Depression link to chronic disease goes both ways

Untreated depression's debilitating nature could trigger chronic disease, new research suggests.

By Susan J. Landers, AMNews staff. March 15, 2004.

Washington -- Which comes first: chronic disease or depression? The question is being asked more frequently as the tangled relationship is examined.

While it is well-known that depression can be triggered by a chronic disease, new evidence is pointing to depression as a possible marker for a whole range of other conditions, too.

During the past decade, depression has been linked prospectively to hypertension, stroke, heart disease, diabetes, obesity and asthma, said Bruce Jonas, PhD, an epidemiologist with the Centers for Disease Control and Prevention's National Center for Health Statistics. While stopping short of identifying depression as a chronic disease risk factor, he noted it is a possibility.

Dr. Jonas was among researchers at a February CDC conference in Washington D.C., to provide evidence that diagnosing and treating depression as well as chronic disease is necessary for patient health.

The connection was also noted by Women's Health Initiative researchers, who reported in the Feb. 9 Archives of Internal Medicine that subclinical depression, often unrecognized by doctors, may pose increased risk of cardiovascular disease among women ages 50 to 79. In that study, women's increased chance of heart disease existed independently of such risk factors as smoking or obesity.

Meanwhile, a 1998 study of about 1,200 Johns Hopkins Medical School students found that those with a history of clinical depression were twice as likely to develop coronary artery disease. The study followed the participants for 40 years.