In many cases the severity of certain medical conditions make them the primary and initial focus of intervention, however, as one begins to explore the research and studies surrounding this topic it becomes clear that mental and physical health issues often overlap.
The Research Behind Comorbidity
Depression is a commonly identified alongside a variety of medical conditions. Edege (2007) conducted a meta-analysis of studies of depression in patients with chronic medical disorders. By combining several studies, Edege was able to clearly show how frequently these chronic health conditions occur with depression.
The 12-month prevalence and age/sex-adjusted odds of major depression by chronic condi-tions were as follows:
|Endstage renal disease||17.0%||3.56|
|Chronic obstructive pulmonary disease||15.4%||3.21|
|Stroke or cerebrovascular accident||11.4%||3.15|
|Coronary artery disease||9.3%||2.30|
|Any chronic condition||8.8%||2.61|
|Congestive heart failure||7.9%||1.96|
The co-occurrence of depression with these chronic medical conditions notably affected the everyday lives and overall ability to function of the patients with comorbid depression more than those who were only affected by the medical condition. Ambulatory visits, emergency room visits, and functional disability were all significantly increased for those who had comorbid depression.
Edege concludes that the “12-month prevalence and odds of major depression are high in individuals with chronic medical conditions, and major depression is associated with significant increases in utilization, lost productivity, and functional disability” (2007). Additionally, the increased utilization of the health care system also increases the financial burden on all parties involved. Ultimately, the study highlights the importance of assessing chronically ill patients for depression.
Psychological factors often go undetected in the care of patients with chronic health conditions, even though they can significantly interfere with a patient’s response to treatment. Globally assessing for depression, anxiety, and other mental health conditions is an effective way of identifying issues that may interfere with medical care and meeting evidence-based medical treatment guidelines.
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Egede, L. E. (2007). Major depression and chronic medical conditions: Prevalence, correlates and association with health resource utilization, lost productivity and functional disability. General Hospital Psychiatry, Vol 29(5), Sept-Oct, 409-416. doi: http://dx.doi.org/10.1016/j.gen-hosppsych.2007.06.002