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Depression is among the most prevalent and disabling mental health disorders worldwide and represents a leading cause of morbidity, mortality, and health-care utilization. Pharmacists, as accessible and trusted front-line health-care providers, are increasingly recognized as integral members of the interdisciplinary mental-health care team. This chapter provides an overview of the epidemiology, etiology, diagnosis, and management of major depressive disorder (MDD) and related depressive conditions, with an emphasis on the pharmacist’s evolving role in screening, monitoring, and optimizing therapy. A comprehensive understanding of the biological, psychological, and social determinants of depression is foundational to patient-centred care. The chapter explores contemporary theories of depression pathophysiology—including monoaminergic, neuroendocrine, inflammatory, and neuroplastic models—while addressing established risk factors such as genetic predisposition, chronic disease, and psychosocial stressors. Diagnostic considerations and differential diagnoses are discussed in alignment with DSM-5 criteria, alongside validated assessment tools such as the PHQ-9 and PHQ-2 that support measurement-based care. Management strategies encompass both non-pharmacological and pharmacological interventions. Evidence is reviewed for non-pharmacological modalities which serve as first-line or adjunctive management strategies, such as psychotherapy, complementary and alternative medicine, exercise, and digital health interventions. Pharmacotherapy selection and monitoring principles are reviewed in accordance with the 2023 Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines, with practical guidance on drug selection, safety, tolerability, and treatment duration. The chapter further examines suicide-risk assessment, adherence barriers, and follow-up principles. Collectively, it emphasizes the pivotal role of pharmacists in improving outcomes, reducing stigma, and supporting patient-centrered, evidence-based management of patients living with depression.

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Depression Assessment

  • 章节

  • 发表日期：

    2025年

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  • Candace Necyk,
  • Theresa Eberhardt,
  • Sherif Hanafy Mahmoud

摘要

Depression is among the most prevalent and disabling mental health disorders worldwide and represents a leading cause of morbidity, mortality, and health-care utilization. Pharmacists, as accessible and trusted front-line health-care providers, are increasingly recognized as integral members of the interdisciplinary mental-health care team. This chapter provides an overview of the epidemiology, etiology, diagnosis, and management of major depressive disorder (MDD) and related depressive conditions, with an emphasis on the pharmacist’s evolving role in screening, monitoring, and optimizing therapy. A comprehensive understanding of the biological, psychological, and social determinants of depression is foundational to patient-centred care. The chapter explores contemporary theories of depression pathophysiology—including monoaminergic, neuroendocrine, inflammatory, and neuroplastic models—while addressing established risk factors such as genetic predisposition, chronic disease, and psychosocial stressors. Diagnostic considerations and differential diagnoses are discussed in alignment with DSM-5 criteria, alongside validated assessment tools such as the PHQ-9 and PHQ-2 that support measurement-based care. Management strategies encompass both non-pharmacological and pharmacological interventions. Evidence is reviewed for non-pharmacological modalities which serve as first-line or adjunctive management strategies, such as psychotherapy, complementary and alternative medicine, exercise, and digital health interventions. Pharmacotherapy selection and monitoring principles are reviewed in accordance with the 2023 Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines, with practical guidance on drug selection, safety, tolerability, and treatment duration. The chapter further examines suicide-risk assessment, adherence barriers, and follow-up principles. Collectively, it emphasizes the pivotal role of pharmacists in improving outcomes, reducing stigma, and supporting patient-centrered, evidence-based management of patients living with depression.