[Consensus depression in adults. Dutch Association for Psychiatry]

Area of Science:

• Psychiatry
• Clinical Psychology

Background:

• Depression is a prevalent yet underdiagnosed and undertreated mental health disorder.
• Lack of a standardized classification system hinders consistent recognition and management.
• Physical symptom presentation and patient/clinician difficulty in labeling mental distress contribute to undertreatment.

Framework:

• A consensus meeting defined key terms: normal feeling of depression, depression as a symptom, and depression as an illness.
• The term 'masked depression' was discouraged to promote clearer communication.
• The Bech version of the Hamilton Depression Rating Scale is recommended for assessing depression severity.

Implementation:

• Cognitive Behavioural Therapy (CBT) and Interpersonal Therapy (IPT) are recommended as evidence-based psychotherapeutic interventions.
• Laboratory tests are not diagnostic for depression but useful for excluding physical conditions, guiding antidepressant selection, and monitoring treatment.
• Addressing social factors is crucial, particularly as women experience depression twice as frequently as men due to social, not solely genetic or hormonal, reasons.

Implications:

• Improved diagnostic clarity and classification can enhance the recognition of depressive disorders.
• Evidence-based therapies and appropriate use of diagnostic tools can lead to more effective treatment strategies.
• Focusing on social determinants and fostering equitable doctor-patient relationships is vital for managing depression, especially in women.