Comorbid depression in chronic somatic diseases (diabetes mellitus, arterial hypertension and chronic respiratory conditions)

Abstract

Depression involves a wide range of mental health problems characterized by the lack of a positive affective background (loss of interest and pleasure in usual or previously enjoyable activities and experiences), low mood and a spectrum of associated emotional, cognitive, physical and behavioral problems. Depression frequently associates chronic somatic diseases, such as diabetes mellitus and hypertension, the prevalence of depression in diabetics is usually between 10–15%, almost double that of the population without diabetes and affecting quality of life and compliance with treatment. The interaction between physical suffering and affective disorders creates a vicious circle that worsens the overall prognosis. To evaluate the particularities of depression in patients with diabetes mellitus and hypertension, by analyzing the specialized literature and the data obtained regarding the patients, as well as identifying effective intervention strategies. A systematic review of the literature was conducted, based on accessible searches from databases such as PubMed, Scopus, NCBI and Web of Science. In this review, the PHQ9 questionnaire was used to assess depressive symptoms. Articles published in the last 5 years investigating the correlation between depression and the aforementioned chronic diseases were included in the review. The impact of these conditions on the general health of patients and the recommended therapeutic options for the management of depression and associated chronic diseases were also analyzed. Depressive disorders, especially major depression, can have a significant impact on physical and mental health, with symptoms such as persistent sadness, loss of interest in enjoyable activities, chronic fatigue, insomnia and mood swings. These symptoms can have a significant impact on quality of life and can impair physical functioning. The association between depression and chronic diseases, such as diabetes and hypertension, is well documented. Studies show that people with depression are at increased risk of developing type 2 diabetes, due to behavioral changes (poor diet, sedentary lifestyle) and hormonal imbalances associated with obesity. Depression can also contribute to increased blood pressure by disrupting the autonomic nervous system and stress hormones such as cortisol, which negatively affect the cardiovascular system. An integrated approach to treatment is important for patients with depression and chronic conditions. Antidepressant and psychological treatments can reduce symptoms of depression and are effective in treating diabetes and hypertension. Therefore, a holistic approach, which takes into account both the mental and physical aspects of the patient, is essential to improve overall health and prevent related complications. Depression in the context of chronic somatic diseases is a particularly complex problem, requiring a collaborative approach from various specialties. Early diagnosis and appropriate treatments can significantly improve the course of the disease and the patient's quality of life.