Depression and associated physical diseases and symptoms
- PMID: 16889110
- PMCID: PMC3181771
- DOI: 10.31887/DCNS.2006.8.2/mgoodwin
Depression and associated physical diseases and symptoms
Abstract
Depression can occur in association with virtually all the other psychiatric and physical diagnoses. Physical illness increases the risk of developing severe depressive illness. There are two broadly different mechanisms. The most obvious has a psychological or cognitive mechanism. Thus, the illness may provide the life event or chronic difficulty that triggers a depressive episode in a vulnerable individual. Secondly, more specific associations appear to exist between depression and particular physical disorders. These may turn out to be of particular etiological interest. The best examples are probably stroke and cardiovascular disease. Finally, major depression, but especially minor depression, dysthymia, and depressive symptoms merge with other manifestations of human distress with which patients present to their doctors. Such somatic presentations test the conventional distinction between physical and mental disorder and are a perennial source of controversy.
La depresión puede asociarse con virtualmente todos los otros diagnósticos físicos y psiquiátricos. La enfermedad física aumenta el riesgo de desarrollar una enfermedad depresiva grave. En términos generales existen dos mecanismos diferentes. El más obvio tiene un mecanismo psicológico o cog-nitivo. De esta manera, la enfermedad puede constituir en sí misma el acontecimiento de vida o traducirse en una dificultad crónica que gatilla un episodio depresivo en un individuo vulnerable. En segundo lugar, parecen existir asociaciones más específicas entre la depresión y ciertos trastornos físicos. Estas pueden resultar de especial interés etiológico. Los mejores ejemplos son probablemente el accidente vascular cerebral y la enfermedad cardiovascular. Finalmente, la depresión mayor, pero especialmente la depresión menor, la distimia y los síntomas depresivos aparecen junto con otras manifestaciones del distrés humano con el cual los pacientes se presentan a sus médicos. Dichas presentaciones somáticas prueban la distinción convencional entre trastorno físico y mental, y constituyen una fuente perenne de controversia.
En pratique, la dépression peut être concomitante de tous les autres troubles physiques et psychiatriques. Les troubles physiques augmentent le risque de développer une dépression sévère. Il existe deux sortes de mécanismes généralement différents. Le plus évident est un mécanisme psychologique ou cognitif. La maladie peut donc être à l'origine de l'événement de vie ou d'une difficulté chronique qui déclenche un épisode dépressif chez un individu vulnérable. Des associations plus spécifiques semblent exister secondairement entre la dépression et les troubles physiques particuliers. Ceci peut s'avérer d'un intérêt étiologique spécifique. Les accidents vasculaires cérébraux et la maladie cardiovasculaire en sont probablement le meilleur exemple. Finalement, la dépression majeure mais surtout la dépression mineure, la dysthymie et les symptômes dépressifs se fondent avec d'autres manifestations de souffrance humaine présentées aux médecins par leurs patients. Ces tableaux somatiques tentent de distinguer les troubles physiques et mentaux et sont une source éternelle de controverses.
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