Many with chronic illnesses have depression too

  • Deborah Condon

The cost of treating a person with a chronic medical illness, such as heart disease or diabetes, jumps by around 50% if that person is also suffering from depression, doctors have warned.

According to Dr Neelam Afzal and Dr Omer Shareef of the Kerry Mental Health Services, depression is thought to be ‘extremely prevalent' with comorbid (additional) medical conditions. In other words, many people with chronic illnesses also have depression.

This is thought to be more common among older patients and/or those in hospital. When depression is present, this ‘presents a complex challenge to physicians, and if left untreated, may lead to the exacerbation of the underlying medical condition', the doctors noted.

For example, depression is very common in patients with heart-related problems. In fact, studies indicate that two in three people who suffer a heart attack develop depression as a result, with up to one in five of these suffering major depressive disorder.

"Depression affects cardiac patients' ability to comply with overall treatment, follow-up with cardiac rehabilitation and make long-term lifestyle changes," the doctors noted.

Meanwhile, patients with diabetes are two to three times more likely to suffer with depression compared to those without the condition.

Among these patients, depression is associated with ‘more diabetes-related medical complications, a higher risk of heart disease, stroke and increased utilisation of healthcare services', the doctors explained.

Depression is also commonly seen in people with other chronic illnesses, including arthritis and various neurological disorders, including Parkinson's disease and epilepsy.

The doctors pointed out that while managing depression in patients with chronic medical illnesses is a ‘complex task that requires specialist expertise, treatment has been shown to improve the general wellbeing of the patients and may well be associated with cost savings'.

In such cases, both physical and emotional symptoms need to be dealt with by a multidisciplinary team.

Antidepressant drugs ‘remain the most readily available treatment of major depressive disorders', while cognitive behaviour therapy ‘is considered a first-line treatment in mild depressive episodes'.

The doctors, who are both senior registrars in psychiatry, said further studies are needed to develop ‘consensus guidelines in this field and to ensure standardised approaches towards patient care'.

The doctors made their comments in World of Irish Nursing & Midwifery (WIN), the journal of the Irish Nurses and Midwives Organisation.

For more information on depression, see our Depression Clinic here

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