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Depression in older adults is estimated to occur in 25% of those with other illnesses, including cancer, arthritis, stroke, chronic lung disease, and cardiovascular disease. Approximately 30% of patients report symptoms of depression to their primary care providers; however, fewer than 10% of these patients have major depression.

Documentation of depression should specify:

  • Severity of depression as MILD, MODERATE, or SEVERE
  • Specific type of depression, if known
    • MAJOR depression
      • When PSYCHOTIC FEATURES occur with SEVERE major depression
    • Nervous depression and neurotic depression are both examples of a MODERATE major depressive disorder
    • Both agitated depression and endogenous depression are types of SEVERE major depression
  • The frequency of symptomatic major depression
    • Is this the first episode e.g., SINGLE EPISODE
    • Is there is a history of major depression with more than one symptomatic episode e.g., “RECURRENT
  • The persistence of symptoms defined as PARTIAL REMISSION or FULL REMISSION, g., not currently experiencing a depression episode

Examples of complete documentation include:

  • Single episode of major depression with mood-incongruent psychotic symptoms
  • Single episode of major depression in full remission
  • Recurrent episodes of major depression

Download the complete tip, Depression.