Depressive disorder is a prevalent mental health issue, with lifetime risks of 8-12% for males and 20-26% for females, occurring more frequently in women and in individuals lacking close relationships. The document discusses various etiological factors, including biological, genetic, psychosocial, and behavioral influences, as well as clinical manifestations of depression and diagnostic evaluations. Treatment options encompass pharmacotherapy with antidepressants and various psychosocial therapies.

1. DEPRESSIVE DISORDER
DR. RAHUL SHARMA
ASSOCIATE PROFESSOR
H.O.D. OF MENTAL HEALTH NURSING
PH. D COORDINATOR
SEEDLING SCHOOL OF NURSING,
JAIPUR NATIONAL UNIVERSITY, JAIPUR

3. INTRODUCTION
 It is a widespread mental health problem affecting many people .
 The lifetime risk of depression in male is 08-12% and in female it is 20-26%.
 Depression occur twice in female in comparison to male.
 The highest incidence of depressive symptoms has been indicated in individual without close
interpersonal relationship and in person who are divorced or separated or widow.
 Prevalence of suicide show large peak in spring season and less in October.
 Major depressive disorder often co-occur with other psychiatric disorder and alcoholic or
substance related disorder.

4. ETIOLOGY
 Biological factors
1. NEUROTRANSMITTER
-: Decreased norepinephrine and serotonin level
-: Deregulation of Acetylcholine and GABA
2. GENETIC
-: When 1 twin is diagnosed with major depression, the other twin has
a greater than 70% chances of developing it.
3. ENDOCRINAL FACTORS
-: Pituitary of adrenal system malfunction and hormonal
abnormalities.

5. Psychosocial factors
 Loss of loved one or any valuable objects.
BEHAVIORAL FACTOR
Experience of uncontrollable events
Example - a fight
COGNITIVE FACTORS
Self negative thoughts.
Depression due to negative cognition
Negative exceptions of environment ( Example - flood,fights,stealing)
Negative expectations of self
Negative expectations of future.

6. SOCIOLOGICAL FACTOR
Stressful life events
Example- death, marriage

7. CLINICAL MANIFESTATION
 Sadness of mood
 Loss of interest
 Loss of pleasure
 Hopelessness
 Worthlessness
 A feeling of inferiority
 Suicidal thought
 Anxiety
 Restlessness
 Spiritual thinking, walk and eat slowly
 Feeling of uneasiness

9. Diagnostic evaluation
 Psychological test for depression to access
severity of depression
 Family history
 according to ICD 10 Criteria

10. TREATMENT
 Pharmacotherapy
Major category of depressant are
1. Selective serotonin re-take inhibitions
2. Citalopram
3. Serialize
4. Tricyclic
ANTIDEPRESSANTS
 Amitriptyline
 Clomipramine
 Imipramine
 Doxepine

11. Mono amino oxidase inhibitors
 Isocarboxazid
 Phenelzine
 Other anti depressant are:-
 Buproprin
 Maprotiline

12. PSYCHOSOCIAL THEORIES
 Cognitive therapy
 Supportive theory
 Family therapy
 Group theory
 Behavioral therapy