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Cited by 1,071Treatment of Major DepressionBipolar Disorder and TreatmentMental Health Treatment and Access

Mood disorders in the medically ill: scientific review and recommendations

Evans, Dwight L., Charney, Dennis S., Lewis, Lydia, Golden, Robert N., Gorman, Jack M., Krishnan, K. Ranga Rama, Nemeroff, Charles B., Bremner, J. Douglas +36 more·2005·Biological Psychiatry
DOI 10.1016/j.biopsych.2005.05.001
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Abstract

Objective The purpose of this review is to assess the relationship between mood disorders and development, course, and associated morbidity and mortality of selected medical illnesses, review evidence for treatment, and determine needs in clinical practice and research.Data sources Data were culled from the 2002 Depression and Bipolar Support Alliance Conference proceedings and a literature review addressing prevalence, risk factors, diagnosis, and treatment. This review also considered the experience of primary and specialty care providers, policy analysts, and patient advocates. The review and recommendations reflect the expert opinion of the authors.Study selection/data extraction Reviews of epidemiology and mechanistic studies were included, as were open-label and randomized, controlled trials on treatment of depression in patients with medical comorbidities. Data on study design, population, and results were extracted for review of evidence that includes tables of prevalence and pharmacological treatment. The effect of depression and bipolar disorder on selected medical comorbidities was assessed, and recommendations for practice, research, and policy were developed.Conclusions A growing body of evidence suggests that biological mechanisms underlie a bidirectional link between mood disorders and many medical illnesses. In addition, there is evidence to suggest that mood disorders affect the course of medical illnesses. Further prospective studies are warranted.

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  • Comorbidity of medical and psychiatric conditions adversely impacts quality of life and prognosis and is associated with shortened life expectancy.

    “Notably, the causal relationship between medical and psychiatric conditions may well be bidirectional; and their comorbidity adversely impacts quality of life and prognosis and is associated with shortened life expectancy [5].”

    From One-day acceptance and commitment training workshops in medical populations (2015) · cites this paper as [5]

  • The causal relationship between medical and psychiatric conditions may well be bidirectional.

    “Notably, the causal relationship between medical and psychiatric conditions may well be bidirectional; and their comorbidity adversely impacts quality of life and prognosis and is associated with shortened life expectancy [5].”

    From One-day acceptance and commitment training workshops in medical populations (2015) · cites this paper as [5]

  • Depression heightens risks for morbidity and mortality from chronic diseases associated with aging, including autoimmune, metabolic, and cardiovascular conditions.

    “Additionally, depression heightens risks for morbidity and mortality from chronic diseases associated with aging, including autoimmune, metabolic, and cardiovascular conditions (2).”

    From Clustering of depression and inflammation in adolescents previously exposed to childhood adversity (2012) · cites this paper as [2]

  • The particular medical illnesses that are more frequent in these psychiatric conditions are those more commonly seen with advanced age, e.g., cardiovascular disease, stroke, dementia, cancer, obesity, type II diabetes mellitus, and osteoporosis.

    “The particular medical illnesses that are more frequent in these psychiatric conditions are those that are more commonly seen with advanced age, e.g., cardiovascular disease (CVD), stroke, dementia, cancer, obesity, type II diabetes mellitus, osteoporosis (Evans et al., 2005).”

    From Psychiatric disorders and leukocyte telomere length: Underlying mechanisms linking mental illness with cellular aging (2015) · cites this paper as Evans et al., 2005

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Authors
Evans, D. L., Charney, D. S., Lewis, L., Golden, R. N., Gorman, J. M., Krishnan, K. R. R., Nemeroff, C. B., Bremner, J. D., Carney, R. M., Coyne, J. C., Delong, M. R., Frasure-Smith, N., Glassman, A. H., Gold, P. W., Grant, I., Gwyther, L., Ironson, G., Johnson, R. L., Kanner, A. M., Katon, W. J., Kaufmann, P. G., Keefe, F. J., Ketter, T., Laughren, T. P., Leserman, J., Lyketsos, C. G., McDonald, W. M., McEwen, B. S., Miller, A. H., Musselman, D., O’Connor, C., Petitto, J. M., Pollock, B. G., Robinson, R. G., Roose, S. P., Rowland, J., Sheline, Y., Sheps, D. S., Simon, G., Spiegel, D., Stunkard, A., Sunderland, T., Tibbits, P., & Valvo, W. J.
Affiliations
  • University of Pennsylvania (US)
  • Washington University in St. Louis (US)
  • University of North Carolina at Chapel Hill (US)
  • Icahn School of Medicine at Mount Sinai (US)
  • Duke University (US)
  • Emory University (US)
  • Columbia University (US)
  • National Institutes of Health (US)
  • University of California San Diego (US)
  • University of Miami (US)
  • Rutgers, The State University of New Jersey (US)
  • Rush University Medical Center (US)
  • University of Washington (US)
  • Stanford University (US)
  • United States Food and Drug Administration (US)
  • Johns Hopkins University (US)
  • Rockefeller University (US)
  • University of Florida (US)
  • University of Pittsburgh (US)
  • University of Iowa (US)
  • Group Health Cooperative (US)
  • American Diabetes Association (US)
Corresponding author
Evans, Dwight L.
ORCID
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2005-08
Volume
58
Issue
3
Pages
175-189
ISSN
0006-3223 (ISSN-L)
DOI
10.1016/j.biopsych.2005.05.001
OpenAlex
W2033028677
Cited by
1,071
References
293
Citations by year
2026: 18 · 2025: 25 · 2024: 30 · 2023: 32 · 2022: 36 · 2021: 41 · 2020: 44 · 2019: 37 · 2018: 51 · 2017: 42 · 2016: 62 · 2015: 72 · 2014: 63 · 2013: 71 · 2012: 64
FWCI
36.71
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
mood disorders, depression, bipolar disorder, comorbidities, morbidity and mortality, prevalence, risk factors, diagnosis, pharmacotherapy, primary care, health policy
MeSH terms
Acquired Immunodeficiency Syndrome, Brain Diseases, Cerebrovascular Disorders, Delivery of Health Care, Humans, Neoplasms, Obesity, Osteoporosis, Pain, Comorbidity, Prevalence, Practice Guidelines as Topic, Mood Disorders, Diabetes Complications

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