Depression and dysthymia are mood disorders

Major depression and dysthymia are psychiatric disorders, classified as affective or mood disorders. Criteria for a depressive episode are depressed mood, loss of interest and enjoyment, and reduced energy leading to increased fatigability and diminished activity. Other symptoms include reduced concentration and pessimistic views of the future. The symptoms need to be present for at least two weeks. Dysthymia is a less severe but persistent form of depression, which lasts at least two years. 75-90% of people who have experienced an episode of depression will experience at least one more episode in their life. Depression often occurs together with other mental disorders, especially with dysthymia, anxiety and alcohol disorders.

Over 18 million Europeans suffer from depression

It is estimated that in one year 18.4 million Europeans aged from 18 to 65 suffer from depression. 12 month prevalence rates range between 3.1 % and 10.1 %

Premature mortality

Depression and dysthymia are associated with an increased premature mortality. More than 90% of suicides are committed in the context of mental disorders, predominately affective and substance abuse disorders. Countries with the highest suicide rates are found in Eastern Europe. In addition, increased premature mortality in depression and dysthymia is caused by a higher rate of accidents and death due to cardiovascular and other somatic diseases.

Depression third leading contributor to European burden of disease

Due to its severity and high prevalence, depression is the third leading contributor to the total burden of disease in Europe. In addition, depression has major economic consequences, with it increasingly contributing to sickness absence from the workplace. 85% of the economic costs caused by depression or other common mental disorders consist of production loss due to sickness absence. People with depression commonly report poor functioning at work as well as relationship difficulties during periods when they are depressed.

Depression caused by both psychosocial and biological factors

Up to now the exact mechanisms causing depression are not identified. What is known is that both psychosocial and the biological factors are contributing to the pathogenesis of depression: at the psychosocial level susceptibility to depression can be increased by e.g. deprivation or traumatisation in early life, and depressive episodes can be triggered e.g. by stress or loss of close relatives. At the biological level susceptibility to depression depends on genetic factors. Women have the double risk of men to become depressed. The reasons for these gender differences in prevalence rates are not completely understood.

Prevention can be effective in reducing underdiagnosis and undertreatment of depression

Depression and dysthymia are generally treated in outpatient settings, usually by a primary care physician. Antidepressants and cognitive psychotherapy are the most common and evidence based treatments. People with mood disorders often do not seek help, not diagnosed as such by their general practitioner and not receive or accept the right treatment. Community-based multilevel intervention programmes have been found to be effective to improve the care of depressed patients.