Depressed People Have High Rates Of Physical Illness

Main Category: Depression
Also Included In: Psychology / Psychiatry
Article Date: 05 May 2008 - 3:00 PDT

email to a friend   printer friendly   view / write opinions

People with recurrent depression have high rates of many common physical illnesses, such as gastric ulcer, rhinitis/hay fever, osteoarthritis, thyroid disease, hypertension and asthma, a new study has found.

Published in the May 2008 issue of the British Journal of Psychiatry, the study compared 1546 people with recurrent depression with 884 psychiatrically healthy controls in terms of past treatment for 16 different physical disorders.

Since many medical disorders are related to obesity, the researchers also examined body mass index (BMI) in both groups.

It was found that 15 physical disorders were significantly more frequent in people with recurrent depression than in controls. However, when BMI, age and gender were taken into account, depression was found to predict 6 disorders - gastric ulcer, asthma, rhinitis, hypertension, thyroid disease and osteoarthritis.

For the remaining physical health problems - diabetes, epilepsy, hypercholesterolaemia (high blood fats), kidney disease, liver disease, heart attack, osteoporosis, rheumatoid arthritis and stroke - the difference between those with and without each disorder could be accounted for by BMI, age or gender.

Both men and women with recurrent depression had significantly higher BMIs than men and women in the control group.

Although the percentages of the two groups were similar in the overweight range, a greater proportion of people with depression were in the obese range, and substantially fewer were in the normal range, compared with controls.

Thus, around a quarter of the men and women with depression were obese, which increases their susceptibility to physical health problems. In this study, obesity was associated with an increase in self-reported rates of hypercholesterolaemia, type II diabetes and heart attack.

High rates of obesity may be caused by some antidepressant medications, or arise because people who are depressed take less exercise and/or 'comfort' eat. However, it is also possible that genetic factors may be involved.

Evidence from previous research, and from this study, lends some support to the hypothesis that there are shared causal factors between recurrent depression, obesity and certain physical disorders.

One possible explanation for this is the effect that stress, and stress hormones, have on the brain and body. For instance, high levels of the stress hormone cortisol may link both obesity and gastric ulcers with depression.

The researchers comment that inflammatory processes that activate stress hormones may also link depression with asthma, hay fever, osteoarthritis and hypertension. These are speculations, however, and need confirmation from further studies.

Although long neglected, the physical health of people with schizophrenia is starting to be addressed, particularly in relation to the weight gain caused by antipsychotic drugs. This study suggests that attention needs to be paid to the physical health needs of people with depression.

"Medical disorders in people with recurrent depression."
Farmer A. et al (2008)
British Journal of Psychiatry, 192, 5, pages 351-355.
Click here to view Abstract online

The Royal College of Psychiatrists

The Royal College of Psychiatrists is the professional and educational body for psychiatrists in the United Kingdom and the Republic of Ireland. We promote mental health by:

-- Setting standards and promoting excellence in mental health care
-- Improving understanding through research and education
-- Leading, representing, training and supporting psychiatrists
-- Working with patients, carers and their organisations

As well as running its membership examination (MRCPsych), and visiting and approving hospitals for training purposes, the College organises scientific and clinical conferences and lectures and continuing professional development activities. The College publishes books, reports and educational material for professionals and the general public. It also publishes the British Journal of Psychiatry, Psychiatric Bulletin and Advances in Psychiatric Treatment, all of which are now available on-line.

The Royal College of Psychiatrists has been in existence in some form since 1841. First as the "Association of Medical Officers of Asylums and Hospitals for the Insane" (later changed to the Medico Psychological Association) then, in 1926 receiving its Royal Charter to become the "Royal Medico Psychological Association, and finally, in 1971 receiving a Supplemental Charter to become the "Royal College of Psychiatrists" we know today.

www.rcpsych.ac.uk