الفهرس 
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Abstract
Depression has been known to present in different severities: mild,
moderate, severe and dysthymia.Research has revealed that there is a
category of unspecified depression which is quite prevalent in both
primary care clinics and psychiatric outpatient clinics.
The category of unspecified depression includes patients having less
than the five symptoms of depression for less than two weeks duration
and patients who complain of depressive symptoms,but do not complain
of depressed mood or anhedonia neverthless,these symptoms are enough
to impair one’s functional capacity (Kendler and Gardner, I998.)
Unspecified depression is found to be comparable in demographics
and clinical characteristics to specified depressive disorders. Unspecified
depression is found to be associated with family dysfunction as
compared to healthy subjects but with a lesser degree than specified
depression subjects. It appears that unipolar depression is presenting in
different degrees of severity along a spectrum.Unspecified depression
may be constructed as the mildest form along a spectrum followed by
dysthymia,then mild,moderate and severe depression, Judd et al,(1997).
Serious impairment can indeed result from even mild symptoms of
depression in absence of depressed mood or anhedonia.The high
prevalence of unspecified depression,the significant psychosocial
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impairment associated with it make unspecified depression a matter for
serious consideration by clinicians and researchers.
The research leading to the discovery of unspecified deprssion and
its establishment as a clinically significant illness may lead to a revised
concept of unipolar depression as ”a single illness” having various
degrees of symptomatology falling along a spectrum. Depressive
symptoms should not be necessarily viewed as static ,but
mobile,changing over the course of time.This revision in concept may
give rise to significant implication for treatment of specified
depression. Currently, researchers recognize that the goal of treatment
should be to reach a complete a symptomatic status as opposed to
reduction of symptoms to subsyndromal level. Otherwise,symptoms may
well recur, simply leading to specified deprssive disorder(Sadek ,N
&Bona J,2000) .
In summary we have demonstrated rates of unspecified depression
in Egyptian primary care clinics and in psychiatric outpatient clinics that
are comparable to those reported from western countries and Japan.Our
study was unique in the inclusion of both specified and unspecified
depressive disorders.
In addition,we have demonstrated that both the depressive disorders
result in significant functional impairment. A major concern is the lack
of specific diagnoses and appropriate therapy for these disorders in
primary care setting.Improved diagnoses and therapy, however,may not
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be forthcoming without a shift in cultural attitudes towards mental
illness.
Our findings can be summarized as follows:
(I) A large proportion of subjects from the general population manifest
depressive syndromes of sufficient severity to affect their personal
and family life, yet they do not meet conventional criteria for any of
specified depressive disorders.
(2) Unspecified depression constitutes a valid diagnostic subtype of
depressive disorder, evidence from clinical features, delimitation
from other conditions and social and personal dysfunctioning
demonstrates that unspecified depression cannot be distinguished
from specified depressive disorders, yet it is significantly distinct
from a normal control group.