comprehensive assessment of multiple factor s is necessary to make this judgment. Al-
though there are no infallible guidelines  for determining whether the relationship
between the mood disturbance and the general medical condition is etiological, several
considerations provide some guidance in this area. One consideration is the presence of a
temporal association between th e onset, exacerbation, or remission of the general medical
condition and that of the mood disturbance. A second consideration is the presence of fea-
tures that are atypical of prim ary Mood Disorders (e.g., atypic al age at onset or course or
absence of family history). Evidence from the literature that suggests th at there can be a di-
rect association between the general medical condition in question and the development
of mood symptoms can provide a useful contex t in the assessment of a particular situation.
Associated Features Supporting Diagnosis
Etiology (i.e., a causal relationship to anothe r medical condition based on best clinical ev-
idence) is the key variable in depressive di sorder due to another medical condition. The
listing of the medical conditions that are said to be able to in duce major depression is never
complete, and the clinician’s best judg ment is the essence of this diagnosis.
There are clear associations, as well as some neuroanatomical correlates, of depression
with stroke, Huntington’s dise ase, Parkinson’s disease, and traumatic brain injury. Among
the neuroendocrine conditions most closely associated with  depression are Cushing’s dis-
ease and hypothyroidism. There are numerous other conditions thought to be associated
with depression, such as multiple sclerosis.  However, the literature’s support for a causal
association is greater with some conditions , such as Parkinson’s disease and Huntington’s
disease, than with others, for which the differ ential diagnosis may be  adjustment disorder,
with depressed mood.