Treating Comorbid Depression Could Increase Adherence To medical illness
December 19, 2008 by rainier
Comorbid depression is the existence of a depressive disorder (i.e. major depression, dysthymia or adjustment disorder) along with a physical disease (infectious, cardiovascular diseases, neurological disorders, diabetes mellitus or cancer). It is neither a chance phenomenon nor a mere feeling of demoralization or sadness brought on by the hardships of a chronic illness. While the prevalence of major depression in the general population can go from an average 3% up to 10%, it is consistently higher in people affected by chronic disease .
Patients with comorbid depression are less likely to adhere to medical treatment or recommendations, and are at increased risk of disability and mortality.
For example, it has been shown that depressed patients are three times more likely not to comply with medical regimens than non-depressed patients; there is also evidence that depression predicts the incidence of heart disease. In the case of infectious diseases, non-adherence can lead to drug resistance, and this has profound public health implications concerning resistant infectious agents.
Illness-associated depression impairs quality of life and several aspects of the functioning of patients with chronic diseases; moreover, it results in higher health care utilization and costs. Clinical trials have consistently demonstrated the efficacy of antidepressant treatment in patients with comorbid depression and chronic medical illness. Such treatment improves their overall medical outcomes.
