Cited by 820Treatment of Major DepressionMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Epidemiology and treatment of depression in patients with chronic medical illness

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J. Katon, Wayne.·2011·Dialogues in Clinical Neuroscience

DOI 10.31887/dcns.2011.13.1/wkatonPMC PMC3181964

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Abstract

There is a bidirectional relationship between depression and chronic medical disorders. The adverse health risk behaviors and psychobiological changes associated with depression increase the risk for chronic medical disorders, and biological changes and complications associated with chronic medical disorders may precipitate depressive episodes. Comorbid depression is associated with increased medical symptom burden, functional impairment, medical costs, poor adherence to self-care regimens, and increased risk of morbidity and mortality in patients with chronic medical disorders. Depression may worsen the course of medical disorders because of its effect on proinflammatory factors, hypothalamic-pituitary axis, autonomic nervous system, and metabolic factors, in addition to being associated with a higher risk of obesity, sedentary lifestyle, smoking, and poor adherence to medical regimens. Both evidence-based psychotherapies and antidepressant medication are efficacious treatments for depression. Collaborative depression care has been shown to be an effective way to deliver these treatments to large primary care populations with depression and chronic medical illness.

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Figure 1. Bidirectional interaction between depression and chronic medical disorders. Reproduced from ref 14: Katon WJ. Clinical and health services relationships between major depression, depressive symptoms, and general medical illness Biol Psychiatry. 2003;54:216-226. Copyright © Elsevier, 2003CC BY-NC-ND · PubMed Central

Figure 2. Relationship of depression and diabetes complications to 10 diabetes symptoms. Reproduced from ref 60: Ludman EJ, Katon W, Russo J, et al. Depression and diabetes symptom burden. Gen Hosp Psychiatry. 2004;26:430-436. Copyright © Elsevier 2004CC BY-NC-ND · PubMed Central

Figure 3. Psychophysiologic effects of depression. HPA, hypothalamicpituitary-adrena Adapted from ref 102: Champaneri S, Wand GS, Malhotra SS, Casagrande SS, Golden SH. Biological basis of depression in adults with diabetes. Curr Diab Rep. 2010;10:396-405. Copyright © Current Science 2010CC BY-NC-ND · PubMed Central

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Authors: J. Katon, W.
Affiliations: Professor and Vice-Chair, Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
Venue: Dialogues in Clinical Neuroscience
Publisher: Informa UK Limited
Published: 2011-03-31
Volume: 13
Issue: 1
Pages: 7-23
ISSN: 1294-8322 (ISSN-L)
1958-5969
DOI: 10.31887/dcns.2011.13.1/wkaton
PMC: PMC3181964
OpenAlex: W2121530613
Cited by: 820
References: 146
Citations by year: 2026: 38 · 2025: 60 · 2024: 58 · 2023: 63 · 2022: 72 · 2021: 75 · 2020: 57 · 2019: 62 · 2018: 55 · 2017: 64 · 2016: 56 · 2015: 43 · 2014: 46 · 2013: 35 · 2012: 26
FWCI: 26.71
Type: journal article
Language: en
Open access: diamond
doi.org
Licence: cc-by-nc-nd
creativecommons.org/licenses/by-nc-nd/3.0/ (vor)
Locations: Dialogues in Clinical Neuroscience (publishedVersion, cc-by-nc-nd)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (K08MH069741, K-24 MH069741)
Topics: Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: depression, chronic disease, comorbidities, bidirectional relationship, inflammation, hypothalamic-pituitary axis, autonomic nervous system, obesity, smoking, medication adherence, psychotherapy, antidepressants, collaborative care, primary care, functional disability, health care costs
MeSH terms: Chronic Disease, Depression, Diabetes Mellitus, Heart Diseases, Humans, Models, Biological, Physician-Patient Relations, Risk Factors, Self Care, Comorbidity

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