Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center.
General Medicine, Department of Medicine, Columbia University Irving Medical Center.
Health Psychol. 2019 Sep;38(9):802-811. doi: 10.1037/hea0000737. Epub 2019 Apr 22.
Depression frequently co-occurs with multiple chronic diseases in complex, costly, and dangerous patterns of multimorbidity. The field of health psychology may benefit from evaluating the temporal characteristics of depression's associations with common diseases, and from determining whether depression is a central connector in multimorbid disease clusters. The present review addresses these issues by focusing on 4 of the most prevalent diseases: hypertension, ischemic heart disease, arthritis, and diabetes.
Study 1 assessed how prior chronic disease diagnoses were associated with current depression in a large, cross-sectional, population-based study. It assessed depression's centrality using network analysis accounting for disease prevalence. Study 2 presents a systematic scoping review evaluating the extent to which depression was prospectively associated with the onset of the 4 prevalent chronic diseases.
In Study 1 depression had the fourth highest betweenness centrality ranking of 26 network nodes and centrally connected many existing diseases and unhealthy behaviors. In Study 2 depression was associated with subsequent incidence of ischemic heart disease and diabetes across multiple meta-analyses. Insufficient information was available about depression's prospective associations with incident hypertension and arthritis.
Depression is central in patterns of multimorbidity and is associated with incident disease for several of the most common chronic diseases, justifying the focus on screening and treatment of depression in those at risk for developing chronic disease. Future research should investigate the mediating and moderating roles of health behaviors in the association between depression and the staggered emergence over time of clusters of multimorbid chronic diseases. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
抑郁症常与多种慢性疾病共同发生，形成复杂、昂贵且危险的共病模式。健康心理学领域可能受益于评估抑郁症与常见疾病关联的时间特征，并确定抑郁症是否是多种疾病集群中的核心连接因素。本综述通过关注 4 种最常见的疾病（高血压、缺血性心脏病、关节炎和糖尿病）来解决这些问题。
研究 1 在一项大型、横断面、基于人群的研究中评估了先前的慢性疾病诊断与当前抑郁症之间的关联。它通过考虑疾病流行率的网络分析评估了抑郁症的中心性。研究 2 提出了一项系统范围的综述，评估了抑郁症在多大程度上与 4 种常见慢性疾病的发病前瞻性相关。
在研究 1 中，抑郁症在 26 个网络节点中具有第四高的介数中心性排名，并且与许多现有的疾病和不健康行为中心连接。在研究 2 中，抑郁症与缺血性心脏病和糖尿病的多个荟萃分析相关。关于抑郁症与高血压和关节炎的发病前瞻性关联，可用的信息不足。
抑郁症在共病模式中处于核心地位，与几种最常见的慢性疾病的发病相关，这证明了在有发展为慢性疾病风险的人群中筛查和治疗抑郁症的重要性。未来的研究应调查健康行为在抑郁症与多种慢性疾病集群随时间交错出现之间的中介和调节作用。
