Name of the Condition

• Major Depressive Disorder, Single Episode, Severe without Psychotic Features (ICD-10 Code: F32.2)

Summary

• Major depressive disorder, single episode, severe without psychotic features is a mental health condition characterized by a deeply pervasive and persistent low mood, loss of interest in most activities, and significant impairment in daily functioning. It is classified as a single episode, meaning the individual is experiencing these symptoms for the first time in this severity and without any delusions or hallucinations.

Causes

• The exact cause of major depressive disorder is not fully understood, but it likely involves a combination of genetic, biological, environmental, and psychological factors. Imbalances in brain chemicals (neurotransmitters) such as serotonin, norepinephrine, and dopamine are also thought to play a role.

Risk Factors

• Risk factors include a family history of depression, significant life changes or trauma, chronic medical conditions, substance abuse, and certain personality traits like low self-esteem or being overly dependent, self-critical, or pessimistic.

Symptoms

• Symptoms include deep sadness or emptiness, loss of interest in hobbies or activities, changes in appetite or weight, sleep disturbances, fatigue, feelings of worthlessness or guilt, difficulty concentrating, and possible thoughts of death or suicide.

Diagnosis

• Diagnosis is typically made based on a thorough clinical evaluation that includes a patient’s medical history, a physical examination, and a psychiatric assessment. Health practitioners may also use standardized questionnaires or rating scales to determine the severity of depression.

Treatment Options

• Treatments include antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), and psychotherapy methods such as cognitive-behavioral therapy (CBT) or interpersonal therapy. In severe cases, electroconvulsive therapy (ECT) may be considered.

Prognosis and Follow-Up

• With appropriate treatment, individuals can achieve symptom relief and return to normal functioning, but some may experience recurrences. Regular follow-up appointments are crucial to monitor progress, adjust treatments, and mitigate relapse risk.

Complications

• Without treatment, major depression can lead to severe disruptions in daily life, increased risk of substance abuse, self-harm, or suicide, and an overall deterioration of physical health due to neglect or poor health habits.

Lifestyle & Prevention

• Regular physical activity, a healthy diet, sufficient sleep, and stress management techniques like mindfulness or yoga can help manage symptoms and potentially prevent the onset of depression. Building a strong support network is also beneficial.

When to Seek Professional Help

• Immediate or urgent medical attention should be sought if experiencing persistent feelings of hopelessness, inability to perform daily tasks, or thoughts of self-harm or suicide. Early intervention can significantly improve outcomes.

Additional Resources

• National Institute of Mental Health (NIMH): www.nimh.nih.gov
• Depression and Bipolar Support Alliance: www.dbsalliance.org
• Mental Health America: www.mhanational.org

Tips for Medical Coders

• Verify the severity and features of depression to ensure accurate coding, distinguishing between single episodes and recurrent depression.
• Avoid coding errors by carefully assessing medical documentation to exclude any psychotic features for this specific code.