ABSTRACT
This chapter reviews the literature regarding the onset, course, and complications of depression in medically ill patients. Depression preceding physical illness may arise due to a number of mechanisms. Symptoms of depression that interfere with the quality of life include dysphoria, anhedonia, and agitation. In addition, depression itself may produce other adverse effects due to associated psychological, social, and behavioral impairment. The relationship may be coincidental when physical illness arises in a person with major depression, dysthymic disorder, or another mood disorder. The onset, diagnosis, or exacerbation of a life-threatening physical illness such as coronary artery disease or carcinoma may directly contribute to depression in some patients. In the physically ill, evaluating the course of depression is especially important in determining its clinical significance. It examines that the association of increased morbidity and depression in medical samples have found that depression is a likely result, rather than a cause, of poorer medical outcome.
