Rates / Tarifs publicitaires
Definitions, New Treament Directions
Disease" and Beyond: Misdiagnosis, Antidepressant Use, and a Proposed
Definition for Bipolar Spectrum Disorder
S Nassir Ghaemi,
James Y Ko, Frederick K Goodwin
of Bipolar Disorder: Focus on Signal Transduction Pathways and the
Regulation of Gene Expression
Yarema Bezchlibnyk, L Trevor Young
and Its Association With Long-Term Medical Conditions
Lisa M Gagnon, Scott B Patten
Disorders: Relevance of Icelandic and Icelandic-Canadian Evidence
to Etiologic Hypotheses
Jóhann Axelsson, Jón G Stefànsson,
Andrés Magnússon, Helgi Sigvaldason, Mikael M Karlsson
Inpatient Religious Commitment: An Association With Mental Health
Marilyn Baetz, David B Larson, Gene Marcoux, Rudy
Bowen, Ron Griffin
Moderating Effects of Coping Strategies on Major Depression in the
JianLi Wang, Scott B Patten
Side Effects in Depression Patients Treated in A Naturalistic Setting:
A Study of Bupropion, Moclobemide, Paroxetine, Sertraline, and Venlafaxine
JD Vanderkooy, Sidney H Kennedy, R Michael Bagby
Delays for Involuntary Psychiatric Patients Associated With Reviews
of Treatment Capacity
Michelle Kelly, Sandra Dunbar, John E Gray, Richard
Letters to the Editor
Major Depression and Its Association With Long-Term Medical Conditions
Lisa M Gagnon, MSc, MD, Scott B Patten,
MD, FRCPC, PhD
Objective: To replicate previously reported
associations between major depressive episodes (MDEs) and long-term
medical conditions in a Canadian community sample.
Methods: A sample of 2542 household residents was selected
using random digit dialing (RDD). Data were collected by telephone
interview. The Composite International Diagnostic Interview (CIDI)-Short
Form for major depression (CIDI-SFMD) was used to identify MDEs
occurring in the previous 12 months. Long-term medical conditions
were identified by self-report.
Results: The prevalence of MDE was elevated in those subjects
who reported 1 or more long-term medical conditions. The association
was not due to confounding by age, sex, social support, or stressful
recent life events.
Conclusion: This study replicates a previously reported
association between depressive disorders and long-term medical conditions.
These cross-sectional associations suggest that medical conditions
may increase the risk of major depression or that major depression
may increase the risk of medical conditions. Alternatively, comorbid
medical conditions may influence the duration of depressive episodes,
or vice versa. These explanations are not mutually exclusive.
(Can J Psychiatry 2002;47:149152)
- Having 1 or more chronic medical conditions is associated
with an increased prevalence of major depression.
- Major depression does not appear to be associated with
- Comorbid medical conditions may cause, perpetuate, or
result from depression.
- The cross-sectional nature of the study limits its causal
- Major depression was measured using an abbreviated instrument
rather than a clinical assessment or a fully structured
research diagnostic interview.
- Evaluation of medical conditions was limited to self-report.
Key Words: mood disorders, major depressive disorder,
depressive disorder epidemiology, cross-sectional studies, comorbidity
: La dépression majeure en association avec les affections
médicales de longue durée
Clinical studies have reported associations between
depressive disorders and various medical conditions, such as heart
disease (1), stroke (2), celiac disease (3), epilepsy (4), and many
others. Only a few studies, however, have evaluated these associations
in community populations. Community studies are important because
clinical findings cannot always be generalized to nonclinical populations.
Two US community studies have examined the relation between depressive
disorders and long-term medical conditions (5,6). In each study,
an elevated prevalence was reported in subjects with 1 or more medical
conditions. However, neither study found that hypertension was associated
with major depression. Similar results were reported in an analysis
of data from the Canadian National Population Health Survey (NPHS):
there was a higher prevalence of major depression in subjects reporting
1 or more long-term medical conditions (7).
The objective of the current analysis was to replicate these findings
using an additional Canadian data source.
Data collection was part of a telephone survey
conducted in Calgary in 1998 and 1999. A description of the methods
employed in this survey has been published previously (8). Major
depression was evaluated using the Composite International Diagnostic
Interview-Short Form for Major Depression (CIDI-SFMD) (9). Information
about long-term medical conditions was collected by self-report
using the following questions: Do you have any long-term medical
conditions diagnosed by a health professional, not including mental
health problems? An optional statement in the interview script
clarified that a long-term condition is one that lasts, or is expected
to last, longer than 6 months.