Overview of mood disorders: diagnosis, classification, and management

Abstract This discussion of the diagnosis, classification, and epidemiology of clinical depression includes details of the associated physical morbidity, mortality, and impairment. Treatment approaches to depressive disorders are categorized with an emphasis on medication management, including improved treatment efficacy and progress with respect to side effects and toxicity. Although considerable advances have been made, with 18 antidepressant compounds being available and the impending release of two new antidepressant compounds in 1994, no one agent has demonstrated greater efficacy than another. Currently available studies suggest that only 21-42% of patients entered into treatment reach full recovery, while 20% of patients do not respond to available treatment but remain chronically depressed. Thus, the development of more efficacious agents that will produce complete remissions in patients who now achieve only partial treatment responses is a major challenge for biochemical, pharmacological, and clinical research of the treatment of mood disorders.