Medical co-morbidity in depressive disorders.

Background: Depression is much more prevalent among those with chronic medical conditions compared to the general population of the United States. Depression is recognized as a cause of increased morbidity and mortality and has been associated with higher health care costs, adverse health behaviors, significant functional impairment, lost work productivity, occupational disability and increased health care utilization.

Method: Searches of Medline, OVIDMedline, PubMed and PsycINFO of all English-language articles published between 1966 and 2007 were conducted using the keywords mood disorders, medical comorbidity, depression, antidepressant therapy. Supplemental references were manually extracted from relevant articles and chapters. Reviews of mechanistic studies and open label and randomized controlled trials of depression in patients with medical co morbidities were reviewed.

Results: Depressive disorders are prevalent among the medically ill and the relationship between depression and medical illness may be bidirectional. Antidepressant medications are effective in the treatment of depression in the medically ill.

Conclusions: Depressive disorders can adversely impact the course of medical illnesses. Available antidepressant treatments are effective for the treatment of depression in the medically ill. Early identification and treatment of depression in medical illness can positively influence medical outcomes and quality of life.