Why Isn’t Depression Being Detected in People with Chronic Illness?

Chronic illnesses present a host of issues for individuals, families, communities, and society. They require lengthy and costly treatment regimens and can be physically and emotionally draining. The financial burden a chronic illness can put on a social network can be exorbitant. But the emotional toll of living with a chronic illness can be even more significant. People who live with a chronic illness or disability have undoubtedly experienced drastic changes in their qualities of life. They may no longer be able to support themselves financially and may require a caregiver to assist with physical activities as well. Add to that the limited mobility or physical pain that can accompany chronic illness, and conditions are ripe for a rapid deterioration of mental well-being. Addressing the psychological problems that can result from being chronically ill is paramount. Not only does psychological health improve overall physical health, but positive mental health can also increase medication adherence and other treatments necessary to combat the chronic illness, thus prolonging and improving life.

Recently, some communities have developed ways to identify which chronically ill individuals also have mental health problems, specifically depression. However, it is unknown how accurate these assessments are. To explore this issue further, Christopher Burton of the Centre for Population Health Sciences at the University of Edinburgh in the UK recently analyzed data from over 67,000 newly diagnosed cardiac and diabetic patients. The participants were evaluated for depression within the first four weeks of diagnoses in an effort to recognize those in need of mental health services.

After researching the data, Burton found that although the number of depression diagnoses increased, they did not do so dramatically. Also, only a small percentage of those receiving diagnoses for depression went on to get treatment. Untreated depression can result in poor mental and physical outcomes. Burton believes that perhaps receiving both diagnoses within one month minimizes the impact of the depression diagnosis, making the treatment of it less urgent when compared to the treatment of the chronic illness. Regardless, Burton believes that financial investments in these types of assessments may not be paying off in mental health outcomes. He said, “Given these findings we recommend careful consideration before further extension of screening for depression in patients with chronic illness.” Burton hopes that future work looks into more effective ways to identify and encourage treatment of depression in individuals with chronic illness.

Reference:
Burton, C., C. Simpson, and N. Anderson. Diagnosis and treatment of depression following routine screening in patients with coronary heart disease or diabetes: A database cohort study. Psychological Medicine 43.3 (2013): 529-37. ProQuest Research Library. Web. 3 Feb. 2013.

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  • Simon

    Simon

    February 12th, 2013 at 11:12 AM

    My thoughts on this are that with someone who is living with a chronic illness, wouldn’t you think that many physicians and family members just simply expect the person to be depressed? They don’t necessarily see this as a separate issue going on with this person, just something that is a byproduct of being chronically ill. I think that this is a real shame for many patientrs because there are many whose quality of life could be massively improved even just by treating them for the depression that they are feeling. You may not be able to cure the illness that is a contributing factor, but it would be nice for them to have some happy days IN SPITE OF the illness that they are having to bear.

  • Charla

    Charla

    February 12th, 2013 at 4:45 PM

    It isn’t that it is not recognized but most doctors think that the ailment that they are treating is the one that is the most important piece of the puzzle to be treated. Therefore if the person does not have a regular mental health provider who is familiar with their case then there is a pretty good chance that their depression is going to go both unacknowledged, undiagnosed, and untreated.

  • doc john

    doc john

    February 13th, 2013 at 3:58 AM

    Those of us in the medical field sometimes have a little more tunnel vision than we would care to admit. we become so focused on dealing with the primary symptoms that we fail to look beyond those and see that there are sometimes other, and quite frankly, more manageable symptoms that we could be addressing as well. We have to do a better job of improving many aspects of our patients’ lives, and not just focus on their primary concern. There is more to life and a good life than strong physical health. There has to be a dedication to improving the mental health of our patient population as well, and sadly this has been ignored for too long in far too many segments of society.

  • Glenda

    Glenda

    February 13th, 2013 at 3:02 PM

    Anybody receiving a diagnosis for a significant disorder should check to see if they are depressed soon after.It should be the norm and not the exception.It is never easy to come to terms with a news like that and diagnosis and possible treatment would do a world of good.

  • Joseph G

    Joseph G

    February 14th, 2013 at 3:56 AM

    There are a lot of good and compassionate doctors in practice. It is not that these doctors do not see that there is depression and sadness there. It is simply that for many of them, they have watched their patients deteriorate and they do not want to be the one to have to add another diagnosis, something else to fret about to the plate. I think that most in that position feel that they are doing the kinder thing by treating them for the terminal illness because in truth much of this just goes along with being sick and at the end of life. I think that we are not giving enough credit to some very good people by stating that may of them are not looking at the whole picture. As a matter of fact I think that most of them are but they are trying to add as little bad news to the otherwise dismal prognosis as possible.

  • Sonia

    Sonia

    February 17th, 2013 at 5:53 AM

    You never know sometimes if this is someone who is seriously depressed too or if the depression or lethargy could be coming from all of the other medications that they could be taking concurrently.

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