Mood disorders in the medically ill: Scientific review and recommendations

Dwight L. Evans, Dennis S. Charney, Lydia Lewis, Robert N. Golden, Jack M. Gorman, K. Ranga Rama Krishnan, Charles B. Nemeroff, J. Douglas Bremner, Robert M. Carney, James C. Coyne, Mahlon R. Delong, Nancy Frasure-Smith, Alexander H. Glassman, Philip W. Gold, Igor Grant, Lisa Gwyther, Gail Ironson, Robert L. Johnson, Andres M. Kanner, Wayne J. KatonPeter G. Kaufmann, Francis J. Keefe, Terence Ketter, Thomas P. Laughren, Jane Leserman, Constantine G. Lyketsos, William M. McDonald, Bruce S. McEwen, Andrew H. Miller, Dominique Musselman, Christopher O'Connor, John M. Petitto, Bruce G. Pollock, Robert G. Robinson, Steven P. Roose, Julia Rowland, Yvette Sheline, David S. Sheps, Gregory Simon, David Spiegel, Albert Stunkard, Trey Sunderland, Paul Tibbits, William J. Valvo

Research output: Contribution to journalReview articlepeer-review

751 Scopus citations


Objective: The purpose of this review is to assess the relationship between mood disorders and development, course, and associated morbidity and mortality of selected medical illnesses, review evidence for treatment, and determine needs in clinical practice and research. Data Sources: Data were culled from the 2002 Depression and Bipolar Support Alliance Conference proceedings and a literature review addressing prevalence, risk factors, diagnosis, and treatment. This review also considered the experience of primary and specialty care providers, policy analysts, and patient advocates. The review and recommendations reflect the expert opinion of the authors. Study Selection/Data Extraction: Reviews of epidemiology and mechanistic studies were included, as were open-label and randomized, controlled trials on treatment of depression in patients with medical comorbidities. Data on study design, population, and results were extracted for review of evidence that includes tables of prevalence and pharmacological treatment. The effect of depression and bipolar disorder on selected medical comorbidities was assessed, and recommendations for practice, research, and policy were developed. Conclusions: A growing body of evidence suggests that biological mechanisms underlie a bidirectional link between mood disorders and many medical illnesses. In addition, there is evidence to suggest that mood disorders affect the course of medical illnesses. Further prospective studies are warranted.

Original languageEnglish
Pages (from-to)175-189
Number of pages15
JournalBiological Psychiatry
Issue number3
StatePublished - 1 Aug 2005


  • Antidepressant therapy
  • Depression
  • Medical comorbidity
  • Mood disorders


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