This article assesses the course of depressive disorders in persons who have comorbid medical illness. The article reviews a series of randomized, controlled studies of antidepressant treatment in subjects who have major depressive disorder (MDD) and selected medical illnesses. It also reviews a series of studies that compare the outcome of antidepressant treatment in subjects who have MDD with and without comorbid medical illness. It reviews hypotheses on the mechanism of the interaction between medical illness and clinical response in MDD. It concludes with clinical strategies recommended in depressed subjects who have medical comorbidity.
aDepression Clinical and Research Program, Massachusetts General Hospital, 50 Staniford Street, Suite 401, Boston, MA 02114, USA
Massachusetts General Hospital, 50 Staniford Street, Suite 401, Boston, MA 02114.
Dr. Iosifescu has received research grant support from Aspect Medical Systems, Forest Laboratories, Janssen Pharmaceutica, NARSAD, and NIMH; he has been a consultant for Aspect Medical Systems, Forest Laboratories Inc., Gerson Lehrman Group, GlaxoSmithkline, and Pfizer Inc., and he has been a speaker for Eli Lilly & Company, Cephalon, Forest Laboratories Inc., Janssen Pharmaceutica, Organon Inc., and Pfizer Inc.
This work was supported by an NIMH K-23 Career Development Award (K23MH067111).
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