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1 - Depression in the medically ill

from Part 1 - Introduction to depression and its determinants

Published online by Cambridge University Press:  17 September 2009

By
Francis Creed  and
Chris Dickens
Edited by
Andrew Steptoe
Francis Creed
Affiliation:
Department of Psychiatry, University of Manchester, Manchester, UK
Chris Dickens
Affiliation:
Department of Psychiatry, University of Manchester, Manchester, UK
Andrew Steptoe
Affiliation:
University College London
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Summary

Introduction

Psychiatric disorders of all types are more common in people with physical illness compared with the general population. Depression is the most common disorder, accounting for approximately 50% of psychopathology in the medically ill, with the remainder made up of various anxiety disorders and mixed subsyndromal symptoms of anxiety and depression. The importance of depression in the medically ill lies in its adverse effect on outcome, most notably health-related quality of life, combined with the fact that it is rarely detected and treated adequately in people who have physical illness.

The prevalence of depression in medically ill populations varies greatly according to the definition of depression and the type of measure used [1–4]. Variation in the definition and measuring instrument are the main reasons for the large variation in the prevalence figures quoted in the literature [5]. A higher prevalence of depression has been reported by studies that have used a self-administered questionnaire compared with those that used standardised research interviews administered by a trained interviewer [6]. The prevalence of depression also varies according to sociodemographic characteristics of the sample and the location of the survey (out-patient, in-patient, community) [3]. Only after all of these factors have been taken into account is it possible to assess whether the prevalence of depression varies according to type of medical disorder, its chronicity or severity [2, 3].

Keywords

cross-sectional studiesdepressionhealthcare costsphysical illnessquality of lifepopulation-based studiespsychiatric disorder
Type
Chapter
Information
Depression and Physical Illness , pp. 3 - 18
Publisher: Cambridge University Press
Print publication year: 2006

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References

Meakin, C. J., Screening for depression in the medically ill: the future of paper and pencil tests. Br. J. Psychiatry 160 (1992), 212–16.Google Scholar
Rodin, G., Voshart, K., Depression in the medically ill: an overview. Am. J. Psychiatry 143 (1986), 696–705.Google Scholar
Mayou, R., Hawton, K., Psychiatric disorder in the general hospital. Br. J. Psychiatry 149 (1986), 172–90.Google Scholar
McDaniel, J. S., Musselman, D. L., Porter, M. R., Reed, D. A., Nemeroff, C. B., Depression in patients with cancer: diagnosis, biology, and treatment. Arch. Gen. Psychiatry 52 (1995), 89–99.Google Scholar
F. H. Creed, Assessing depression in the context of physical illness. In Robinson, M. M., Katon, C. L. E., Depression and Physical Illness, ed. (Chichester: John Wiley & Sons, 1997), pp. 3–19.
Creed, F., Psychological disorders in rheumatoid arthritis: a growing consensus?Ann. Rheum. Dis. 49 (1990), 808–12.Google Scholar
Martucci, M., Balestrieri, M., Bisoffi, G., et al., Evaluating psychiatric morbidity in a general hospital: a two-phase epidemiological survey. Psychol. Med. 29 (1999), 823–32.Google Scholar
Gainotti, G., Azzoni, A., Marra, C., Frequency, phenomenology and anatomical-clinical correlates of major post-stroke depression. Br. J. Psychiatry 175 (1999), 163–7.Google Scholar
Creed, F., Morgan, R., Fiddler, M., et al., Depression and anxiety impair health-related quality of life and are associated with increased costs in general medical inpatients. Psychosomatics 43 (2002), 302–9.Google Scholar
Bridges, K. W., Goldberg, D. P., The validation of the GHQ-28 and the use of the MMSE in neurological in-patients. Br. J. Psychiatry 148 (1986), 548–53.Google Scholar
House, A., Knapp, P., Bamford, J., Vail, A., Mortality at 12 and 24 months after stroke may be associated with depressive symptoms at 1 month. Stroke 32 (2001), 696–701.Google Scholar
House, A., Mood disorders in the physically ill: problems of definition and measurement. J. Psychosom. Res 32 (1988), 345–53.Google Scholar
Dunn, G., Pickles, A., Tansella, M., Vazquez-Barquero, J. L., Two-phase epidemiological surveys in psychiatric research. Br. J. Psychiatry 174 (1999), 95–100.Google Scholar
Solomon, A., Haaga, D. A., Arnow, B. A., Is clinical depression distinct from subthreshold depressive symptoms? A review of the continuity issue in depression research. J. Nerv. Ment. Dis. 189 (2001), 498–506.Google Scholar
Rucci, P., Gherardi, S., Tansella, M., et al., Subthreshold psychiatric disorders in primary care: prevalence and associated characteristics. J. Affect. Dis. 76 (2003), 171–81.Google Scholar
Wells, K. B., Golding, J. M., Burnam, M. A., Psychiatric disorder in a sample of the general population with and without chronic medical conditions. Am. J. Psychiatry 145 (1988), 976–81.Google Scholar
Pincus, T., Callahan, L. F., Bradley, L. A., Vaughn, W. K., Wolfe, F., Elevated MMPI scores for hypochondriasis, depression, and hysteria in patients with rheumatoid arthritis reflect disease rather than psychological status. Arth. Rheum. 29 (1986), 1456–66.Google Scholar
Endicott, J., Measurement of depression in patients with cancer. Cancer 53 (1984), 2243–9.Google Scholar
Wesley, A. L., Gatchel, R. J., Garofalo, J. P., Polatin, P. B., Toward more accurate use of the Beck Depression Inventory with chronic back pain patients. Clin. J. Pain 15 (1999), 117–21.Google Scholar
Holm, J. E., Penzien, D. B., Holroyd, K. A., Brown, T. A., Headache and depression: confounding effects of transdiagnostic symptoms. Headache 34 (1994), 418–23.Google Scholar
Lustman, P. J., Clouse, R. E., Griffith, L. S., Carney, R. M., Freedland, K. E., Screening for depression in diabetes using the Beck Depression Inventory. Psychosom. Med. 59 (1997), 24–31.Google Scholar
Aikens, J. E., Reinecke, M. A., Pliskin, N. H., et al., Assessing depressive symptoms in multiple sclerosis: is it necessary to omit items from the original Beck Depression Inventory?J. Behav. Med. 22 (1999), 127–42.Google Scholar
Zigmond, A. S., Snaith, R. P., The hospital anxiety and depression scale. Acta Psychiatr. Scand. 67 (1983), 361–70.Google Scholar
Lyons, J. S., Strain, J. J., Hammer, J. S., Ackerman, A. D., Fulop, G., Reliability, validity, and temporal stability of the geriatric depression scale in hospitalized elderly. Int. J. Psychiatr. Med. 19 (1989), 203–9.Google Scholar
Incalzi, R. A., Cesari, M., Pedone, C., Carbonin, P. U., Construct validity of the 15-item geriatric depression scale in older medical inpatients. J. Geriatr. Psychiatr. Neurol. 16 (2003), 23–8.Google Scholar
Herrmann, C., International experiences with the Hospital Anxiety and Depression Scale: a review of validation data and clinical results. J. Psychosom. Res. 42 (1997), 17–41.Google Scholar
Bjelland, I., Dahl, A. A., Haug, T. T., Neckelmann, D., The validity of the Hospital Anxiety and Depression Scale: an updated literature review. J. Psychosom. Res. 52 (2002), 69–77.Google Scholar
Johnston, M., Pollard, B., Hennessey, P., Construct validation of the hospital anxiety and depression scale with clinical populations. J. Psychosom. Res. 48 (2000), 579–84.Google Scholar
World Health Organization. Schedules for Clinical Assessment in Neuropsychiatry. Washington, DC: American Psychiatric Press, 1994.
Arolt, V., Fein, A., Driessen, M., Dorlochter, L., Maintz, C., Depression and social functioning in general hospital in-patients. J. Psychosom. Res. 45 (1998), 117–26.Google Scholar
Feldman, E., Mayou, R., Hawton, K., Ardern, M., Smith, E. B., Psychiatric disorder in medical in-patients. Q. J. Med. 63 (1987), 405–12.Google Scholar
Silverstone, P. H., Prevalence of psychiatric disorders in medical inpatients. J. Nerv. Ment. Dis. 184 (1996), 43–51.Google Scholar
Nair, M. G., Pillay, S. S., Psychiatric disorder in a South African general hospital: prevalence in medical, surgical, and gynecological wards. Gen. Hosp. Psychiatry 19 (1997), 144–8.Google Scholar
Silverstone, P. H., Lemay, T., Elliott, J., Hsu, V., Starko, R., The prevalence of major depressive disorder and low self-esteem in medical inpatients. Can. J. Psychiatry 41 (1996), 67–74.Google Scholar
Katon, W., Ciechanowski, P., Impact of major depression on chronic medical illness. J. Psychosom. Res. 53 (2002), 859–63.Google Scholar
Carson, A. J., Ringbauer, B., MacKenzie, L., Warlow, C., Sharpe, M., Neurological disease, emotional disorder, and disability: they are related – a study of 300 consecutive new referrals to a neurology outpatient department. J. Neurol. Neurosurg. Psychiatry 68 (2000), 202–6.Google Scholar
Lowe, B., Grafe, K., Zipfel, S., et al., Diagnosing ICD-10 depressive episodes: superior criterion validity of the Patient Health Questionnaire. Psychother. Psychosom. 73 (2004), 386–90.Google Scholar
Kisely, S., Goldberg, D., Simon, G., A comparison between somatic symptoms with and without clear organic cause: results of an international study. Psychol. Med. 27 (1997), 1011–19.Google Scholar
Üstün, T. B., Sartorius, N., Mental Illness in General Health Care. An International Study. Chichester: John Wiley & Sons 1995.
Harrison, J., Barrow, S., Gask, L., Creed, F., Social determinants of GHQ score by postal survey. J. Public. Health. Med. 21 (1999), 283–8.Google Scholar
Neeleman, J., Ormel, J., Bijl, R. V., The distribution of psychiatric and somatic III health: associations with personality and socioeconomic status. Psychosom. Med. 63 (2001), 239–47.Google Scholar
Hansen, M. S., Fink, P., Frydenberg, M., et al., Mental disorders among internal medical inpatients: prevalence, detection, and treatment status. J. Psychosom. Res. 50 (2001), 199–204.Google Scholar
Livingston, G., Watkin, V., Milne, B., Manela, M. V., Katona, C., Who becomes depressed? The Islington community study of older people. J. Affect. Dis. 58 (2000), 125–33.Google Scholar
Finlay-Jones, R., Brown, G. W., Types of stressful life event and the onset of anxiety and depressive disorders. Psychol. Med. 11 (1981), 803–15.Google Scholar
Murphy, E., Social origins of depression in old age. Br. J. Psychiatry 141 (1982), 135–42.Google Scholar
Cole, M. G., Bellavance, F., Mansour, A., Prognosis of depression in elderly community and primary care populations: a systematic review and meta-analysis. Am. J. Psychiatry 156 (1999), 1182–9.Google Scholar
Patten, S. B., Long-term medical conditions and major depression in a Canadian population study at waves 1 and 2. J. Affect. Dis. 63 (2001), 35–41.Google Scholar
Hotopf, M., Mayou, R., Wadsworth, M., Wessely, S., Temporal relationships between physical symptoms and psychiatric disorder: results from a national birth cohort. Br. J. Psychiatry 173 (1998), 255–61.Google Scholar
Murphy, E., Brown, G. W., Life events, psychiatric disturbance and physical illness. Br. J. Psychiatry 136 (1980), 326–38.Google Scholar
Hemingway, H., Marmot, M., Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. Br. Med. J. 318 (1999), 1460–67.Google Scholar
Dickens, C. M., Percival, C., McGowan, L., et al., The risk factors for depression in first myocardial infarction patients. Psychol. Med. 34 (2004), 1083–92.Google Scholar
Lloyd, G. G., Cawley, R. H., Distress or illness? A study of psychological symptoms after myocardial infarction. Br. J. Psychiatry 142 (1983), 120–25.Google Scholar
Kessler, R. C., Ormel, J., Demler, O., Stang, P. E., Comorbid mental disorders account for the role impairment of commonly occurring chronic physical disorders: results from the National Comorbidity Survey. J. Occup. Environ. Med. 45 (2003), 1257–66.Google Scholar
Druss, B. G., Rosenheck, R. A., Sledge, W. H., Health and disability costs of depressive illness in a major US corporation. Am. J. Psychiatry 157 (2000), 1274–8.Google Scholar
Ware, J. E. Jr, Sherbourne, C. D., The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med. Care 30 (1992), 473–83.Google Scholar
McHorney, C. A., Ware, J. E. Jr, Raczek, A. E., The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med. Care 31 (1993), 247–63.Google Scholar
Ware, J. E. Jr, Kosinski, M., Bayliss, M. S., et al., Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med. Care 33 (1995), AS264–79.Google Scholar
Surtees, P. G., Wainwright, N. W., Khaw, K. T., Day, N. E., Functional health status, chronic medical conditions and disorders of mood. Br. J. Psychiatry 183 (2003), 299–303.Google Scholar
Creed, F., Ratcliffe, J., Fernandez, L., et al., Health-related quality of life and health care costs in severe, refractory irritable bowel syndrome. Ann. Intern. Med. 134 (2001), 860–68.Google Scholar
Guthrie, E., Jackson, J., Shaffer, J., et al., Psychological disorder and severity of inflammatory bowel disease predict health-related quality of life in ulcerative colitis and Crohn's disease. Am. J. Gastroenterol. 97 (2002), 1994–9.Google Scholar
Herrmann, C., Brand-Driehorst, S., Kaminsky, B., et al., Diagnostic groups and depressed mood as predictors of 22-month mortality in medical inpatients. Psychosom. Med. 60 (1998), 570–77.Google Scholar
Williams, L. S., Ghose, S. S., Swindle, R. W., Depression and other mental health diagnoses increase mortality risk after ischemic stroke. Am. J. Psychiatry 161 (2004), 1090–95.Google Scholar
Barsky, A. J., Wyshak, G., Klerman, G. L., Medical and psychiatric determinants of outpatient medical utilization. Med. Care 24 (1986), 548–60.Google Scholar
Simon, G. E., VonKorff, M., Barlow, W., Health care costs of primary care patients with recognized depression. Arch. Gen. Psychiatry 52 (1995), 850–56.Google Scholar
Hemert, A. M., Hengeveld, M. W., Bolk, J. H., Rooijmans, H. G., Vandenbroucke, J. P., Psychiatric disorders in relation to medical illness among patients of a general medical out-patient clinic. Psychol. Med. 23 (1993), 167–73.Google Scholar
Nimnuan, C., Hotopf, M., Wessely, S., Medically unexplained symptoms: an epidemiological study in seven specialities. J. Psychosom. Res. 51 (2001), 361–7.Google Scholar
Feder, A., Olfson, M., Gameroff, M., et al., Medically unexplained symptoms in an urban general medicine practice. Psychosomatics 42 (2001), 261–8.Google Scholar
Kooiman, C. G., Bolk, J. H., Brand, R., Trijsburg, R. W., Rooijmans, H. G., Is alexithymia a risk factor for unexplained physical symptoms in general medical outpatients?Psychosom. Med. 62 (2000), 768–78.Google Scholar
Strik, J. J., Honig, A., Lousberg, R., Denollet, J., Sensitivity and specificity of observer and self-report questionnaires in major and minor depression following myocardial infarction. Psychosomatics 42 (2001), 423–8.Google Scholar
Escobar, J. I., Gara, M., Silver, R. C., Waitzkin, H., Holman, A., Compton, W., Somatisation disorder in primary care. Br. J. Psychiatry 173 (1998), 262–6.Google Scholar
Escobar, J. I., Waitzkin, H., Silver, R. C., Gara, M., Holman, A., Abridged somatization: a study in primary care. Psychosom. Med. 60 (1998), 466–72.Google Scholar

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  • Depression in the medically ill
    • By Francis Creed, Department of Psychiatry, University of Manchester, Manchester, UK, Chris Dickens, Department of Psychiatry, University of Manchester, Manchester, UK
  • Edited by Andrew Steptoe, University College London
  • Book: Depression and Physical Illness
  • Online publication: 17 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544293.002
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  • Depression in the medically ill
    • By Francis Creed, Department of Psychiatry, University of Manchester, Manchester, UK, Chris Dickens, Department of Psychiatry, University of Manchester, Manchester, UK
  • Edited by Andrew Steptoe, University College London
  • Book: Depression and Physical Illness
  • Online publication: 17 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544293.002
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Depression in the medically ill
    • By Francis Creed, Department of Psychiatry, University of Manchester, Manchester, UK, Chris Dickens, Department of Psychiatry, University of Manchester, Manchester, UK
  • Edited by Andrew Steptoe, University College London
  • Book: Depression and Physical Illness
  • Online publication: 17 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544293.002
Available formats
×