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Unipolar Depression

MedGen UID:
22552
•Concept ID:
C0041696
•
Mental or Behavioral Dysfunction
Synonyms: Depression, Unipolar; Depressions, Unipolar; Unipolar Depressions
 
OMIM®: 608516

Definition

A mood disorder having a clinical course involving one or more episodes of serious psychological depression that last two or more weeks each, do not have intervening episodes of mania or hypomania, and are characterized by a loss of interest or pleasure in almost all activities and by some or all of disturbances of appetite, sleep, or psychomotor functioning, a decrease in energy, difficulties in thinking or making decisions, loss of self-esteem or feelings of guilt, and suicidal thoughts or attempts. [from NCI]

Professional guidelines

PubMed

Augmentation strategies for treatment resistant major depression: A systematic review and network meta-analysis.
Nuñez NA, Joseph B, Pahwa M, Kumar R, Resendez MG, Prokop LJ, Veldic M, Seshadri A, Biernacka JM, Frye MA, Wang Z, Singh B
J Affect Disord 2022 Apr 1;302:385-400. Epub 2022 Jan 2 doi: 10.1016/j.jad.2021.12.134. PMID: 34986373Free PMC Article
Psychotic Depression: Diagnosis, Differential Diagnosis, and Treatment.
Dubovsky SL, Ghosh BM, Serotte JC, Cranwell V
Psychother Psychosom 2021;90(3):160-177. Epub 2020 Nov 9 doi: 10.1159/000511348. PMID: 33166960
Exercise as a treatment for depression: A meta-analysis.
Kvam S, Kleppe CL, Nordhus IH, Hovland A
J Affect Disord 2016 Sep 15;202:67-86. Epub 2016 May 20 doi: 10.1016/j.jad.2016.03.063. PMID: 27253219

Recent clinical studies

Etiology

Cannabis Use Disorder and Subsequent Risk of Psychotic and Nonpsychotic Unipolar Depression and Bipolar Disorder.
Jefsen OH, Erlangsen A, Nordentoft M, Hjorthøj C
JAMA Psychiatry 2023 Aug 1;80(8):803-810. doi: 10.1001/jamapsychiatry.2023.1256. PMID: 37223912Free PMC Article
Distinguishing between depression in bipolar disorder and unipolar depression using magnetic resonance imaging: a systematic review.
Siegel-Ramsay JE, Bertocci MA, Wu B, Phillips ML, Strakowski SM, Almeida JRC
Bipolar Disord 2022 Aug;24(5):474-498. Epub 2022 Jan 30 doi: 10.1111/bdi.13176. PMID: 35060259
Bipolar depression: the clinical characteristics and unmet needs of a complex disorder.
McIntyre RS, Calabrese JR
Curr Med Res Opin 2019 Nov;35(11):1993-2005. Epub 2019 Aug 5 doi: 10.1080/03007995.2019.1636017. PMID: 31311335
Differential diagnosis of bipolar disorder and major depressive disorder.
Hirschfeld RM
J Affect Disord 2014 Dec;169 Suppl 1:S12-6. doi: 10.1016/S0165-0327(14)70004-7. PMID: 25533909
Bipolar disorder diagnosis: challenges and future directions.
Phillips ML, Kupfer DJ
Lancet 2013 May 11;381(9878):1663-71. doi: 10.1016/S0140-6736(13)60989-7. PMID: 23663952Free PMC Article

Diagnosis

Cannabis Use Disorder and Subsequent Risk of Psychotic and Nonpsychotic Unipolar Depression and Bipolar Disorder.
Jefsen OH, Erlangsen A, Nordentoft M, Hjorthøj C
JAMA Psychiatry 2023 Aug 1;80(8):803-810. doi: 10.1001/jamapsychiatry.2023.1256. PMID: 37223912Free PMC Article
Distinguishing between depression in bipolar disorder and unipolar depression using magnetic resonance imaging: a systematic review.
Siegel-Ramsay JE, Bertocci MA, Wu B, Phillips ML, Strakowski SM, Almeida JRC
Bipolar Disord 2022 Aug;24(5):474-498. Epub 2022 Jan 30 doi: 10.1111/bdi.13176. PMID: 35060259
Differentiating between bipolar and unipolar depression in functional and structural MRI studies.
Han KM, De Berardis D, Fornaro M, Kim YK
Prog Neuropsychopharmacol Biol Psychiatry 2019 Apr 20;91:20-27. Epub 2018 Mar 28 doi: 10.1016/j.pnpbp.2018.03.022. PMID: 29601896
Differential diagnosis of bipolar disorder and major depressive disorder.
Hirschfeld RM
J Affect Disord 2014 Dec;169 Suppl 1:S12-6. doi: 10.1016/S0165-0327(14)70004-7. PMID: 25533909
Bipolar disorder diagnosis: challenges and future directions.
Phillips ML, Kupfer DJ
Lancet 2013 May 11;381(9878):1663-71. doi: 10.1016/S0140-6736(13)60989-7. PMID: 23663952Free PMC Article

Therapy

Racemic Ketamine as an Alternative to Electroconvulsive Therapy for Unipolar Depression: A Randomized, Open-Label, Non-Inferiority Trial (KetECT).
Ekstrand J, Fattah C, Persson M, Cheng T, Nordanskog P, Åkeson J, Tingström A, Lindström MB, Nordenskjöld A, Movahed Rad P
Int J Neuropsychopharmacol 2022 May 27;25(5):339-349. doi: 10.1093/ijnp/pyab088. PMID: 35020871Free PMC Article
Augmentation strategies for treatment resistant major depression: A systematic review and network meta-analysis.
Nuñez NA, Joseph B, Pahwa M, Kumar R, Resendez MG, Prokop LJ, Veldic M, Seshadri A, Biernacka JM, Frye MA, Wang Z, Singh B
J Affect Disord 2022 Apr 1;302:385-400. Epub 2022 Jan 2 doi: 10.1016/j.jad.2021.12.134. PMID: 34986373Free PMC Article
Exercise as a treatment for depression: A meta-analysis.
Kvam S, Kleppe CL, Nordhus IH, Hovland A
J Affect Disord 2016 Sep 15;202:67-86. Epub 2016 May 20 doi: 10.1016/j.jad.2016.03.063. PMID: 27253219
Dose equivalents of antidepressants: Evidence-based recommendations from randomized controlled trials.
Hayasaka Y, Purgato M, Magni LR, Ogawa Y, Takeshima N, Cipriani A, Barbui C, Leucht S, Furukawa TA
J Affect Disord 2015 Jul 15;180:179-84. Epub 2015 Mar 31 doi: 10.1016/j.jad.2015.03.021. PMID: 25911132
Differential diagnosis of bipolar disorder and major depressive disorder.
Hirschfeld RM
J Affect Disord 2014 Dec;169 Suppl 1:S12-6. doi: 10.1016/S0165-0327(14)70004-7. PMID: 25533909

Prognosis

Efficacy and safety of psilocybin-assisted treatment for major depressive disorder: Prospective 12-month follow-up.
Gukasyan N, Davis AK, Barrett FS, Cosimano MP, Sepeda ND, Johnson MW, Griffiths RR
J Psychopharmacol 2022 Feb;36(2):151-158. doi: 10.1177/02698811211073759. PMID: 35166158Free PMC Article
Postpartum anhedonia: Emergent patterns in bipolar and unipolar depression.
Gollan JK, Yang A, Ciolino JD, Sit D, Wisner KL
Psychiatry Res 2021 Dec;306:114274. Epub 2021 Nov 9 doi: 10.1016/j.psychres.2021.114274. PMID: 34837882
Psychotic Depression: Diagnosis, Differential Diagnosis, and Treatment.
Dubovsky SL, Ghosh BM, Serotte JC, Cranwell V
Psychother Psychosom 2021;90(3):160-177. Epub 2020 Nov 9 doi: 10.1159/000511348. PMID: 33166960
The Relationship between Typus Melancholicus and Unipolar Depression: A Literature Review.
Oudart E, Hanak C, Ammendola S
Psychiatr Danub 2020 Sep;32(Suppl 1):188-193. PMID: 32890388
Mortality and life expectancy in persons with severe unipolar depression.
Laursen TM, Musliner KL, Benros ME, Vestergaard M, Munk-Olsen T
J Affect Disord 2016 Mar 15;193:203-7. Epub 2016 Jan 6 doi: 10.1016/j.jad.2015.12.067. PMID: 26773921

Clinical prediction guides

Well-Being Therapy for Depression.
Romanazzo S, Cosci F
Adv Exp Med Biol 2024;1456:273-290. doi: 10.1007/978-981-97-4402-2_14. PMID: 39261434
Identification of shared disease marker genes and underlying mechanisms between major depression and rheumatoid arthritis.
Dmitrzak-Węglarz M, Rybakowski J, Szczepankiewicz A, Kapelski P, Lesicka M, Jabłońska E, Reszka E, Pawlak J
J Psychiatr Res 2023 Dec;168:22-29. Epub 2023 Oct 18 doi: 10.1016/j.jpsychires.2023.10.036. PMID: 37871462
Efficacy and safety of psilocybin-assisted treatment for major depressive disorder: Prospective 12-month follow-up.
Gukasyan N, Davis AK, Barrett FS, Cosimano MP, Sepeda ND, Johnson MW, Griffiths RR
J Psychopharmacol 2022 Feb;36(2):151-158. doi: 10.1177/02698811211073759. PMID: 35166158Free PMC Article
Racemic Ketamine as an Alternative to Electroconvulsive Therapy for Unipolar Depression: A Randomized, Open-Label, Non-Inferiority Trial (KetECT).
Ekstrand J, Fattah C, Persson M, Cheng T, Nordanskog P, Åkeson J, Tingström A, Lindström MB, Nordenskjöld A, Movahed Rad P
Int J Neuropsychopharmacol 2022 May 27;25(5):339-349. doi: 10.1093/ijnp/pyab088. PMID: 35020871Free PMC Article
The Relationship between Typus Melancholicus and Unipolar Depression: A Literature Review.
Oudart E, Hanak C, Ammendola S
Psychiatr Danub 2020 Sep;32(Suppl 1):188-193. PMID: 32890388

Recent systematic reviews

Comparative efficacy and tolerability of pharmacological interventions for acute bipolar depression in adults: a systematic review and network meta-analysis.
Yildiz A, Siafis S, Mavridis D, Vieta E, Leucht S
Lancet Psychiatry 2023 Sep;10(9):693-705. doi: 10.1016/S2215-0366(23)00199-2. PMID: 37595997
The Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Report: Serotonergic Psychedelic Treatments for Major Depressive Disorder.
Rosenblat JD, Husain MI, Lee Y, McIntyre RS, Mansur RB, Castle D, Offman H, Parikh SV, Frey BN, Schaffer A, Greenway KT, Garel N, Beaulieu S, Kennedy SH, Lam RW, Milev R, Ravindran AV, Tourjman V, Ameringen MV, Yatham LN, Taylor V
Can J Psychiatry 2023 Jan;68(1):5-21. Epub 2022 Aug 17 doi: 10.1177/07067437221111371. PMID: 35975555Free PMC Article
Distinguishing between depression in bipolar disorder and unipolar depression using magnetic resonance imaging: a systematic review.
Siegel-Ramsay JE, Bertocci MA, Wu B, Phillips ML, Strakowski SM, Almeida JRC
Bipolar Disord 2022 Aug;24(5):474-498. Epub 2022 Jan 30 doi: 10.1111/bdi.13176. PMID: 35060259
Augmentation strategies for treatment resistant major depression: A systematic review and network meta-analysis.
Nuñez NA, Joseph B, Pahwa M, Kumar R, Resendez MG, Prokop LJ, Veldic M, Seshadri A, Biernacka JM, Frye MA, Wang Z, Singh B
J Affect Disord 2022 Apr 1;302:385-400. Epub 2022 Jan 2 doi: 10.1016/j.jad.2021.12.134. PMID: 34986373Free PMC Article
Ketamine and other glutamate receptor modulators for depression in adults with unipolar major depressive disorder.
Dean RL, Hurducas C, Hawton K, Spyridi S, Cowen PJ, Hollingsworth S, Marquardt T, Barnes A, Smith R, McShane R, Turner EH, Cipriani A
Cochrane Database Syst Rev 2021 Sep 12;9(9):CD011612. doi: 10.1002/14651858.CD011612.pub3. PMID: 34510411Free PMC Article

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