Talk:Major depressive disorder

FA review needed

These issues have not been addressed. SandyGeorgia (Talk) 15:46, 20 November 2020 (UTC)

Management

... section is getting stubby ... lots of short paragraphs and information that needs to be merged or possibly removed. I see student editing here. (Also found info chunked in to the lead that was nowhere in the body, so fixed that.) SandyGeorgia (Talk) 18:50, 17 August 2020 (UTC)

Elderly

This section looks also like it was chunked in as an afterthought. It duplicates some management information, which can be merged to Management or deleted, and the rest of it can go within the other sections as appropriate (prognosis or epidemiology?). SandyGeorgia (Talk) 19:08, 17 August 2020 (UTC)

Terminology

This section is not "terminology" and some of it looks undue; relevant content can be merged elsehwere. SandyGeorgia (Talk) 19:11, 17 August 2020 (UTC)

Stigma

Out of whack, and looks like people are just chunking in random factoids here, rather than following WP:WIAFA. "There has been a continuing discussion of whether neurological disorders and mood disorders may be linked to creativity," has WHAT to do with stigma? The section is not very well written. SandyGeorgia (Talk) 19:13, 17 August 2020 (UTC)

Sigh....I'll compare current with featured version in the first instance for structure etc. Cas Liber (talk · contribs) 23:25, 17 August 2020 (UTC)

That section dates right back to the FAC. I can see it there almost unchanged in December 2008. So I think I might be the guilty party on that one. :P - I do think we need to do something about the length of the article and updating etc. Am looking now.Cas Liber (talk · contribs) 01:20, 18 August 2020 (UTC)

If you are guilty, so am I;) SandyGeorgia (Talk) 01:37, 18 August 2020 (UTC)

First talk message - 4th year American medical student updating the page

Hello! I am planning to update this article over the coming days with some updated language and diagnostic criteria. While this is part of a class, I have devoted much of my time in medical school to learning about the field of psychiatry and plan to complete post-graduate psychiatric training. Please let me know if you have further suggestions.

My first opportunities to edit showed themselves in the opening paragraphs of the Lead Section. Here is my suggested update:

Major depressive disorder (MDD), also known simply as depression, is a mental disorder characterized by pervasive low, or depressed, mood and/or anhedonia, a lack of interest in normally enjoyable activities.[1] In order to meet the diagnostic criteria for MDD diagnosis, one must experience two or more weeks of depressed mood or anhedonia, along with 4 or more of the following symptoms (for a total of 5 symptoms): unintentional changes in weight, dysruption to regular sleep patterns (sleeping more or less), becoming physically slowed or fidgeting uncontrollably, having low or no energy, experiencing an increase in feelings of guilt or worthlessness, disruption in concentration or volition, and thoughts of suicide.[1] Those affected may also occasionally have delusions or hallucinations. Some people have periods of depression separated by years, while others nearly always have symptoms present. Major depression is more severe, significantly affects, daily function, and lasts longer than sadness,[2] which is understood to be a normal part of life.[1]

The diagnosis of major depressive disorder is based on the person's reported experiences and a mental status examination.[3] There are no diagnostic laboratory tests for the disorder, but testing may be done to rule out physiologic conditions that can cause similar symptoms. Those with major depressive disorder are typically treated with counseling and antidepressant medication. Medication appears to be effective, but the effect may only be significant in the most severely depressed.[4] (add that citation) Dozens of psychotherapies have emerged and shown themselves to have variable efficacy, including cognitive behavioral therapy, interpersonal therapy, and behavioral activation therapy.[5] Additionally, electroconvulsive therapy (ECT) and other forms of neuromodulation may be considered if other measures are not effective.[6] Besides ECT, emerging neuromodulatory therapies include repetitive transcranial magnetic stimulation (rTMS) and deep brain stimulation (DBS).[7] Hospitalization may be necessary in cases with a risk of harm to self and may occasionally occur against a person's wishes.

References

1) Diagnostic and statistical manual of mental disorders : DSM-5. American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force. (5th ed ed.). Arlington, VA: American Psychiatric Association. 2013. ISBN 978-0-89042-554-1. OCLC 830807378.

2) Patton, Lauren L.; Glick, Michael, eds. (2015-10-19). "The ADA Practical Guide to Patients with Medical Conditions". doi:10.1002/9781119121039.

3) "APA Dictionary of Psychology". dictionary.apa.org. Retrieved 2020-11-13.

4) Munkholm, Klaus; Winkelbeiner, Stephanie; Homan, Philipp (2020-08-27). Naudet, Florian (ed.). "Individual response to antidepressants for depression in adults-a meta-analysis and simulation study". PLOS ONE. 15 (8): e0237950. doi:10.1371/journal.pone.0237950. ISSN 1932-6203. PMC 7451660. PMID 32853222.

5) Cuijpers, Pim; Karyotaki, Eirini; de Wit, Leonore; Ebert, David D. (2020-04-02). "The effects of fifteen evidence-supported therapies for adult depression: A meta-analytic review". Psychotherapy Research. 30 (3): 279–293. doi:10.1080/10503307.2019.1649732. ISSN 1050-3307.

6) Moreines, Jared L.; McClintock, Shawn M.; Holtzheimer, Paul E. (2011-01). "Neuropsychologic effects of neuromodulation techniques for treatment-resistant depression: A review". Brain Stimulation. 4 (1): 17–27. doi:10.1016/j.brs.2010.01.005. PMC 3023999. PMID 21255751. Check date values in: |date= (help)

7) McGirr, Alexander; Berlim, Marcelo T. (2018-09). "Clinical Usefulness of Therapeutic Neuromodulation for Major Depression". Psychiatric Clinics of North America. 41 (3): 485–503. doi:10.1016/j.psc.2018.04.009. Check date values in: |date= (help)

8) Bair, Matthew J.; Robinson, Rebecca L.; Katon, Wayne; Kroenke, Kurt (2003-11-10). "Depression and Pain Comorbidity: A Literature Review". Archives of Internal Medicine. 163 (20): 2433. doi:10.1001/archinte.163.20.2433. ISSN 0003-9926.

SingingPsych (talk) 12:02, 20 November 2020 (UTC)

Hi SingingPsych; welcome to Wikipedia and thank you for approaching the talk page of the article before editing. You might want to know that you can copy proposed text from your sandbox to article talk with the actual inline refs, and add {{reflist-talk}} after it so that the actual citations will be placed on talk automatically without you having to copy them in.

There are quite a few issues with your proposed text and I hope we can orient your good work towards edits that are more likely to stick.

• My first concern is whether your instructor (Mhrichards, who has never edited Wikipedia) or Helaine (Wiki Ed) or Ian (Wiki Ed) explained to your course that students are discouraged from editing Featured articles (FA) as they are a very hard place to start learning about Wikipedia guidelines, policies and conventions. There was no talk page notification here that you planned to edit, so I regret that your effort may have been wasted, as most of your proposed changes won't work. This particular FA is curated by an experienced Wikipedian who is also a practicing psychiatrist (Casliber) and you might enjoy collaborating with Cas on future endeavors here.
• Please have a look at WP:MEDMOS, WP:WIAFA, WP:LEAD, WP:OWN#Featured articles and WP:TECHNICAL as they are the background for some of the issues with your proposed text.

So, in terms of the specific issues: this article does need some work and some parts of it have fallen out of date, but starting by rewriting the lead is not a recommended approach even for experienced Wikipedians. It is always better to work on the body of the article, and later rewrite the lead as a summary of the most important parts of the article. Rewriting a lead without having first written the body of the article takes the body out of sync with the lead. Please have a careful look at WP:LEAD.

1. We would not typically introduce a word like anhedonia in the lead. Leads are supposed to be more accessible to layreaders than the rest of the article, and that is not a word we need to teach readers right off. See WP:MTAU.
2. We would not typically use a dictionary definition in a featured article as a better source is likely to be available.
3. When citing the DSM, you should give a page number (yes, I know, that hasn't been done throughout other Featured articles, but see WP:OTHERSTUFFEXISTS. Ditto for books.
4. FAs require a consistent citation style. (See WP:WIAFA). This article uses the Diberri Boghog citation filler tool that generates a citation from a PMID and uses Vancouver author format. (You have generally provided no PMIDs.)
5. Listing out the diagnostic criteria in detail the lead is not an appropriate summary. It burdens the lead with excess detail. The lead gives an overview that hopefully will entice the reader to continue reading.

Prose issues and WP:MOS issues

• In order to meet the diagnostic criteria for MDD diagnosis, ... in order to is almost always redundant ... see Tony1's writing exercises in the Advice section of this link.
• along with 4 or more of the following symptoms (for a total of 5 symptoms): ... this breaches WP:MOSNUM (digits less than ten are spelled out in most, not all, circumstances). That sort of thing is fine for articles that are not Featured, but provides an example of why it is harder to begin editing with a featured article.
• See WP:ENGVAR. This article uses American English, not British ... dysruption to regular sleep patterns ... followed in the same sentence by a switch back to ... disruption in concentration or volition,
• Your proposed first para covers diagnosis, yet so does the second. Leads need to be organized in a way that the main points are covered in a broad summary.
• Additionally, electroconvulsive therapy ... see Tony1's writing excercises ... additionally is redundant.

These are only intended as samples to show you why your effort, which would be an exemplary start on an article that is not already assessed at the FA level, cannot be implemented in an FA. My recommendation is that you start work on an article that is not an FA, or you work on the parts in the body of this article that need updating, so that those improvements can later be summarized to the lead. Best regards, SandyGeorgia (Talk) 15:28, 20 November 2020 (UTC)