Journal
NATURE REVIEWS DISEASE PRIMERS
Volume 2, Issue -, Pages -Publisher
NATURE PORTFOLIO
DOI: 10.1038/nrdp.2016.65
Keywords
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Categories
Funding
- Jansen Research
- VICI grant from the Dutch Scientific Organization
- National Institute for Health Research Mental Health Biomedical Research Centre in Mental Health at South London, Maudsley NHS Foundation Trust and King's College London
- Medical Research Council (UK) [MR/J002739/1, MR/L014815/1]
- Wellcome Trust
- Johnson Johnson
- Lundbeck
- Brain Resource, Inc.
- Abbot Laboratories
- Alkermes, Inc.
- American Cyanamid
- Aspect Medical Systems
- AstraZeneca
- Avanir Pharmaceuticals
- BioResearch
- BrainCells Inc.
- Bristol-Myers Squibb
- CeNeRx BioPharma
- Cephalon
- Cerecor
- Clintara, LLC
- Covance
- Covidien
- Eli Lilly and Company
- EnVivo Pharmaceuticals, Inc.
- Euthymics Bioscience, Inc.
- Forest Pharmaceuticals, Inc.
- FORUM Pharmaceuticals
- Ganeden Biotech, Inc.
- GlaxoSmithKline
- Harvard Clinical Research Institute
- Hoffman-LaRoche
- Icon Clinical Research
- i3 Innovus/Ingenix
- Janssen RD, LLC
- Jed Foundation
- Johnson & Johnson Pharmaceutical Research Development
- Lichtwer Pharma GmbH
- Lorex Pharmaceuticals
- Lundbeck Inc.
- MedAvante
- Methylation Sciences Inc.
- National Alliance for Research on Schizophrenia & Depression (NARSAD)
- National Center for Complementary and Alternative Medicine (NCCAM)
- National Coordinating Center for Integrated Medicine (NiiCM)
- National Institute of Drug Abuse (NIDA)
- National Institute of Mental Health (NIMH)
- Neuralstem, Inc.
- Novartis AG
- Organon Pharmaceuticals
- PamLab, LLC.
- Pfizer Inc.
- Pharmacia-Upjohn
- Pharmaceutical Research Associates., Inc.
- Pharmavite(R) LLC
- PharmoRx Therapeutics
- Photothera
- Reckitt Benckiser
- Roche Pharmaceuticals
- RCT Logic, LLC
- Sanofi-Aventis US LLC
- Shire
- Solvay Pharmaceuticals, Inc.
- Stanley Medical Research Institute (SMRI)
- Synthelabo
- Takeda Pharmaceuticals
- Tal Medical
- Wyeth-Ayerst Laboratories
- Medical Research Council [MR/L014815/1, MR/N029488/1, G108/603] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0513-10051] Funding Source: researchfish
- MRC [MR/N029488/1, G108/603, MR/L014815/1] Funding Source: UKRI
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Major depressive disorder (MDD) is a debilitating disease that is characterized by depressed mood, diminished interests, impaired cognitive function and vegetative symptoms, such as disturbed sleep or appetite. MDD occurs about twice as often in women than it does in men and affects one in six adults in their lifetime. The aetiology of MDD is multifactorial and its heritability is estimated to be approximately 35%. In addition, environmental factors, such as sexual, physical or emotional abuse during childhood, are strongly associated with the risk of developing MDD. No established mechanism can explain all aspects of the disease. However, MDD is associated with alterations in regional brain volumes, particularly the hippocampus, and with functional changes in brain circuits, such as the cognitive control network and the affective-salience network. Furthermore, disturbances in the main neurobiological stress-responsive systems, including the hypothalamic-pituitary-adrenal axis and the immune system, occur in MDD. Management primarily comprises psychotherapy and pharmacological treatment. For treatment-resistant patients who have not responded to several augmentation or combination treatment attempts, electroconvulsive therapy is the treatment with the best empirical evidence. In this Primer, we provide an overview of the current evidence of MDD, including its epidemiology, aetiology, pathophysiology, diagnosis and treatment.
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