Mood Disorders Secondary to Systemic Medical Conditions.

Area of Science:

• Psychiatry
• Internal Medicine
• Medical Psychology

Background:

• Mounting evidence suggests secondary mood disorders are distinct clinical entities.
• Unlike neurological conditions, medical conditions show variable prevalence and lack CNS lesions.
• Research on mood disorders secondary to medical illness is emerging.

Purpose of the Study:

• To selectively review literature on mood disorders secondary to medical conditions published since 1990.
• To examine potential pathophysiologic mechanisms for these depressions.
• To explore mood disorders in endocrine disorders, coronary artery disease, cancer, and end-stage renal disease.

Main Methods:

• Selective literature review of studies published since 1990.
• Focus on mood disorders secondary to endocrine disorders, coronary artery disease, cancer, and end-stage renal disease.
• Examination of potential pathophysiologic mechanisms.

Main Results:

• Mood disorders secondary to medical conditions exhibit wide prevalence variability.
• No evidence of structural central nervous system (CNS) lesions as a basis for these mood disorders.
• Potential mechanisms include cytokines, cerebrovascular disease, altered platelet function, and CNS dysregulation.

Conclusions:

• Recent advances challenge old constructs of depression in medical illness.
• Longitudinal studies for specific diseases are needed.
• Further research on the pathophysiology of these mood disorders is required.