Diabetes and depression in general practice: meeting the challenge of managing comorbidity

Chew-Graham, Carolyn; Sartorius, Norman; Cimino, Larry C; Gask, Linda

Abstract

BACKGROUND
One of the greatest challenges facing medicine in the 21st century is comorbidity, where two or more diseases occur together in the same individual. The World Health Organization estimates that two-thirds of people >55 years of age with a chronic disorder have more than one illness at the same time. Comorbidity of depression and anxiety disorders with physical illness is particularly frequent. Lifetime prevalence of depression is between 2% and 15%, and growing; and people with chronic physical illness or long-term conditions (LTCs) are two to three times more likely to suffer from depression than people without physical health problems. This leads to significantly greater reductions in health status.1 In addition, people are likely to have multimorbidity, with several LTCs, which increases complexity of management.2

There are numerous interactions between depression and LTCs (Box 1). It is suggested that up to 30% of patients with diabetes also have depression, with over half of these patients reaching diagnostic criteria for major depression.

Box 1.
Possible interactions between depression and long-term conditions
People with physical illness:

are at high risk for depressive disorders; and

may have symptoms of depression or anxiety.

Depressive disorders may:

be a risk factor for physical illness;

amplify the symptoms of physical illness; and

adversely affect the trajectory of physical illness or increase the probability of complications of physical illnesses.

Patients with depression may present with a variety of symptoms, for which current medicine finds no organic cause. The more numerous such symptoms, the more probable is the diagnosis of depression.

Citation

Chew-Graham, C., Sartorius, N., Cimino, L. C., & Gask, L. (2014). Diabetes and depression in general practice: meeting the challenge of managing comorbidity. British Journal of General Practice (BJGP), 64(625), 386-387. https://doi.org/10.3399/bjgp14x680809

• Journal Article Type: Editorial
• Online Publication Date: Jul 28, 2014
• Publication Date: 2014-08
• Deposit Date: Nov 22, 2023
• Journal: British Journal of General Practice
• Print ISSN: 0960-1643
• Electronic ISSN: 1478-5242
• Publisher: Royal College of General Practitioners
• Peer Reviewed: Peer Reviewed
• Volume: 64
• Issue: 625
• Pages: 386-387
• DOI: https://doi.org/10.3399/bjgp14x680809
• Keywords: Family Practice
• Public URL: https://keele-repository.worktribe.com/output/643732
• Publisher URL: https://bjgp.org/content/64/625/386