Relationship of depression to medical illness: A critical review

doi:10.1016/0165-0327(81)90036-7

Journal of Affective Disorders

Volume 3, Issue 2, June 1981, Pages 111-121

https://doi.org/10.1016/0165-0327(81)90036-7 Get rights and content

Abstract

The relationship between medical illness and depression is critically reviewed. Evidence for an association exists but is based on relatively few studies of adequate research design. Data suggest the period prevalence of depressive syndrome in medically ill patients is around 18% for the severely medically ill. An etiology relationship has not established. The incidence of diseases in the medical subspecialities of endocrinology, neurology, cardiology, gastroenterology, and rheumatology appears to be increased in patients with depression. A causal relationship has been suggested in the first four.

References (30)

J. Brim et al.
Primary and secondary affective disorder
Comp. Psychiat.
(1980)
C.F. Herridge
Physical disorders in psychiatric illness — A study of 209 consecutive admissions
Lancet
(1960)
J.J. Schwab et al.
A study of the somatic symptomatology of depression in medical inpatients
Psychosom
(1965)
D. Wood et al.
Primary and secondary affective disorder, Part 1 (Past social history and current episodes in 92 depressed inpatients)
Comp. Psychiat.
(1977)
R.A. Woodruff et al.
The natural history of affective disorders, Part 1 (Symptoms of 72 patients at the time of index hospital admission)
J. Psychiat. Res.
(1967)
H.S. Akiskal et al.
Differentiation of primary affective illness from situational, symptomatic and secondary depression
Arch. Gen. Psychiat.
(1979)
American Psychiatric Association
Diagnostic and Statistical Manual of Mental Disorders
(1968)
American Psychiatric Association
Diagnostic and Statistical Manual of Mental Disorders
(1980)
N.C. Andreasen et al.
Secondary depression — Familial, clinical and research perspectives
Amer. J. Psychiat.
(1979)
A.T. Beck
Measuring depression — The depression inventory

A.T. Beck

How to use the Beck Depression Inventory

D.W. Davies

Physical illness in psychiatric outpatients

Brit. J. Psychiat.

(1965)

J.P. Feighner et al.

Diagnostic criteria for use in psychiatric research

Arch. Gen. Psychiat.

(1972)

R.M. Glass et al.

Psychiatric screening in a medical clinic — An evaluation of a self-report inventory

Arch. Gen. Psychiat.

(1978)

S.B. Guze et al.

Secondary affective disorder — A study of 95 cases (Preliminary communication)

Psychol. Med.

(1971)

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Citation Excerpt :
The level of functional impairment presented by specific disease processes should also be investigated. For example, previous research has demonstrated the significant impact of disability on negative affective states (Berkman, Berkman, Kasl, Freeman, et al., 1986; Turner & Noh, 1988; Kathol & Petty, 1981; Neff, Husaini, & McCorkel, 1980), and disability has been linked to many forms of crime and deviance (Li & Moore, 2001; Moore, Greer, & Li, 1994). Further, anger is a key emotion identified by GST linking strain and criminal offending (Agnew, 1992), but unfortunately the WCF data do not include measures of anger.
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^∗: Fellow Associate in Psychiatry and Internal Medicine.

^∗∗: Fellow in Psychiatry.

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Relationship of depression to medical illness: A critical review

Abstract

Comp. Psychiat.

Lancet

Psychosom

Comp. Psychiat.

J. Psychiat. Res.

Differentiation of primary affective illness from situational, symptomatic and secondary depression

Arch. Gen. Psychiat.

Diagnostic and Statistical Manual of Mental Disorders

Diagnostic and Statistical Manual of Mental Disorders

Secondary depression — Familial, clinical and research perspectives

Amer. J. Psychiat.

Measuring depression — The depression inventory

How to use the Beck Depression Inventory

Physical illness in psychiatric outpatients

Brit. J. Psychiat.

Diagnostic criteria for use in psychiatric research

Arch. Gen. Psychiat.

Psychiatric screening in a medical clinic — An evaluation of a self-report inventory

Arch. Gen. Psychiat.

Secondary affective disorder — A study of 95 cases (Preliminary communication)

Psychol. Med.