The Relationship Between Mental and Physical Health By Jane Collingwood

Mental and Physical Health People with depression often have worse physical health, as well as a worse idea of health, compared to those without depression. Patients with both depression and physical health problems are at particular risk: The physical problem can complicate the diagnosis of depression by masking its symptoms.

It can work the other way as well It can work the other way as well. People with any long term physical illnesses tend to feel more psychologically distressed compared to healthy people. Poor physical health brings an increased risk of depression, as do the social and relationship problems that are very common among patients with long term illness.

A 2009 study of patients with severe heart disease found that 1 in 5 of the participants had at least mild depression, defined as a score of 14 or more on the widely-used Beck Depression Inventory. 17% were taking antidepressants. The researchers say that for these patients, “depression is an independent determinant of health-related quality of life.”

Professor David Goldberg of the Institute of Psychiatry, London, UK, reports that the rate of depression in patients with a long term illness is almost three times higher than normal.

He states that “Depression among those with long term physical illnesses is likely to be missed by professionals who care for physically sick patients,” “This is because health professionals are more worried about the physical disorder which is usually the reason for the hospital appointment, and may not be aware of the depression that they are also experiencing.”

Depressive illness can also come about before a physical disease. It has been linked to coronary heart disease, stroke, colorectal cancer, back pain, irritable bowel syndrome, multiple sclerosis, and possibly type 2 diabetes. Professor Goldberg believes that untreated depression causes much needless suffering, whereas effective treatment can lower ill health, lengthen survival and increase quality of life.

Less severe depression may be helped by lifestyle advice on sleep and physical activity, adapted to any physical disabilities. Other treatments include cognitive-behavioural therapy, either as a self-help program, computer-based, or with a therapist in groups or individually.

A 2003 study found that the treatment of depression in arthritis patients led to improved arthritis-related pain intensity, less interference with daily activities due to arthritis, and better overall health status and quality of life.

Bibliography Moy, M. L. et al. Multivariate models of determinants of health-related quality of life in severe chronic obstructive pulmonary disease. The Journal of Rehabilitation Research and Development, Vol. 46, 2009, pp. 643-54. Goldberg D. The detection and treatment of depression in the physically ill. World Psychiatry, Vol. 9, February 2010, pp. 16-20. Lin, E. H. et al. Effect of improving depression care on pain and functional outcomes among older adults with arthritis: a randomized controlled trial. The Journal of the American Medical Association, Vol. 290, November 2003, pp. 2428-29.