Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management

作者：Michael Berk, Ole Köhler‐Forsberg, Megan Turner, Brenda W.J.H. Penninx, Anna Wrobel, Joseph Firth, Amy Loughman, Nicola Reavley, John J. McGrath, Natalie C. Momen, Oleguer Plana‐Ripoll, Adrienne O’Neil, Dan Siskind, Lana J. Williams, André F. Carvalho, Lianne Schmaal, Adam J. Walker, Olivia Dean, Ken Walder, Lesley Berk, Seetal Dodd, Alison R. Yung, Wolfgang Marx · 发表于：World Psychiatry · 年份：2023 · DOI：10.1002/wps.21110 · 被引用次数：315 · 研究领域：Cardiac Health and Mental Health、Health, psychology, and well-being、Mental Health Treatment and Access

Populations with common physical diseases - such as cardiovascular diseases, cancer and neurodegenerative disorders - experience substantially higher rates of major depressive disorder (MDD) than the general population. On the other hand, people living with MDD have a greater risk for many physical diseases. This high level of comorbidity is associated with worse outcomes, reduced adherence to treatment, increased mortality, and greater health care utilization and costs. Comorbidity can also result in a range of clinical challenges, such as a more complicated therapeutic alliance, issues pertaining to adaptive health behaviors, drug-drug interactions and adverse events induced by medications used for physical and mental disorders. Potential explanations for the high prevalence of the above comorbidity involve shared genetic and biological pathways. These latter include inflammation, the gut microbiome, mitochondrial function and energy metabolism, hypothalamic-pituitary-adrenal axis dysregulation, and brain structure and function. Furthermore, MDD and physical diseases have in common several antecedents related to social factors (e.g., socioeconomic status), lifestyle variables (e.g., physical activity, diet, sleep), and stressful live events (e.g., childhood trauma). Pharmacotherapies and psychotherapies are effective treatments for comorbid MDD, and the introduction of lifestyle interventions as well as collaborative care models and digital technologies provide promising st...