Cover

Half-title

Title

Copyright

Contents

Contributors

Preface

REFERENCE

Part 1 Introduction to depression and its determinants

1 Depression in the medically ill

Introduction

‘Depressive disorder’ or ‘depression’ in the medically ill

Standardised research interviews

Self-administered questionnaires

Standardised observer-rated research interviews

Depressive disorders in medical in-patients

Depressive disorders in medical out-patients and primary care

Population-based studies

Consequences of depressive disorder in people with physical illness

REFERENCES

2 Psychosocial factors, depression and illness

Introduction

Sociodemographic factors

Gender differences in depression

Marital status and depression

Depression and socioeconomic position

Life events, chronic strain and major difficulties

Major difficulties and chronic strains

Resolution events

Gender differences in response to life events

Life events, marital status and depression

Predisposition to life events

Social vulnerability to depression

Early lack of care, abuse, neglect and risk of depression

Life events and outcome of depressive disorder

Social support

Health selection and social support

Social support and outcome of depressive disorder

Ethnicity and depression

Ethnicity and social support

Work and depression

Psychosocial work characteristics

Psychosocial work characteristics and mental health

Psychosocial work characteristics, personality and depression

Psychosocial risk factors and depression in the elderly

Associations of psychosocial factors with depression and physical illness

REFERENCES

Part 2 Depression and specific health problems

3 Depression and the development of coronary heart disease

Introduction

Longitudinal studies of depression and CHD

CHD in patients with clinical depression

Anxiety and psychological distress in relation to CHD

Depression and subclinical atherosclerosis

Timing of associations with depression

Pathways relating depression to CHD development

Endothelial function and vascular inflammation

Haemostatic processes and platelet function

Neuroendocrine and autonomic function

Limitations to studies of mechanisms

Conclusions

Acknowledgements

REFERENCES

4 Depression and prognosis in cardiac patients

Depression and CHD outcomes

Biobehavioural mechanisms

Traditional risk factors

Platelet activity

Autonomic nervous system functioning

HPA axis functioning

Heart-rate variability

Baroreceptor-mediated heart-rate control

Endothelial dysfunction

Inflammation

Behavioural and lifestyle risk factors

Conclusions

REFERENCES

5 The management of depression in patients with coronary heart disease

Introduction

Depressive disorders

Effects of depression in cardiac patients

Treatments for depression

Pharmacotherapy

Psychotherapy

Cognitive–behavioural therapy

Interpersonal psychotherapy

Psychotherapy for depression in CHD patients

Other treatments

Exercise

Treating depression in order to reduce medical morbidity and mortality in CHD

Pharmacotherapy

Psychotherapy

The ENRICHD clinical trial

Summary and conclusions

Acknowledgements

REFERENCES

6 Depression and physical disability

Disability: a functional indicator of physical health

Describing the link between disability and depression

Disability increases the risk of depression

Depression increases the risk of disability

Temporal sequence of the link between depression and disability

Explaining the link between depression and disability

Behavioural explanatory mechanisms

Psychosocial explanatory mechanisms

Biological explanatory mechanisms

Intervening to break the link between depression and disability

Pharmacotherapy

Exercise interventions

Summary and conclusions

REFERENCES

7 Chronic pain and depression: twin burdens of adaptation

Introduction

Antecedent hypothesis

Consequence hypothesis

Common pathogenesis

Cognitive–behavioural theories

Psychoneuroimmunological developments

Depression and the immune system

Evolving understanding of pain

Pain, depression and the immune system

Role and function of antidepressants

Chronicity: the role of sensitisation

Resilience

Emotion complexity

Conclusion

REFERENCES

8 The interrelationship of depression and diabetes

Introduction: diabetes

Epidemiology

Diagnosis of depression in patients with diabetes

Prevalence of depression in diabetic patients

Sociocultural risk factors for depression in diabetes

Impact of diabetes on depression

Impact of depression on diabetes

Biology

Increased release of counter-regulatory hormones in depression

Alterations in glucose transport in depression

Increased immuno-inflammatory activation in depression

Treatment of depression in patients with diabetes

Critique of the empirical literature

Psychopharmacological treatment of depression and diabetes

Impact of psychological interventions on glycaemic control

Combination psychotherapy and psychopharmacology interventions

Future directions for research

Acknowledgements

REFERENCES

9 Depression and chronic fatigue

Introduction

Epidemiology of fatigue

Chronic fatigue syndrome

Fatigue as part of depressive illness

Is chronic fatigue syndrome a subclinical depressive illness?

Fatigue and depression following infections

Vital exhaustion and ischaemic heart disease

Pathophysiology discriminates fatigue and depression

Treatment similarities and differences between fatigue and depression

Secondary fatigue

Conclusions

REFERENCES

10 Cancer and depression

Introduction

Prevalence of depression among cancer patients

Dilemmas in the diagnosis and assessment of depression in cancer patients

Controversy in the diagnosis of depression

Prevalence of depression by cancer type, stage and treatment

Disease site

Disease stage

Treatments of cancer

Detection and treatment of depression in cancer patients

Screening for depression in cancer patients

Treatment for depression in cancer patients

Effectiveness of delivery versus efficacy of treatment of depression in cancer

Relevance of primary medical care

Depression and cancer incidence, progression and survival: death is not everything

Conclusions

Acknowledgements

REFERENCES

11 Depression and obesity

Introduction

Community-based cross-sectional studies

Community-based prospective studies

Studies with clinical samples of obese individuals

Moderating variables

Binge eating

Body image and dieting

General methodological issues

Conclusions

REFERENCES

Part 3 Biological and behavioural processes

12 Inflammation, sickness behaviour and depression

Introduction

Inflammation and cytokines

Cytokine-induced sickness behaviour is an adaptive response to infection

From cytokine-induced sickness behaviour to depression

Conclusions and perspectives

Acknowledgements

REFERENCES

13 The hypothalamic–pituitary–adrenal axis: cortisol, DHEA and mental and behavioural function

Introduction

Cortisol, DHEA and the brain

HPA axis development, dysfunction and psychiatric disorder

Measurement of circulating adrenal steroids

Cortisol and unipolar depression

DHEA

Specific social adversities, steroids and monoamines

Infant stress

Deprivation, maltreatment and traumatic experience

Severe conduct disorders

Acknowledgements

REFERENCES

14 Depression and immunity: biological and behavioural mechanisms

Introduction

Clinical characteristics of depression

Definition of depression

Clinical course

Depression, morbidity and mortality

Multisystem physiological abnormalities in depression

Central modulation of immunity: effects of corticotropin-releasing hormone

Autonomic nervous system

Neuroendocrine axis

Immunological findings in depression

Enumerative measures

Functional measures

Stimulated cytokine production

Circulating levels of cytokines: evidence for pro-inflammatory activation

Viral-specific immune measures

Assays of in vivo responses

Clinical moderating factors

Treatment of depression

Mechanisms of immune dysfunction in depression

Biological mediators

Behavioural mechanisms

Smoking: prevalence and immune effects

Alcohol dependence: immune effects in depression

Activity and exercise: immune consequences in depression

Disordered sleep and immunity: relevance to depression

Clinical implications of immunity in depression

Cardiovascular disease

Infectious disease risk

Rheumatoid arthritis: neuroimmune mechanisms

Summary

Acknowledgements

REFERENCES

15 Smoking and depression

Introduction

Some conceptual and methodological considerations of ‘depression’

Some conceptual and methodological considerations of ‘smoking’

Are smokers more depressed than non-smokers?

Initiation stage

Maintenance stage

Relapse stage

Does smoking reduce depressive symptoms?

Initiation stage

Maintenance stage

Relapse stage

Summary

Potential conceptual frameworks of smoking–depression relationships

Predisposition model

Consequence model

Spectrum model

Pathoplasticity model

Summary

Potential moderators of smoking–depression associations

Conclusions and future directions

Acknowledgements

REFERENCES

16 Depression and physical activity

Introduction

Population studies of physical activity and depressive symptoms

Longitudinal studies

Treatment of depression and subsequent physical activity

Effects on depression of increasing exercise levels

Illustrative studies

Physical activity interventions in medical conditions

Understanding the mechanisms

Inflammation and immunity

Neuroendocrine function

Cardiovascular stress reactivity

Conclusions

Acknowledgements

REFERENCES

17 Depression and adherence to medical advice

Adherence to chronic disease regimens

Defining and assessing adherence

Defining and assessing depression

Research on depression and adherence to medical regimens

Methods for identifying, including and evaluating studies

Overview of existing research

Intervention studies

Conclusions

REFERENCES

Part 4 Conclusions

18 Integrating clinical with biobehavioural studies of depression and physical illness

Depression and health outcomes

Depression and overall mortality risk

Causal and reciprocal processes

Methodological problems

Depression and patient care in medical conditions

Identification of depressive states in clinical medicine

Understanding the consequences of depressive states

Treatment issues

REFERENCES

Index