Relationship between depression and other medical illnesses.

Depression occurring in the setting of a nonpsychiatric medical illness is often considered to be a psychological reaction. Clinicians attribute the patient's feelings of vulnerability, fear, and diminished self-esteem to the onset of a severe illness. However, recent data have forced reconsideration of this belief and new models of the relationship between depression and other medical illnesses have emerged. Compelling evidence suggests that depression is an independent risk factor that contributes to the development of ischemic heart disease (IHD) and increases cardiac mortality. However, abandoning the concept of depression as a reaction to illness seems premature as the relationship between depression and other illnesses is complex and may vary. This article will discuss different models of interaction between depression and other illnesses using patients with IHD, cerebrovascular disease, and erectile dysfunction (ED) as illustrations.