Cited by 965Psychosomatic Disorders and Their TreatmentsCardiac Health and Mental HealthAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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The association of depression and anxiety with medical symptom burden in patients with chronic medical illness

Katon, Wayne, Lin, Elizabeth H.B., Kroenke, Kurt·2007·General Hospital Psychiatry

DOI 10.1016/j.genhosppsych.2006.11.005

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Abstract

Background Primary care patients with anxiety and depression often describe multiple physical symptoms, but no systematic review has studied the effect of anxiety and depressive comorbidity in patients with chronic medical illnesses.Methods MEDLINE databases were searched from 1966 through 2006 using the combined search terms diabetes, coronary artery disease (CAD), congestive heart failure (CHF), asthma, COPD, osteoarthritis (OA), rheumatoid arthritis (RA), with depression, anxiety and symptoms. Cross-sectional and longitudinal studies with >100 patients were included as were all randomized controlled trials that measure the impact of improving anxiety and depressive symptoms on medical symptom outcomes.Results Thirty-one studies involving 16,922 patients met our inclusion criteria. Patients with chronic medical illness and comorbid depression or anxiety compared to those with chronic medical illness alone reported significantly higher numbers of medical symptoms when controlling for severity of medical disorder. Across the four categories of common medical disorders examined (diabetes, pulmonary disease, heart disease, arthritis), somatic symptoms were at least as strongly associated with depression and anxiety as were objective physiologic measures. Two treatment studies also showed that improvement in depression outcome was associated with decreased somatic symptoms without improvement in physiologic measures.Conclusions Accurate diagnosis of comorbid depressive and anxiety disorders in patients with chronic medical illness is essential in understanding the cause and in optimizing the management of somatic symptom burden.

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Authors: Katon, W., Lin, E. H. B., & Kroenke, K.
Affiliations: University of Washington (US)
Group Health Cooperative (US)
Indiana University (US)
Corresponding author: Katon, Wayne
ORCID: Lin, Elizabeth H.B.
Kroenke, Kurt
Venue: General Hospital Psychiatry
Publisher: Elsevier BV
Published: 2007-03
Volume: 29
Issue: 2
Pages: 147-155
ISSN: 0163-8343 (ISSN-L)
DOI: 10.1016/j.genhosppsych.2006.11.005
OpenAlex: W2024439382
Cited by: 965
References: 89
Citations by year: 2026: 31 · 2025: 31 · 2024: 33 · 2023: 43 · 2022: 56 · 2021: 50 · 2020: 47 · 2019: 49 · 2018: 68 · 2017: 53 · 2016: 55 · 2015: 62 · 2014: 70 · 2013: 55 · 2012: 53
FWCI: 7.18
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: General Hospital Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
National Institute of Mental Health (K08MH069741, MH 071268, R01MH071268, MH069741, MH-067587, R01MH067587)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: depression, anxiety, chronic disease, somatic symptom burden, comorbidities, diabetes mellitus, coronary artery disease, congestive heart failure, asthma, chronic obstructive pulmonary disease, osteoarthritis, rheumatoid arthritis, primary care patients
MeSH terms: Adult, Anxiety, Chronic Disease, Depression, Female, Health Status, Humans, Male, Surveys and Questionnaires, Comorbidity, Cost of Illness

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The association of depression and anxiety with medical symptom burden in patients with chronic medical illness

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