Comorbidity of Depression with Physical Disorders: Research and Clinical Implications

Abstract

Depression is prevalent in patients with physical disorders, particularly in those with severe disorders such as cancer, stroke, and acute coronary syndrome. Depression has an adverse impact on the courses of these diseases that includes poor quality of life, more functional impairments, and a higher mortality rate. Patients with physical disorders are at higher risk of depression. This is particularly true for patients with genetic and epigenetic predictors, environmental vulnerabilities such as past depression, higher disability, and stressful life events. Such patients should be monitored closely. To appropriately manage depression in these patients, comprehensive and integrative care that includes antidepressant treatment (with considerations for adverse effects and drug interactions), treatment of the physical disorder, and collaborative care that consists of disease education, cognitive reframing, and modification of coping style should be provided. The objective of the present review was to present and summarize the prevalence, risk factors, clinical correlates, current pathophysiological aspects including genetics, and treatments for depression comorbid with physical disorders. In particular, we tried to focus on severe physical disorders with high mortality rates, such as cancer, stroke, and acute coronary syndrome, which are highly comorbid with depression. This review will enhance our current understanding of the association between depression and serious medical conditions, which will allow clinicians to develop more advanced and personalized treatment options for these patients in routine clinical practice.

Illness burden and physical outcomes associated with collaborative care in patients with comorbid depressive disorder in chronic medical conditions: A systematic review and meta-analysis

“…This comorbidity can easily lead to disability, such as in the workplace [18,19], and high health care costs [20]. In such cases of comorbidity, the treatment response is often less favourable for both the chronic medical condition [21] and the mental disorder [22][23][24]. Research has shown that CC is effective, as compared to CAU, in improving depressive and anxiety disorders [25][26][27][28][29][30][31][32][33], and the National Institute for Health and Care Excellence (NICE) guidelines on depression recommend CC as the treatment of choice in the case of concomitant chronic medical disorders [34].…”

Patient and Practitioner Perspectives on Culturally Centered Integrated Care to Address Health Disparities in Primary Care

“…41 Integrated models of primary and mental health care are designed to enhance acceptability and availability of mental health services and enable collaborative care to address both physical and mental health needs.…”

A Study on Knowledge, Attitude and Practices of Emergency Physicians in Management of Patients with Mental Health Disorders in the City of Hyderabad, India

“…The government of India estimates, in its MH policy, that 2 out of 10 Indians are likely to suffer from some form of mental illness by the year 2020 (2). Depression has been linked to common conditions that present to the Emergency Department (ED) such as cardio-vascular illnesses, stroke, COPD, diabetes, chronic kidney disease, and cancer (3)(4)(5)(6)(7)(8)(9). As such, the prevalence of depression was found to be higher in ED patients when compared to the general population (10).…”