Chapman Daniel P, Perry Geraldine S, Strine Tara W
Emerging Investigations and Analytic Methods Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Prev Chronic Dis. 2005 Jan;2(1):A14. Epub 2004 Dec 15.
Chronic diseases have assumed an increasingly important role in public health research and intervention. Without treatment, depressive disorders characteristically assume a chronic course and are expected, by 2020, to be second only to heart disease in the global burden of disease. Thus, understanding the relationship between depressive disorders and chronic disease appears vital to public health assessment and health care delivery.
Articles for review were primarily identified by a Medline search emphasizing the subject headings mental disorders or depression crossed with selected chronic diseases and conditions including asthma, arthritis, cardiovascular disease, cancer, diabetes, and obesity.
Mental illnesses - most specifically, depressive disorders - were associated with increased prevalence of chronic diseases. This association between depression and chronic disease appears attributable to depressive disorders precipitating chronic disease and to chronic disease exacerbating symptoms of depression. The complex interrelationship between depressive disorders and chronic disease has important implications for both chronic disease management and the treatment of depression.
Depressive disorders assume an important role in the etiology, course, and outcomes associated with chronic disease. Multivariate community-based research and intervention fostering the detection and treatment of depressive disorders is needed, as is further examination of the role exerted by mental illnesses other than depression in the pathogenesis of chronic disease.
慢性病在公共卫生研究与干预中发挥着越来越重要的作用。未经治疗的抑郁症通常呈慢性病程，预计到2020年，在全球疾病负担中，抑郁症将仅次于心脏病，位居第二。因此，了解抑郁症与慢性病之间的关系对于公共卫生评估和医疗保健服务至关重要。
用于综述的文章主要通过医学索引数据库（Medline）检索确定，检索重点为精神障碍或抑郁症的主题词，并与选定的慢性病和病症交叉检索，这些慢性病和病症包括哮喘、关节炎、心血管疾病、癌症、糖尿病和肥胖症。
精神疾病——最具体而言，抑郁症——与慢性病患病率增加相关。抑郁症与慢性病之间的这种关联似乎归因于抑郁症引发慢性病以及慢性病加重抑郁症症状。抑郁症与慢性病之间复杂的相互关系对慢性病管理和抑郁症治疗均具有重要意义。
抑郁症在与慢性病相关的病因、病程和结局中发挥着重要作用。需要开展基于社区的多变量研究和干预措施，以促进抑郁症的检测和治疗，同时还需要进一步研究除抑郁症之外的其他精神疾病在慢性病发病机制中的作用。
