title: Mood disorders in the medically ill: scientific review and recommendations.
abstract: OBJECTIVE
  The purpose of this review is to assess the relationship between mood disorders and development, course, and associated morbidity and mortality of selected medical illnesses, review evidence for treatment, and determine needs in clinical practice and research.
  
  
  METHODS
  Data were culled from the 2002 Depression and Bipolar Support Alliance Conference proceedings and a literature review addressing prevalence, risk factors, diagnosis, and treatment. This review also considered the experience of primary and specialty care providers, policy analysts, and patient advocates. The review and recommendations reflect the expert opinion of the authors.
  
  
  METHODS
  Reviews of epidemiology and mechanistic studies were included, as were open-label and randomized, controlled trials on treatment of depression in patients with medical comorbidities. Data on study design, population, and results were extracted for review of evidence that includes tables of prevalence and pharmacological treatment. The effect of depression and bipolar disorder on selected medical comorbidities was assessed, and recommendations for practice, research, and policy were developed.
  
  
  CONCLUSIONS
  A growing body of evidence suggests that biological mechanisms underlie a bidirectional link between mood disorders and many medical illnesses. In addition, there is evidence to suggest that mood disorders affect the course of medical illnesses. Further prospective studies are warranted.
authors.affiliation: School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104, USA. psych@mail.med.upenn.edu
authors.forename: Dwight L
authors.initials: DL
authors.lastname: Evans
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Charney
authors.forename: Lydia
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authors.lastname: Lewis
authors.forename: Robert N
authors.initials: RN
authors.lastname: Golden
authors.forename: Jack M
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authors.lastname: Gorman
authors.forename: K Ranga Rama
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authors.lastname: Krishnan
authors.forename: Charles B
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authors.lastname: Nemeroff
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Bremner
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authors.forename: James C
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authors.lastname: Coyne
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authors.lastname: Frasure-Smith
authors.forename: Alexander H
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authors.lastname: Glassman
authors.forename: Philip W
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authors.forename: Igor
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authors.forename: Lisa
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authors.lastname: Gwyther
authors.forename: Gail
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authors.lastname: Ironson
authors.forename: Robert L
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authors.lastname: Johnson
authors.forename: Andres M
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authors.lastname: Kanner
authors.forename: Wayne J
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authors.lastname: Katon
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authors.lastname: Kaufmann
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
authors.forename: Terence
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authors.lastname: Ketter
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Laughren
authors.forename: Jane
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authors.lastname: Leserman
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
authors.forename: William M
authors.initials: WM
authors.lastname: McDonald
authors.forename: Bruce S
authors.initials: BS
authors.lastname: McEwen
authors.forename: Andrew H
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authors.lastname: Miller
authors.forename: Dominique
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authors.lastname: Musselman
authors.forename: Christopher
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authors.lastname: O'Connor
authors.forename: John M
authors.initials: JM
authors.lastname: Petitto
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Pollock
authors.forename: Robert G
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authors.lastname: Robinson
authors.forename: Steven P
authors.initials: SP
authors.lastname: Roose
authors.forename: Julia
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authors.lastname: Rowland
authors.forename: Yvette
authors.initials: Y
authors.lastname: Sheline
authors.forename: David S
authors.initials: DS
authors.lastname: Sheps
authors.forename: Gregory
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authors.lastname: Simon
authors.forename: David
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authors.lastname: Spiegel
authors.forename: Albert
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authors.lastname: Stunkard
authors.forename: Trey
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authors.lastname: Sunderland
authors.forename: Paul
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authors.lastname: Tibbits
authors.forename: William J
authors.initials: WJ
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mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D001927:Brain Diseases / Q000150:complications* / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D015897:Comorbidity; D003695:Delivery of Health Care / Q000592:standards*; D048909:Diabetes Complications / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism / Q000628:therapy; D006801:Humans; D019964:Mood Disorders / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D009765:Obesity; D010024:Osteoporosis; D010146:Pain; D017410:Practice Guidelines as Topic; D015995:Prevalence