Clinically significant depressive disorder

Hypertension - Clinically significant depressive disorder Factor

This factor only applies for reasonable hypothesis cases.

Meaning of depressive disorder

The 'Hypertension' Statement of Principle (SOP) specifies "any depressive disorder attracting a diagnosis under DSM IV…". This can be taken to include the following diagnoses (ICD codes as shown):

• depression - major depressive disorder - one episode only (296.2)
• depression - major depressive disorder - more than one episode (296.3)
• anxiety - depression (300.4)
• depression - reactive / neurotic / with anxiety (300.4)
• dysthymia (300.4)
• neurotic depression (300.4)
• substance induced mood disorder with depressive features (292.84)
• mood disorder due to a general medical condition with depressive features (293.83)
• depressive psychosis - one episode only (296.2)
• depressive psychosis - more than one episode (296.3)
• atypical depressive disorder (296.82)
• depressive type psychosis (298.0)
• depression - not otherwise specified (311)

All these diagnoses are covered by the Repatriation Medical Authority (RMA) SOP definition of depressive disorder.  A diagnosis of a depressive disorder would need to have been made by a psychiatrist and the report conform with the Repatriation Commission Guidelines for Psychiatric Compensation Claims.

Clinically significant

The Hypertension SOP requires the depressive disorder to be clinically significant for at least the six months immediately prior to the clinical onset or worsening of hypertension.  The RMA has defined clinically significant as "sufficient to warrant ongoing management by a psychiatrist, counsellor or General Practitioner".

Generally it would be expected that if a depressive disorder warranted treatment then treatment would be sought. However, where treatment was not sought, a person's depressive disorder might still meet the definition of "clinically significant" if there was persuasive and professional evidence, based on a comprehensive clinical history, that ongoing management had been warranted.

Last reviewed for CCPS 12 March 2008.

Investigative Documents

Preliminary questions [33321]

25246 the veteran has had depressive disorder at some time.

39978 depressive disorder means a major depressive episode, recurrent major depressive disorder, dysthymic disorder, depressive disorder not otherwise specified, substance-induced mood disorder with depressive features, or mood disorder due to a general medical condition with depressive features, or with major depressive-like episodes.

25248 the veteran's identified illness or injury was clinically significant.

33322 the veteran has established the causal connection between the depressive disorder and operational service for hypertension.

33323 the veteran's identified illness or injury was clinically significant for the six months immediately before the clinical onset of hypertension.

33324 the veteran has established the causal connection between the depressive disorder and operational service for the clinical onset of hypertension.

or

7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335 the condition under consideration permanently worsened.

33325 the veteran's identified illness or injury was clinically significant for the six months immediately before the clinical worsening of hypertension.

33326 the veteran has established the causal connection between the depressive disorder and operational service for the clinical worsening of hypertension.

Clinical onset and operational service [33324]

25253 the identified illness or injury, which was clinically significant, is causally related to operational service.

Clinical worsening and operational service [33326]

25253 the identified illness or injury, which was clinically significant, is causally related to operational service.

33327 the clinical onset of hypertension occurred prior to that part of operational service to which the identified illness or injury, which was clinically significant, is causally related.