Women may have a greater chance of developing depression as a comorbidity to cardiovascular disease, particularly after having a stroke.

Sex- and Gender-Related Diagnostic Issues Pertaining to Depressive Disorder Due to Another Medical Condition

Contributing factors include:
- Sex- and Gender-Related Issues

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Complications from pre-existing conditions like chronic illness can lead to the development of a Depressive Disorder Due to Another Medical Condition, which is a prominent and persistent period of low mood and interest. 

Depressive Disorder Due to Another Medical Condition

A. A prominent and persistent disturbance in mood that predominates in the clinical picture and is characterized by depressed mood or markedly diminished interest or pleasure in all, or almost all, activities.

B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition.

C. The disturbance is not better explained by another mental disorder (e.g., adjustment disorder, with depressed mood, in which the stressor is a serious medical condition).

D. The disturbance does not occur exclusively during the course of a delirium.

E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Coding note: The ICD-10-CM code depends on the specifier.

[DSM-5-TR] Diagnostic Criteria for Depressive Disorder Due to Another Medical Condition 

Sex differences in the prevalence of depressive disorder due to another medical condition depend on the sex differences associated with the underlying medical condition.

Prevalence of Depressive Disorder Due to Another Medical Condition

For CVAs, onset of depression can be acute (stroke) or weeks to months following the accident. 

Static brain injuries and other central nervous system diseases, mood symptoms may be episodic 

With Parkinson’s disease and Huntington’s disease, depression often precedes major motor and cognitive impairments.

In Cushing’s syndrome and hypothyroidism, depression can be an early symptom.

In pancreatic cancer, depression often precedes other features.

Development and Course of Depressive Disorder Due to Another Medical Condition

Biological markers depend on the underlying medical condition. For example, steroid levels in blood or urine can support the diagnosis of Cushing's disease, which is associated with manic or depressive syndrome.

Diagnostic Markers of Depressive Disorder Due to Another Medical Condition 

Medical conditions that are associated with the cause of depressive disorder due to another medical condition are called comorbid conditions. Individuals with various medical conditions, such as Cushing's disease, can experience delirium before or alongside depressive symptoms. It is common for individuals with depressive disorders, regardless of their cause, to also experience symptoms of anxiety, which are usually generalized.

Comorbid Diagnosis to Depressive Disorder Due to Another Medical Condition

When diagnosing Depressive Disorder Due to Another Medical Condition, establishing causality (etiology) between the medical condition and the depression is the most important variable. Medical conditions commonly associated with this depressive disorder include:
- Autoimmune disorders (e.g., systemic lupus erythematosus) and vitamin deficiencies (e.g., vitamin B12)
- Endocrine conditions (e.g., Cushing’s syndrome, hypothyroidism)
- Focal lesions (e.g., cerebrovascular accident, traumatic brain injury, neoplasm)
- Huntington’s disease
- Multiple sclerosis
- Parkinson’s disease.

Associated Features of Depressive Disorder Due to Another Medical Condition

Risk and prognostic factors for Depressive Disorder Due to Another Medical Condition vary by the underlying illness. Following a stroke (cerebrovascular accident), depression is most likely to occur shortly after the event, with left frontal lesions posing the greatest risk. However, depression onset 2 to 6 months post-stroke shows no such anatomical association, suggesting alternative causes. For Parkinson's disease, early onset, severe motor symptoms, and longer disease duration are associated with increased depression risk. In traumatic brain injury (TBI), depression is more likely in women, those with a prior history of depression, early psychiatric symptoms, lower brain volume, and unemployment.

Risk and Prognostic Factors of Depressive Disorder Due to Another Medical Condition

The differential diagnosis for depressive disorder due to another medical condition includes depressive disorders not attributable to a medical condition, substance/medication-induced depressive disorder, delirium or major or mild neurocognitive disorder, adjustment disorder, and demoralization. These alternatives are distinguished by the timing, context, and likely cause of the depressive symptoms.

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