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Treating depression in the medically ill.
Psychiatr Clin North Am. 2007 Mar; 30(1):77-90.PC

Abstract

Depression frequently is comorbid with a variety of medical illnesses; individuals who have such comorbidities may have increased morbidity and lower functional status. Usual antidepressant treatments can be effective in depressed patients who have comorbid medical illness. These patients, however, experience lower rates of recovery and remission of depressive symptoms and higher rates of relapse during follow-up than seen in patients who have MDD with no medical comorbidity. Comorbid medical illness therefore is a marker of treatment resistance in MDD. Collaborative treatments combining antidepressants, psychotherapy, education, and case management may be effective and could overcome the risk of treatment resistance. Two clinical strategies seem warranted in light of the studies presented here: (1) an increased index of suspicion for depression in medically ill patients, and (2) more intensive antidepressant treatment in depressed patients who have medical comorbidity.

Authors+Show Affiliations

Depression Clinical and Research Program, Massachusetts General Hospital, 50 Staniford Street, Suite 401, Boston, MA 02114, USA. diosifescu@partners.org

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

17362805

Citation

Iosifescu, Dan V.. "Treating Depression in the Medically Ill." The Psychiatric Clinics of North America, vol. 30, no. 1, 2007, pp. 77-90.
Iosifescu DV. Treating depression in the medically ill. Psychiatr Clin North Am. 2007;30(1):77-90.
Iosifescu, D. V. (2007). Treating depression in the medically ill. The Psychiatric Clinics of North America, 30(1), 77-90.
Iosifescu DV. Treating Depression in the Medically Ill. Psychiatr Clin North Am. 2007;30(1):77-90. PubMed PMID: 17362805.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treating depression in the medically ill. A1 - Iosifescu,Dan V, PY - 2007/3/17/pubmed PY - 2007/5/26/medline PY - 2007/3/17/entrez SP - 77 EP - 90 JF - The Psychiatric clinics of North America JO - Psychiatr. Clin. North Am. VL - 30 IS - 1 N2 - Depression frequently is comorbid with a variety of medical illnesses; individuals who have such comorbidities may have increased morbidity and lower functional status. Usual antidepressant treatments can be effective in depressed patients who have comorbid medical illness. These patients, however, experience lower rates of recovery and remission of depressive symptoms and higher rates of relapse during follow-up than seen in patients who have MDD with no medical comorbidity. Comorbid medical illness therefore is a marker of treatment resistance in MDD. Collaborative treatments combining antidepressants, psychotherapy, education, and case management may be effective and could overcome the risk of treatment resistance. Two clinical strategies seem warranted in light of the studies presented here: (1) an increased index of suspicion for depression in medically ill patients, and (2) more intensive antidepressant treatment in depressed patients who have medical comorbidity. SN - 0193-953X UR - https://www.unboundmedicine.com/medline/citation/17362805/Treating_depression_in_the_medically_ill_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0193-953X(06)00110-9 DB - PRIME DP - Unbound Medicine ER -