Depression

Abstract

Depression is a chronic disorder associated with significant morbidity and mortality, and likely to become the second most debilitating disease worldwide by 2020. As defined by the Diagnostic and Statistical Manual of Mental Disorders , fourth edition (DSM‐IV), depression is the persistent presence over a period of at least two weeks of at least five of nine of its cardinal symptoms: depressed mood and anhedonia (of which at least one must be present), clinically significant weight gain/loss or increase/decrease in appetite, sleep disturbance, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or of excessive guilt, decrease in concentration, and recurrent thoughts of death or suicide. Culture can influence numerous processes interfacing with this disorder, including symptom presentation, prevalence, utilization of services, and selection of and response to treatment.