Abstract
Major depression is the most common psychiatric disorder that occurs in a number of neurological diseases. Symptoms and signs of major depression are sometimes inherent to the neurological disease, sometimes depression appears first, followed by a neurological disorder.
The diagnosis and treatment of major depression has to be timely to prevent more severe and difficult to manage course of the neurological disease. Early recognition of depressive symptoms and its appropriate treatment significantly improve patients' quality of life.
Underlying mechanisms of major depression are still unknown. Interactions between many risk factors, such as biological, psychological, social and environmental are involved.
The main clinical symptoms of major depression include persistent feeling of sadness, lack of interest in outside stimuli and slow psychomotor speed. Differential diagnostics have to exclude dementia and depressive syndrome induced by psychoactive substances and drugs.
An acute depressive syndrome is known as a depressive phase and can be moderate or severe. Antidepressants and psychotherapy are the main treatment modalities for major depression.
Therapeutic effect on the main symptoms of major depression is usually observed within 6-8 weeks after starting treatment. Major depression associated with stroke, multiple sclerosis, chronic pain, migraine, epilepsy and Parkinson's disease is discussed in detail, including currently recommended medical treatments.