ABSTRACT
Depression, anxiety and distress are common among people suffering from chronic physical illness, but the relationships are complex. There is evidence that depression and other negative emotional states are risk factors for the development of a variety of health outcomes, while serious illness also elicits psychological distress. Comorbid depression and distress are associated with poor outcomes in several chronic illnesses including coronary heart disease, diabetes, chronic obstructive pulmonary disease, some cancers, chronic pain and arthritis. The mechanisms linking depression and distress with illness include habitual lifestyle factors such as physical inactivity and smoking, poor treatment adherence, and biological processes including systemic inflammation, adrenocortical and autonomic dysregulation. Screening for depression and distress has been advocated. Treatments of psychological conditions may improve quality of life and emotional state in people with serious illnesses. The evidence for effects of interventions targeting depression and distress on the course of chronic illness is equivocal.
