MDD (also known as major depressive disorder) is characterised by prolonged and clinically significant symptoms of depression that are not clearly caused by another medical condition. With a lifetime prevalence of 3–21%, the various sub-types of MDD are associated with significant morbidity, disability and mortality, including an increased risk of suicide. The wider societal impact of MDD is also considerable, with a reduced ability to work and be productive. Therapeutic approaches include pharmacological and non-pharmacological treatments, although up to 3 in 10 patients fail to respond to treatment and are considered treatment resistant (fail to respond to two or more antidepressants during a single episode of major depression).
Plus, suicide risk is significantly elevated among patients with major depression.
Note: these data refer to a mixed population of both patients and carers – separate data for each group was not made available
Depressive disorders are classified according to the 2013 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) or the International Classification of Diseases, 10th Revision (ICD-10) classification of mental and behavioural disorders. An update to the ICD has been developed (ICD-11), but global uptake and implementation is still underway.
MDD often follows a chronic course, first conceptualised in 1991 by the MacArthur Foundation Research Network on the Psychobiology of Depression task force. On average, a patient faces just under 4 lifetime episodes, with the longest episode lasting 26 weeks.
Symptoms meet DSM-5 / ICD-10 criteria
≥ 2 weeks
MDD episode remission
A less symptomatic state
HAMD-17 ≤ 4
A new period of MDD symptoms
The COVID-19 pandemic has caused a decline in mental wellbeing among all age groups in Europe, especially among those who have lost their jobs.
Note: Based on WHO-5 mental well-being index. People with a WHO-5 score of 50 or lower are considered to be at risk of depression
Chart adapted from Eurofound
WHO reports that mental health is a leading cause of disability worldwide.
Plus, patients with depression are more than 1.5 times likely to develop ischaemic heart disease than the general population.
ACNP, American College of Neuropsychiatry. DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. ED, Emergency department. ER, Emergency room. HAMD-17, Hamilton Depression Rating Scale. ICD-10, International Classification for Diseases, 10th Revision. MDD, Major depressive disorder. SAD, Seasonal affective disorder.