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Management and Treatment of Patients With Major Depressive Disorder and Chronic Diseases: A Multidisciplinary
Susana Sousa Almeida1, Francesca Benedetta Zizzi2, Agnese Cattaneo3
1Portuguese Institute of Oncology Porto (IPO Porto), Hospital Cuf Porto (HCuf Porto), University of Porto (FMUP), Porto, Portugal.
Insights
Major depressive disorder (MDD) is common in chronic physical diseases, impacting quality of life and increasing healthcare costs. A personalized, multidisciplinary approach can improve patient compliance and outcomes.
Area of Science:
- Clinical Medicine
- Psychiatry
- Public Health
Background:
- Major Depressive Disorder (MDD) prevalence is 2-3x higher in chronic physical disease patients (up to 20-40%).
- Comorbidity of MDD with chronic illness leads to reduced quality of life, increased symptom burden, poor adherence, functional impairment, and higher mortality.
- Psychological aspects of chronic diseases are often inadequately addressed in routine clinical practice.
Purpose of the Study:
- To propose a consensus for managing patients with Major Depressive Disorder (MDD) and chronic medical comorbidities.
- To emphasize the importance of integrated care for improving patient outcomes and reducing healthcare burdens.
Main Methods:
- This document is a consensus proposal based on existing evidence regarding MDD and chronic diseases.
- It outlines a framework for healthcare professionals managing these complex patient cases.
Main Results:
- A structured approach involving proper diagnosis, multidisciplinary teams, and personalized treatment plans is recommended.
- This strategy aims to enhance patient compliance, improve treatment outcomes, and reduce long-term relapses and complications.
Conclusions:
- Effective management of MDD in patients with chronic physical diseases requires a shift towards integrated and personalized care.
- Healthcare professionals should proactively address the emotional impact of chronic conditions, particularly depressive symptoms.
Abstract:
In patients with physical chronic diseases, the prevalence of major depressive disorder (MDD) is approximately 2- to 3-fold higher than in the general population, and it can reach up to 20-40%. The comorbidity of MDD with chronic medical diseases is associated with poorer quality of life, increased medical symptom burden, poor adherence to self-care regimens, increased risk of functional impairment, morbidity, and mortality, and also higher medical costs. Despite this evidence, in routine practice, psychological issues and concerns are frequently inadequately managed. This consensus document proposes that a proper diagnosis, a multidisciplinary approach, and a personalized treatment plan would allow patients with MDD and chronic comorbidities to be more compliant, to improve the outcomes, to reduce possible relapses in the long term, and to prevent or better manage complications and adverse events. This proposal might be useful for any health professionals who deal with patients with chronic diseases, as it can help to pay more attention to the emotional impact of these conditions, in particular in terms of depressive symptoms.
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