Delving deeper on depression

THERE are calls for a major overhaul of the way depression is diagnosed and treated to better recognise its triggers.

A group of international psychologists has challenged the classification of “major depression” and argues it would be better managed if it was broken down into 12 separate disorders.

“We argue that depression is not a single disease, it is a heterogeneous syndrome, with patients differing remarkably in symptom profile, pathophysiology and treatment responsiveness,” says Severi Luoto, a PhD candidate in evolutionary psychology at the University of Auckland.

The 12 suggested subtypes, published in journal Brain, Behaviour, and Immunity, are based on the various underlying causes or triggers for the depression, such as illness, loneliness, a traumatic experience or long-term stress.

“If a depressive episode appears to be a response to an adverse life event, clinicians should evaluate whether the symptoms are adaptive or whether the depression episode has exacerbated into pathological depression,” said co-author Professor Rantala, a member of the Turku Brain and Mind Center in Finland.

Professor Gordon Parker from UNSW and Black Dog Institute has applauded the paper and says tying treatment to cause is “infinitely better”. He says simply diagnosing someone with “major depression” is not helpful.

“It’s no more than a GP saying to a patient they’ve got major breathlessness; the breathless might reflect asthma or pneumonia.”