The impact of anxiety and mood disorders on physical disease: The worried not-so-well

Abstract

Depression and anxiety can adversely affect the course of chronic physical illnesses, increasing morbidity and mortality. The literature during the past year is reviewed for gastrointestinal disorders, cancer, pain, heart disease, diabetes, and pulmonary disease. Causes for this relationship are behavioral and biological. Behavioral factors in patients with depressive and anxiety disorders include unhealthy lifestyle choices, disrupted sleep, and poor adherence to medical regimens. Biological mechanisms include increased inflammatory response and disruption of the hypothalamic-pituitary-adrenal axis.

The spectrum of worry in the community-dwelling elderly

“…Older adults are higher in emotional control and mood stability (Mather & Carstensen, 2005;Phillips, Henry, Hosie, & Milne, 2006), and there is evidence that ageing is associated with an intrinsic reduction in susceptibility to both anxiety and depression (Jorm, 2000), and that older adults have a greater tolerance of uncertainty and less belief in the functional value of worrying compared to younger adults (Basevitz, Pushkar, Chaikelson, Conway, & Dalton, 2008). The decline may also reflect a survivorship effect; worry has been associated in some studies with increased mortality (Carpeggiani et al, 2005;Lavretsky et al, 2003;Sobel & Markov, 2005;Strik, Denollet, Lousberg, & Honig, 2003). The cross-sectional nature of our study does not allow us to test these associations.…”

Impact of depression and social support on nonadherence to antipsychotic drugs in persons with schizophrenia in Thailand

“…Moreover, because positive beliefs in the benefits of treatment are important for adherence, pessimistic thoughts about the illness and loss of faith in treatment which are commonly found in depressed persons11 may lead to nonadherence. Evidence of depression affecting nonadherence has been found in other illnesses, including infectious disease, diabetes, heart disease, and osteoporosis 22–25. Because persons with schizophrenia already suffer from negative symptoms, the impact of depression on reducing motivation, which associates with nonadherence,26 might be stronger than in other patient groups 15…”

Mokken scaling analysis of the Hospital Anxiety and Depression Scale in individuals with cardiovascular disease

“…According to several reviews (2, 3) and a recent meta-analysis (4), the presence of depression and/or anxiety disorders is linked with increased incidence of recurrent cardiac events, sudden death and poorer prognoses in individuals with CVD. Within the context of CVD, physical ailments inhibit functioning which can lead to anxiety and depression, which can in turn lead to the worsening of CVD (2). Furthermore, such symptoms are generally uncorrelated with disease indices, highlighting their importance as an issue to be considered in addition to the physical ailment (5).…”

“…Anxiety and depression are more predictive of functional impairment in individuals with medical conditions, such as CVD, than the severity of the physical ailment itself: the severity of the anxiety/depression is indicative of the severity of the risk to the individual (2).…”