When two disorders or illnesses occur in the same person, simultaneously or sequentially, they are described as either comorbid or co-occurring. People with co-occurring physical and mental conditions represent a significant portion of the population. Comorbidity is associated with elevated symptom burden, functional impairment, decreased length and quality of life and increased costs. Collaborative, integrated care models that use a multidisciplinary team have been shown to provide effective treatment for co-occurring mental and physical health conditions.
Why Depression and Medical Illnesses Often Occur Together
- Medical disorders may contribute biologically to depression.
- Medically ill people may become clinically depressed as a psychological reaction to the prognosis, the pain and/or incapacity caused by the illness or its treatment.
- Though occurring together, depression and a general medical disorder may be unrelated.
Heart Disease and Depression
- Depression occurs in 40 to 65 percent of patients who have experienced a heart attack.
- After a heart attack, patients with clinical depression have a three to four times greater chance of death within the next six months.
Stroke and Depression
- Depression occurs in 10 to 27 percent of stroke survivors
- An additional 15-40 percent of stroke survivors experience some symptoms of depression within two months after the stroke
Cancer and Depression
- One in four people with cancer also suffer from clinical depression.
- Depression is sometimes mistaken as a side effect of corticosteroids or chemotherapy, both treatments for cancer.
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- People with adult onset diabetes have a 25 percent chance of having depression.
- Depression also affects as many as 70 percent of patients with diabetic complications.
Common Symptoms of Depression and Other Medical Disorders
- Weight loss, sleep disturbances, and low energy may occur in people with diabetes, thyroid disorders, some neurological disorders, heart disease, cancer and stroke –and also are common symptoms of depression.
- Apathy, poor concentration and memory loss can occur in individuals with Parkinson’s disease and Alzheimer’s disease – and also are common symptoms of depression.
- Medications for high blood pressure, Parkinson’s disease, and other medical problems can produce side effects similar to the symptoms of depression.
Importance of Treatment
- People who get treatment for co-occurring depression often experience an improvement in their overall medical condition, better compliance with general medical care and a better quality of life.
- More than 80 percent of people with depression can be treated successfully with medication, psychotherapy or a combination of both.
- Early diagnosis and treatment can reduce patient discomfort and morbidity, and can also reduce the costs associated with misdiagnosis, and the risks and costs associated with suicide.