Recurrent brief depression

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Recurrent short depression (RBD) defines mental disorders characterized by episodes of intermittent depression, unrelated to the menstrual cycle in women, occurring between about 6-12 times per year, at least for a year or more meeting diagnostic criteria for major depressive episodes (DSM-IV and ICD-10) except for durations that are in RBD less than 14 days, usually 2-4 days. Despite the short duration of depressive episodes, such episodes are a severe idea and suicidal and disturbed functions are rather common. The majority of patients with RBD also reported symptoms of anxiety and increased irritability. Hipersomnia is also quite common. Approximately 1/2 patients who meet the diagnostic criteria for RBD may have short episodes of short additional hypomania which is a marker of RBD severity. RBD may be the only existing mental disorder, but RBD may also occur as part of a history of episodes of depressive depression or recurrent bipolar disorder. RBD is also seen among some patients with personality disorders.

Video Recurrent brief depression

Prevalence

The lifetime prevalence of RBD has been estimated at 2.6-10.0%, and a one year prevalence at 5.0-8.2%. The World Health Organization's project on "Psychological problems in general health care", based on primary care samples, reported a one year prevalence of 3.7 to 9.9%. However, none of these studies distinguishes between RBD and without history of other mood disorders (eg severe depression). The DSM-IV field trials estimated the life time of RBD to be only about 2%.

Maps Recurrent brief depression

Cause

The cause (aetiology) of RBD is unknown, but recent findings may show an association between RBD and bipolar disorder, which indicates the importance of genetic factors. A small subgroup of patients with RBD have temporal lobe epilepsy.

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Diagnosis

From the International Statistical Classification of Mental and Behavioral Disorders:

F33 Recurrent depressive disorder

• G1. At least one previous episode, light (F32.0), moderate (F32.1), or heavy (F32.2 or F32.3), takes up to 2 weeks and is separated from the current episode at least 2 months free from significant mood symptoms.
• G2. Never in the past had any episodes that met the hypomanic or manic criteria or episodes (F30.-).
• G3. The most common exclusion criteria are used: this episode is not caused by the use of psychoactive substance (F1) or an organic mental disorder, in the sense of F0. It is recommended to specify the dominant types of previous episodes (mild, moderate, severe, uncertain).

F33.0 Recurrent depressive disorder, mild episode current

• • A. General criteria for recurrent depression disorder (F33) are met.
  • B. The current episode meets the criteria for episodes of depression, mild severity (F32.0).
    • The fifth character can be used to determine the presence of somatic syndrome, as defined in F32, in the current episode:
      • F33.00 without somatic syndrome
      • F33.01 with somatic syndrome

F33.1 Recurrent depressive disorder, moderate episode current

• • A. General criteria for recurrent depression disorder (F33) are met.
  • B. The current episode meets the criteria for episodes of depression, moderate severity (F32.1).
    • The fifth character can be used to determine the presence of somatic syndrome, as defined in F32, in the current episode:

F33.10 tanpa sindrom somatik

F33.11 with somatic syndrome

F33.2 Recurrent depressive disorder, current episodes severe without psychotic symptoms

• • A. General criteria for recurrent depression disorder (F33) are met.
  • B. The current episode meets the criteria for severe depressive episodes without psychotic symptoms (F32.2).

F33.3 Recurrent depressive disorder, current episodes severe with psychotic symptoms

• • A. General criteria for recurrent depression disorder (F33) are met.
  • B. The current episode meets the criteria for severe depressive episodes with psychotic symptoms (F32.3). The fifth character can be used to determine whether the psychotic symptoms are congruent or congruent to the mood:

F33.30 with congruent psychotic symptoms of mood

F33.31 with unsuitable psychotic mood symptoms

F33.4 Recurrent depressive disorder, currently in remission

• • A. The general criteria for recurrent depression disorder (F33) have been met in the past.
  • B. The current state does not meet the criteria for episodes of depression (F32.-) of any severity, or for other disorders in F3 (patients may receive treatment to reduce the risk of subsequent episodes).

F33.8 Other recurring depressive disorders

F33.9 Recurrent, non-specific depressive disorder

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Treatment

Both psychotherapy and different drugs (eg serotonin reuptake inhibitors - SSRIs or mood stabilizers, eg lithium, antiepileptics) have been suggested as treatment. However, no randomized controlled trial of RBD has been performed.

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History

The disorder characterized by periods of depressive episodes lasting many hours to days has been described since 1852 and labeled "periodic melancholy", "intermittent depressive disorder" or "very short depression". The third version of the Diagnostic and Statistical Manual of Mental Disorders (1980), which relies heavily on findings from research conducted in inpatient and outpatient settings, requires at least 14 days duration for the diagnosis of depression. No diagnostic category is allocated for depressive episodes of shorter duration. Thus, intermittent depressive disorder, included in the Diagnostic Criteria for Research (1975) was considered to identify a minor version of major depression ("minor depression") and not included in DSM-III.

However, based on data from epidemiological studies, psychiatrist and Swiss researcher Jules Angst invented the concept of "recurrent brief depression" (RBD) and provided diagnostic criteria for this type of mood disorder in 1985. Several other European studies independently confirmed the occurrence of RBD in the population general and clinical samples. RBD is thus included in the classification of 10 mental and behavior disorders (ICD-10 F38.1) published by the World Health Organization in 1992 (WHO, 1992; WHO, 1993). Less frequent episodes of brief depression are labeled as rare short depressions and are not included in ICD-10. The American mental disorder classification system, DSM-IV (1994), provided the provisional diagnostic criteria for RBD, but decided to wait for further research before incorporating RBD in the classification system. The fate of RBD in DSM-5, expected to occur in 2013, is unknown.

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References

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External links

• J. Editorial Angst on RBD History
• W. Maier's article on RBD in Primary Care Settings

Source of the article : Wikipedia