Depressive disorders and comorbidity: somatic illness vs. side effect.
BACKGROUND
The rate of comorbid depression and medical illness varies from 10 to 40%. Patients with depressive disorder compared to general population more often have cardiovascular and cerebrovascular disorders, diabetes, irritable bowel syndrome, and some types of tumor. Side effects of mental health medications may appear in a form that is very similar to clinical presentation of somatic illness. Side effects that appear during treatment of depressive disorder, e. g. cardiovascular, gastrointestinal, movement disorders, etc., may provoke certain diagnostic issues regarding origin of such symptoms (somatic illness vs. side effect). The aim of this article is to review literature regarding comorbidity of depressive disorder and somatic illness and to point at possible diagnostic problems in differentiating comorbid somatic illness and side effects of antidepressants.


METHODS
Literature research included structured searches of Medline and other publications on the subject of comorbidity of depressive disorder and somatic disorders and possible diagnostic problems in differentiating comorbid somatic illnesses from side effects of antidepressants.


CONCLUSIONS
Comorbidity between depressive disorder and various somatic disorders appears often. Investigations suggest that depressive disorder is underdiagnosed in such cases. Side effects of antidepressants are sometimes very hard to differentiate from symptoms of somatic illness, which may lead to diagnostic issues. Bearing in mind frequent comorbidity between of depressive and somatic disorders, early recognition of such comorbidity is important, as well as the selection of antidepressant. It is important to recognize depressive disorder in patients with somatic illnesses, as well as somatic illness in patients primarily treated because of depressive disorder.
University Department of Psychiatry, Psychiatric Hospital Vrapce, Zagreb, Croatia. suzana.uzun@bolnica-vrapce.hr
Suzana
S
Uzun
Oliver
O
Kozumplik
Radmila
R
Topić
Miro
M
Jakovljević
D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D003937:Diagnosis, Differential; D017831:Diagnosis, Dual (Psychiatry); D006801:Humans; D012307:Risk Factors
D000928:Antidepressive Agents