Depression as a Syndrome

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Major depressive episode is the most common depressive syndrome. A syndrome is a configuration of symptoms that often occur together and constitute a recognizable condition. Although the presence of a major depressive syndrome is a necessary characteristic of major depressive disorder, it is not sufficient. The syndrome can occur for other reasons. For example, medications or drugs of abuse, as well as general medical conditions, can have direct physiological effects which can trigger the symptoms of a major depressive episode. Similarly, the loss of a loved one can result in this configuration of symptoms. In the latter case, unless the symptoms persist for longer than 2 months, or produce marked functional impairment, suicidality, or psychosis, they are considered to be part of the normal course of bereavement.

The implication is that major depressive syndrome is much more prevalent than major depressive disorder. Currently, major depressive disorder is conceptualized as a clinical entity that may have genetic, other biological, and psychosocial sources, much like a specific illness. Major depressive syndrome is a condition that may be triggered by specific life events or by physical influences on the body, but it does not necessarily imply an underlying psychopathological process. These assumptions reflect a basic dilemma in the mental health field, namely, whether there is a qualitative difference between "normal" conditions (such as depressed mood or major depressive syndrome) and the officially recognized mental disorders (such as major depressive disorder), or whether the latter are merely quantitatively more intense and longer lasting manifestations of normal mood fluctuations.

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