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关于抑郁症的一点背景调研

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Major depressive disorder (MDD), also known simply as depression, is a mental disordercharacterized by at least two weeks of low moodthat is present across most situations.[1] It is often accompanied by low self-esteemloss of interestin normally enjoyable activities, low energy, and pain without a clear cause.[1] People may also occasionally have false beliefs or see or hear things that others cannot.[1] Some people have periods of depression separated by years in which they are normal, while others nearly always have symptoms present.[3] Major depressive disorder can negatively affect a person's personal, work, or school life as well as sleeping, eating habits, and general health.[1][3] Between 2–7% of adults with major depression die by suicide,[2] and up to 60% of people who die by suicide had depression or another mood disorder.[6]

The cause is believed to be a combination of genetic, environmental, and psychological factors.[1] Risk factors include a family history of the condition, major life changes, certain medications, chronic health problems, and substance abuse.[1][3] About 40% of the risk appears to be related to genetics.[3] The diagnosis of major depressive disorder is based on the person's reported experiences and a mental status examination.[7] There is no laboratory test for major depression.[3] Testing, however, may be done to rule out physical conditions that can cause similar symptoms.[7] Major depression should be differentiated from sadness, which is a normal part of life and is less severe.[3] The United States Preventive Services Task Force (USPSTF) recommends screening for depression among those over the age 12,[8][9] while a prior Cochrane review found that the routine use of screening questionnaires have little effect on detection or treatment.[10]

Typically, people are treated with counseling and antidepressant medication.[1] Medication appears to be effective, but the effect may only be significant in the most severely depressed.[11][12] It is unclear whether medications affect the risk of suicide.[13] Types of counseling used include cognitive behavioral therapy (CBT) and interpersonal therapy.[1][14] If other measures are not effective electroconvulsive therapy (ECT) may be tried.[1] Hospitalization may be necessary in cases with a risk of harm to self and may occasionally occur against a person's wishes.[15]

Major depressive disorder affected approximately 216 million people (3% of the world's population) in 2015.[5] The percentage of people who are affected at one point in their life varies from 7% in Japan to 21% in France.[4] Lifetime rates are higher in the developed world (15%) compared to the developing world (11%).[4] It causes the second most years lived with disability, after low back pain.[16] The most common time of onset is in a person's 20s and 30s.[3][4] Females are affected about twice as often as males.[3][4] The American Psychiatric Association added "major depressive disorder" to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980.[17] It was a split of the previous depressive neurosis in the DSM-II, which also encompassed the conditions now known as dysthymia and adjustment disorder with depressed mood.[17] Those currently or previously affected may be stigmatized.[18]

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