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 

Causality (etiology) is the most important variable for diagnosis. 
Associated conditions include: 

- Autoimmune disorders like  systemic lupus erythematosus, and deficiencies of certain vitamins, such as vitamin B12
- Endocrine conditions like Cushing’s syndrome and hypothyroidism
- Focal lesions such as cerebrovascular accident (CVA), Traumatic brain injury (TBI), and neoplasm 
- Huntington’s disease
- Multiple sclerosis
- Parkinson’s disease

Associated Features of Depressive Disorder Due to Another Medical Condition

Sex differences in prevalence depend somewhat on the sex difference associated with the medical condition i.e. common conditions for men and women.

Prevalence of Depressive Disorder Due to Another Medical Condition

Other possible disorders that could be causing symptoms include:

- Depressive disorders not due to another medical condition

- Medication-induced depressive disorder

- Delirium and major or mild neurocognitive disorder

- Adjustment disorders

- Demoralization

Differential Diagnosis to 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

Depression is more likely to happen shortly after a CVA (stroke).
The location of the lesion in the brain is strongly linked to the risk of depression. Left frontal strokes pose the greatest risk, while right frontal lesions have the least risk. However, a lack of association  between the location of the brain lesion and the side of the brain it occurred on with depression that happens 2 to 6 months after a stroke suggests that later onset may be caused by different things, such as a major depressive disorder, adjustment disorder, or feeling demoralized.


Parkinson's disease and traumatic brain injury (TBI) can also increase the risk of depression.
In Parkinson's disease, early onset, severe motor symptoms, and longer disease duration are associated with depression.


In TBI, depression is more likely in women with prior history of depression, early psychiatric symptoms following the injury, lower brain volume, and unemployment.

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

Related Diagnostic Issues 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.

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