Depressive Disorders

  • Leilani FelicianoEmail author
  • Amber M. Gum
  • Katherine A. Johanson


Mood disorders are among the most commonly seen psychiatric disorders, occurring in about 20.8% of the general population (lifetime prevalence rate) (Kessler et al., 2005) and up to 37.4% in late life populations (Luppa et al., 2012). They are found among adult, child, and older adult populations and cut across racial, ethnic, and socioeconomic groups. Mood disorders are costly not only to the individual in terms of emotional suffering and physical distress but also to families (e.g., disrupted household routine and economic burden) and to our society. In fact, in 2017, the World Health Organization reported that depression is now considered to be the most disabling condition in the world, representing the leading cause of disability. Depression is noted to account for 7.5% of all years lived with a disability (WHO, 2017a, 2017b). In addition, of all mental health disorders, mood disorders are responsible for the highest suicide risk in more developed countries (Nock et al., 2008).


  1. Alexopoulos, G. S., Abrams, R. C., Young, R. C., & Shamoian, C. A. (1988). Cornell scale for depression in dementia. Biological Psychiatry, 23(3), 271–284.Google Scholar
  2. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.Google Scholar
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.Google Scholar
  4. American Psychiatric Association. (2015). Practice guidelines for the psychiatric evaluation of adults (3rd ed.). Available from:
  5. Angst, J., Azorin, J.-M., Bowden, C. L., Perugi, G., Vieta, E., Gamma, A., & Young, A. H. (2011). Prevalence and characteristics of undiagnosed bipolar disorders in patients with a major depressive episode: The BRIDGE Study. JAMA Psychiatry, 68, 791–799.Google Scholar
  6. Areán, P., Raue, P. J., McCulloch, C., Kanellopoulos, D., Seirup, J. K., Banerjee, S., … Alexopoulos, G. S. (2015). Effects of problem-solving therapy and clinical case management on disability in low-income older adults. American Journal of Geriatric Psychiatry, 23, 1307–1314.Google Scholar
  7. Arroll, B., Goodyear-Smith, F., Crengle, S., Gunn, J., Kerse, N., Fishman, T., … Hatcher, S. (2010). Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Annals of Family Medicine, 8(4), 348–353.Google Scholar
  8. Banerjee, N., Roy, K., & Takkar, D. (2000). Premenstrual dysphoric disorder: A study from India. International Journal of Fertility & Women’s Medicine, 45(5), 342–344.Google Scholar
  9. Barg, F. K., Huss-Ashmore, R., Wittink, M. N., Murray, G. F., Bogner, H. R., & Gallo, J. J. (2006). A mixed-methods approach to understanding loneliness and depression in older adults. Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 61B(6), S329–S339.Google Scholar
  10. Bech, P. (1996). The Bech, Hamilton and Zung scales for mood disorders: Screening and listening a twenty years update with reference to DSM-IV and ICD-10 (2nd ed.). Berlin, Germany: Springer.Google Scholar
  11. Beck, A. T., Guth, D., Steer, R. A., & Ball, R. (1997). Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care. Behaviour Research and Therapy, 35(8), 785–791.Google Scholar
  12. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.Google Scholar
  13. Camacho, D., Estrada, E., Lagomasino, I. T., Aranda, M. P., & Green, J. (2017). Descriptions of depression and depression treatment in older Hispanic immigrants in a geriatric collaborative care program. Aging & Mental Health, 22(8), 1050–1056. Scholar
  14. Carmody, T. J., Rush, A. J., Bernstein, I., Warden, D., Brannan, S., Burnham, D., … Trivedi, M. H. (2006). The Montgomery Asberg and the Hamilton ratings of depression: A comparison of measures. European Neuropsychopharmacology, 16(8), 601–611.Google Scholar
  15. Comijs, H. C., Nieuwesteeg, J., Kok, R., van Marwijk, H. W., van der Mast, R. C., Naarding, P., … Stek, M. L. (2015). The two-year course of late-life depression; results from the Netherlands study of depression in older persons. BMC Psychiatry, 15, 20.Google Scholar
  16. Conner, K. O., Carr Copeland, V., Grote, N. K., Koeske, G., Rosen, D., Reynolds, C. F., III, & Brown, C. (2010). Mental health treatment seeking among older adults with depression: The impact of stigma and race. American Journal of Geriatric Psychiatry, 18, 531–543.Google Scholar
  17. Conner, K. O., Lee, B., Mayers, V., Robinson, D., Reynolds, C. F., III, Albert, S., & Brown, C. (2010). Attitudes and beliefs about mental health among African American older adults suffering from depression. Journal of Aging Studies, 24, 266–277.Google Scholar
  18. Copeland, W. E., Angold, A., Costello, E. J., & Egger, H. (2013). Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder. The American Journal of Psychiatry, 170(2), 173–179.Google Scholar
  19. Crowley, R. A., & Kirschner, N., for the Health and Public Policy Committee of the American College of Physicians. (2015). The integration of care for mental health, substance abuse, and other behavioral health conditions into primary care: Executive summary of an American College of Physicians position paper. Annals of Internal Medicine, 163(4), 298–299.Google Scholar
  20. Diez-Quevedo, C., Rangil, T., Sanchez-Planell, L., Kroenke, K., & Spitzer, R. L. (2001). Validation and utility of the patient health questionnaire in diagnosing mental disorders in 1003 general hospital Spanish inpatients. Psychosomatic Medicine, 63(4), 679–686.Google Scholar
  21. Epperson, C. N., Steiner, M., Hartlage, S. A., Eriksson, E., Schmidt, P. J., Jones, I., & Yonkers, K. A. (2012). Premenstrual dysphoric disorder: Evidence for a new category for DSM-5. American Journal of Psychiatry, 169, 465–475.Google Scholar
  22. Farrer, L., Leach, L., Griffiths, K. M., Christensen, H., & Jorm, A. F. (2008). Age differences in mental health literacy (Vol. 8, p. 125). BMC Public Health.
  23. Feliciano, L., Renn, B. N., & Segal, D. L. (2018). Depressive disorders. In D. C. Beidel & C. Freuh (Eds.), Adult psychopathology and diagnosis (8th ed., pp. 247–298). Hoboken, NJ: John Wiley & Sons, Inc.Google Scholar
  24. Gallo, J. J., & Rabins, P. V. (1999). Depression without sadness: alternative presentations of depression in late life. American Family Physician, 60(3), 820–826.Google Scholar
  25. Gildengers, A. G., Butters, M. A., Chisholm, D., Anderson, S. J., Begley, A., Holm, M., … Mulsant, B. H. (2012). Cognition in older adults with bipolar disorder versus major depressive disorder. Bipolar Disorders, 14, 198–205.Google Scholar
  26. Grau, K., Plener, P. L., Hohmann, S., Fegert, J. M., Brahler, E., & Straub, J. (2018). Prevalence rate and course of symptoms of disruptive mood dysregulation disorder (DMDD): A population-based study. Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie, 46(1), 29–38.Google Scholar
  27. Gum, A. M., Schonfeld, L., Tyler, S., Fishleder, S., & Guerra, L. (2016). One-visit behavioral intervention for older primary care patients with mild-moderate depressive symptoms: A pilot study. Southern Medical Journal, 109, 442–447.Google Scholar
  28. Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6(4), 278–296.Google Scholar
  29. Hegeman, J. M., Kok, R. M., van der Mast, R. C., & Giltay, E. J. (2012). Phenomenology of depression in older compared with younger adults: Meta-analysis. British Journal of Psychiatry, 200, 275–281.Google Scholar
  30. Hopko, D. R., Bourland, S. L., Stanley, M. A., Beck, J. G., Novy, D. M., Averill, P. M., & Swann, A. C. (2000). Generalized anxiety disorder in older adults: Examining the relation between clinician severity ratings and patient self-report measures. Depression and Anxiety, 12(4), 217–225.Google Scholar
  31. Huang, F. Y., Chung, H., Kroenke, K., Delucchi, K. L., & Spitzer, R. L. (2006). Using the Patient Health Questionnaire-9 to measure depression among racially and ethnically diverse primary care patients. Journal of General Internal Medicine, 21(6), 547–552.Google Scholar
  32. Jackson-Triche, M. E., Greer Sullivan, J., Wells, K. B., Rogers, W., Camp, P., & Mazel, R. (2000). Depression and health-related quality of life in ethnic minorities seeking care in general medical settings. Journal of Affective Disorders, 58(2), 89–97.Google Scholar
  33. Jimenez, D. E., Alegria, M., Chen, C.-N., Chan, D., & Laderman, M. (2010). Prevalence of psychiatric illnesses in older ethnic minority adults. Journal of the American Geriatrics Society, 58, 256–264.Google Scholar
  34. Joiner, T. E., Jr., Walker, R. L., Pettit, J. W., Perez, M., & Cukrowicz, K. C. (2005). Evidence-based assessment of depression in adults. Psychological Assessment, 17(3), 267–277.Google Scholar
  35. Kessler, R. C., Berglund, P., Demler, O., Jin, R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602.Google Scholar
  36. Kiosses, D. N., & Alexopoulos, G. S. (2014). Problem-solving therapy in the elderly. Current Treatment Options in Psychiatry, 1, 15–26.Google Scholar
  37. Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.Google Scholar
  38. Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Lowe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. General Hospital Psychiatry, 32, 345–359.Google Scholar
  39. Lewis-Fernandez, R., & Diaz, N. (2002). The cultural formulation: A method for assessing cultural factors affecting the clinical encounter. Psychiatric Quarterly, 73(4), 271–295.Google Scholar
  40. Lewis-Fernandez, R., Das, A. K., Alfonso, C., Weissman, M. M., & Olfson, M. (2005). Depression in US Hispanics: diagnostic and management considerations in family practice. Journal of the American Board of Family Practice, 18(4), 282–296.Google Scholar
  41. Lewis-Fernández, R., Aggarwal, N. K., Bäärnhielm, S., Rohlof, H., Kirmayer, L. J., Weiss, M. G., … Lu, F. (2014). Culture and psychiatric evaluation: Operationalizing cultural formulation for DSM-5. Psychiatry, 77, 130–154.Google Scholar
  42. Lotrakul, M., Sumrithe, S., Saipanish, R., Lotrakul, M., Sumrithe, S., & Saipanish, R. (2008). Reliability and validity of the Thai version of the PHQ-9. BMC Psychiatry, 8, 46.Google Scholar
  43. Luppa, M., Sikorski, C., Luck, T., Ehreke, L., Konnopka, A., Wiese, B., … Riedel-Heller, S. G. (2012). Age- and gender-specific prevalence of depression in latest-life – Systematic review and meta-analysis. Journal of Affective Disorders, 136(3), 212–221. Scholar
  44. Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.Google Scholar
  45. Nock, M. K., Borges, G., Bromet, E. J., Alonso, J., Angermeyer, M., Beautrais, A., et al. (2008). Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. British Journal of Psychiatry, 192(2), 98–105.Google Scholar
  46. Noguera, A., Centeno, C., Carvajal, A., Tejedor, M. A. P., Urdiroz, J., & Martínez, M. (2009). “Are you discouraged? Are you anxious, nervous, or uneasy?”: In Spanish some words could be better than others for depression and anxiety screening. Journal of Palliative Medicine, 12, 707–712.Google Scholar
  47. Phelan, E., Williams, B., Meeker, K., Bonn, K., Frederick, J., LoGerfo, J., & Snowden, M. (2010). A study of the diagnostic accuracy of the PHQ-9 in primary care elderly. BMC Family Practice, 11, 63.Google Scholar
  48. Plutchik, R., Platman, S. R., & Fieve, R. R. (1968). Repeated measurements in the manic-depressive illness: Some methodological problems. Journal of Psychology, 70, 131–137.Google Scholar
  49. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.Google Scholar
  50. Reynolds, T., Thornicroft, G., Abas, M., Woods, B., Hoe, J., Leese, M., & Orrell, M. (2000). Camberwell assessment of need for the elderly: Development, validity and reliability. British Journal of Psychiatry, 176, 444–452.Google Scholar
  51. Sachdev, P. S., Mohan, A., Taylor, L., & Jeste, D. V. (2015). DSM-5 and mental disorders in older individuals: An overview. Harvard Review of Psychiatry, 23, 320–328.Google Scholar
  52. Segal, D. L., Coolidge, F. L., Cahill, B. S., & O’Riley, A. A. (2008). Psychometric properties of the Beck Depression Inventory II (BDI-II) among community-dwelling older adults. Behavior Modification, 32(1), 3–20.Google Scholar
  53. Segal, D. L., & Williams, K. N. (2014). Structured and semistructured interviews for differential diagnosis: Fundamental issues, applications, and features. In D. C. Beidel, B. C. Frueh, & M. Hersen (Eds.), Adult psychopathology and diagnosis (7th ed., pp. 103–129). Hoboken, NJ: Wiley.Google Scholar
  54. Seitz, D., Purandare, N., & Conn, D. (2010). Prevalence of psychiatric disorders among older adults in long-term care homes: A systematic review. International Psychogeriatrics, 22(7), 1025–1039.Google Scholar
  55. Spitzer, R. L., Williams, J. B., Kroenke, K., Hornyak, R., & McMurray, J. (2000). Validity and utility of the PRIME-MD patient health questionnaire in assessment of 3000 obstetric- gynecologic patients: The PRIME-MD Patient Health Questionnaire Obstetrics-Gynecology Study. American Journal of Obstetrics and Gynecology, 183(3), 759–769.Google Scholar
  56. Steer, R. A., Rissmiller, D. J., & Beck, A. T. (2000). Use of the Beck Depression Inventory-II with depressed geriatric inpatients. Behavior Research and Therapy, 38(3), 311–318.Google Scholar
  57. Stein, J., Pabst, A., Weyerer, S., Werle, J., Maier, W., Heilmann, K., … Riedel-Heller, S. G. (2016). The assessment of met and unmet care needs in the oldest old with and without depression using the Camberwell Assessment of Need for the Elderly (CANE): Results of the AgeMooDe study. Journal of Affective Disorders, 193, 309–317.Google Scholar
  58. Vandeleur, C. L., Fassassi, S., Castelao, E., Glaus, J., Strippoli, M. F., Lasserre, A. M., … Preisig, M. (2017). Prevalence and correlates of DSM-5 major depressive and related disorders in the community. Psychiatry Research, 250, 50–58.Google Scholar
  59. Wakefield, J. C., & First, M. B. (2012). Validity of the bereavement exclusion to major depression: Does the empirical evidence support the proposal to eliminate the exclusion in DSM-5? World Psychiatry, 11, 3–10.Google Scholar
  60. World Health Organization. (2017a). Depression: Fact sheet. Retrieved from
  61. World Health Organization. (2017b). Depression and other mental health disorders: Global health estimates. Retrieved from;jsessionid=3E50852D0FB6969318AC902C0D1C7051?sequence=1
  62. Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49.Google Scholar
  63. Zachar, P., & Kendler, K. S. (2014). A diagnostic and statistical manual of mental disorders history of premenstrual dysphoric disorder. The Journal of Nervous and Mental Disease, 202(4), 346–352.Google Scholar

Copyright information

© Springer International Publishing AG 2019

Authors and Affiliations

  • Leilani Feliciano
    • 1
    Email author
  • Amber M. Gum
    • 2
  • Katherine A. Johanson
    • 1
  1. 1.University of ColoradoColorado SpringsUSA
  2. 2.Louis de la Parte Florida Mental Health Institute University of South FloridaTampaUSA

Personalised recommendations