1. WPA Educational Programme on Depressive Disorders Volume One: Fundamentals Copyright © 2010. World Psychiatric Association

2. Patients with moderate depressive episode: May also have considerable difficulty maintaining personal and vocational roles functions; Some symptoms may be quite severe but on the whole fewer in number and less intense than severe episodes. Must fulfill general criteria for a depressive episode, have two of three typical symptoms and have four additional symptoms as outlined in ICD-10 Classification of Mental Disorders. Copyright © 2010. World Psychiatric Association2

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5. Epidemiologic Findings: Several large epidemiological studies have been conducted. One of the earliest by National Institute of Mental Health (NIMH) Epidemiologic Catchment Area (ECA) found: –9.5% of the US population over 18 years of age was afflicted by a mood disorder in any one year period (Regier et al. 1993) More recent studies in other population groups, using similar ascertainment tools have provided additional results. –Lifetime prevalence approaches 17-18% Copyright © 2010. World Psychiatric Association5

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7. Impact of Depressive Illnesses Impact of depression on society is well-documented (Desjarlais et al. 1995) The Global Burden of Disease study found depression was the fourth most burdensome of all medical conditions throughout the world in 1990; And predicted it would rise to second by 2020 (Murray and Lopez 1996) Copyright © 2010. World Psychiatric Association7

8. Impact of Depressive Illnesses Disability Adjusted Life Years (DALY) is a metric, introduced in 1998 by the Harvard School of Public Health in collaboration with the World Bank and World Health organization. DALY represents the sum of years of life lost due to premature mortality (YLL) in the population and years lost due to disability for incident cases of the health condition. Neurospsychiatric disorders accounted for about 28% of total DALYs lost due to non-communicable diseases in 2005. Copyright © 2010. World Psychiatric Association8

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15. The Three Phases of Treatment for Depression Depressive disorders are often recurrent. Therefore, treatment is generally viewed in three phases: acute, continuation, and maintenance (or prophylaxis) phases. Demarcations between the different phases is often somewhat blurred. Copyright © 2010. World Psychiatric Association15

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22. 22 Copyright © 2010. World Psychiatric Association