- Depression is a common, serious, and costly illness that affects
1 in 10 adults in the United States each year; costs the nation between
$30 billion to $44 billion annually; and causes impairment, suffering,
and disruption of personal, family, and work life.
- Though 80 percent
of depressed people can be effectively treated, two-thirds of those suffering
from this illness do not seek or receive appropriate treatment.
- Of
particular significance, Depression often Co-occurs with Medical, Psychiatric,
and Substance Abuse Disorders. When this happens, the presence of both
illnesses is frequently unrecognized and may lead to serious and unnecessary
consequences for patients and families.
Depression Co-occurs with Medical Illnesses
- The rate of Major Depression among those with medical illnesses
is significant. In primary care, estimates range from 5 to 10 percent;
among medical inpatients, the rate is 10 to 14 percent.
- Depressed
feelings can be a common reaction to many medical illnesses. However, Depression
severe enough to receive a psychiatric diagnosis is not the expected reaction
to medical illness. For that reason, when present, specific treatment should
be considered for Clinical Depression even in the presence of another disorder.
Research has shown that Major Depression occurs in the
following:
- Between 40 and 65 percent of patients who have had a heart
attack. They may also have a shorter life expectancy than non-depressed heart
attack patients.
- Approximately 25 percent of Cancer patients.
- Between 10 and 27 percent
of post-Stroke patients.
Failure to recognize and treat Co-occurring Depression
may result in increased impairment and diminished improvement in the medical
disorder.
Proper diagnosis and treatment of Co-occurring Depression
may bring substantial benefits to the patient through improved medical status,
enhanced quality of life, a reduction in the degree of pain and disability,
and improved treatment compliance and cooperation.
Depression Co-occurs with Psychiatric Disorders
A higher than average Co-occurrence of Depression with other psychiatric
disorders, such as Anxiety and Eating Disorders, has been documented.
- Concurrent Depression is present in 13 percent of patients with Panic
Disorder. In about 25 percent of these patients, the Panic Disorder preceded
the Depressive Disorder.
- Between 50 and 75 percent of eating disorder patients
(Anorexia Nervosa and Bulimia) have a lifetime history of Major Depressive
Disorder.
In such cases, detection of Depression can help clarify the initial diagnosis
and may result in more effective treatment and better outcome for the patient.
Depression Co-occurs with Substance Abuse Disorders
Substance Abuse Disorders (both alcohol and other substances) frequently
co-exist with Depression.
- Substance Abuse Disorders are present in 32 percent of individuals with
Depressive Disorders. They co-occur in 27 percent of those with Major Depression
and 56 percent of those with Bipolar Disorder.
Substance use must be discontinued in order to clarify the diagnoses and
maximize the effectiveness of psychiatric interventions. Treatment for Depression
as a separate condition is necessary if the Depression remains after the
substance use problem is ended.
Action Steps
- Do Not Ignore Symptoms! Health care professionals should be
aware of the possibility of Depression
Co-occurring with Medical Illnesses.
Individuals or family members with concerns about the Co-occurrence
of Depression should discuss these issues with the physician. A consultation
with a psychiatrist or other mental health clinician may be recommended
to clarify the diagnosis.
- Get The Word Out! NAMI IOWA emphasizes the importance of (1)
professional and public awareness of the co-occurrence of Depression with
medical, psychiatric, or substance abuse disorders; and (2) proper diagnosis
and treatment of Depression.
Information provided by National Institute of Mental Health
If you or someone you know would like more information on
mental illness or wish to request an educational presentation, please contact:
NAMI IOWA (Alliance for the Mentally Ill
of Iowa)
5911 Meredith Drive Suite E
Des Moines IA 50322-1903
Phone: (515) 254-0417 or (800) 417-0417 IOWA ONLY
Fax: (515) 254-1103
Email: info@namiiowa.com
