurgical treatment that has been used especially to treat movement disorders such as Parkinson's disease. It requires a neurosurgeon to drill a hole in the skull and insert an electrode into the patient's tissue. Then, a device located in the chest transmits a signal to the implanted electrode through wires located underneath the scalp.

Physical exercise: gardening, washing a car or taking the stairs instead of the elevator, etc.

Prevention: behavioral interventions, such as interpersonal therapy; the " Coping with Depression" course (CWD), psychoeducational interventions, etc.