The Differential Diagnosis of Depression

DEPRESSIVE disorders are conditions whose high prevalence^1,2and frequent need for medical intervention³require increased understanding in the general medical community. Antidepressants are prescribed with increasing frequency by a wide range of medical practitioners and a recent listing of the most prescribed drugs included seven antidepressants.⁴Data from an ongoing National Institute of Mental Health epidemiologic study,²using diagnostic criteria fromDSM-III,⁵indicate that in the general population there is a six-month prevalence of depressive disorders (bipolar and unipolar) of about 5%. Furthermore, over 75% of persons with recent depressive disorders have sought medical treatment of some type in the last six months and nearly half of all mental health—related visits made by depressed individuals are to general medical practitioners.³These figures constitute a compelling reason for all physicians to be familiar with the typology of depressive disorders. In psychiatry, as in all fields