eMJA: Depression and physical illness: more complex than simple comorbidity

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Depression and physical illness: more complex than simple comorbidity

David M Clarke

MJA 2009; 190 (7): S52-S53

Depression alone is debilitating, and this effect is multiplied in people with physical illness

Depression is common when people have physical illness — every clinician knows that. And, as may be expected, the literature confirms that depression is worse with more severe disease, especially when there is poor social support and other adverse life situations.1 What has been freshly highlighted over recent years, however, is the enormous impact of depression. Depression alone produces a level of disability equivalent to any other chronic disease and, when combined with physical illness, this effect is multiplied.2 The recent World Health Organization World Health Surveys indicated that depression produced the greatest decrement in health of any chronic disease, and the comorbid state of depression incrementally worsened health more than any other disease combination.3 Depression also increases consumption of health care resources; depression was associated with a 17%–46% increase in health costs in the large WHO LIDO study.4

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