[Consensus depression in adults. Dutch Association for Psychiatry].

Depression is a frequent and treatable disorder, but it is insufficiently recognized. A generally used classification system is lacking. In a consensus meeting the following terms were defined: a normal feeling of depression, depression as a symptom and depression as an illness. The use of the term 'masked depression' was advised against. The undertreatment mentioned is caused by the following factors: presentation of physical symptoms by depressive patients, unfamiliarity of patients with depressive disorders and difficulties of patients and GPs in labelling depression as mental. Depressive disorders have various causes. For scoring the severity of depression the Bech version of the Hamilton Depression Rating Scale is preferred. There is no valid laboratory test for diagnosing depression. Laboratory tests are recommended to exclude physical disorders, for choosing an antidepressant and for the follow-up of drug treatment. Cognitive Behavioural Therapy and Interpersonal Therapy are preferred psychotherapeutic methods because of their scientifically proved efficacy. Women suffer from depression twice as frequently as men, which is due to social factors rather than to genetic or hormonal factors. Therefore hormonal therapy is not indicated, a more equal doctor-patient relationship is. Patients with a depressive disorder may consider suicide; this should regularly be discussed with them.