Prevalence, Pathogenesis, and Diagnosis of Depressive Disorders in the Medically Ill

Depressive disorders are among the most frequent conditions seen in primary care. Although figures vary, a large international study recently found median prevalence rates of more than 10% in primary care settings. Among patients suffering from a medical illness, the rates are higher—between 22% and 33% for medical inpatients overall, with varying rates for specific illnesses. . However, the prevalence rates of depression reported in association with specific illnesses varies widely, due largely to a number of problems that pervade the literature in this area, including disagreement about what constitutes a depressive disorder in the medically ill, lack of validated assessment measures for use in medically ill populations, sociodemographic heterogeneity in the populations examined, and lack of appropriate control groups. The chapter discuses the issues of the prevalence, pathogenesis and diagnosis of depression in patients with medical illness.