The various comorbidities of Major Depressive Disorder (MDD) adversely affect patients’ quality of life. MDD frequently occurs alongside substance-related and anxiety disorders, as well as a host of other physical conditions such as type 2 diabetes. This slide deck includes graphic illustrations of a retrospective analysis of patient data performed to compare the prevalence of chronic conditions in patients with MDD.

This slide deck has been developed in collaboration with the former Lundbeck International Neuroscience Foundation.

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slide deck

Introduction

Major Depressive Disorder – Comorbidities – slide 1
Comorbidity

A retrospective analysis of patient data was performed to compare the prevalence of chronic conditions in patients with MDD. Of the total population studied, roughly one in ten had depression.

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Major Depressive Disorder – Comorbidities – slide 2
Prevalence of chronic conditions in patients with MDD

In this study, data from the 2007 and 2009 releases of the Medical Expenditure Panel Survey (MEPS) were used.[Bhattacharya et al., 2014] The MEPS is a nationally representative annual survey of households representing the US non-institutionalised civilian population.[Bhattacharya et…

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Major Depressive Disorder – Comorbidities – slide 3
Prevalence of MDD in patients with chronic conditions

The analysis discussed here concludes that there exists a bidirectional relationship between depression and chronic illnesses.[Voinov et al., 2013]

Reference: Voinov B, Richie WD, Bailey RK. Depression and chronic diseases: it is time for a synergistic mental health and…

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Major Depressive Disorder – Comorbidities – slide 4
Depression adds to the burden of chronic conditions

The WHO (World Health Organization) World Health Survey studied >240, 000 adults, aged ≥18 years, across 60 countries.[Moussavi et al., 2007] An average of 9.3–23.0% of participants with one or more chronic physical disease also had comorbid depression.[Moussavi et…

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Major Depressive Disorder – Comorbidities – slide 5
The effect of comorbidities on patients’ quality of life

The various comorbidities of MDD (psychiatric and physical) adversely affect the quality of life of the patient.[IsHak et al., 2014; IsHak et al., 2018; Zhou et al., 2017] This emphasises the point that attending physicians need to be alive…

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Neuropsychiatric comorbidities

Major Depressive Disorder – Comorbidities – slide 6
Neuropsychiatric comorbidities
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Major Depressive Disorder – Comorbidities – slide 7
Psychiatric comorbidities of MDD

The study by Thaipisuttikul and colleagues was a cross-sectional study, conducted between October 2012 and January 2014.[Thaipisuttikul et al., 2014] In total, 190 patients with MDD, as confirmed by the Mini International Neuropsychiatric Interview (MINI), were included.[Thaipisuttikul et al.,…

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Major Depressive Disorder – Comorbidities – slide 8
Anxiety

The Patient Health Questionnaire is a self-administered tool of 2 (PHQ-2) or 9 (PHQ-9) items.[Kroenke et al., 2001; Spitzer et al., 1999] The PHQ-9 establishes the clinical diagnosis of depression and can additionally be used to track the severity…

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Major Depressive Disorder – Comorbidities – slide 9
Obsessive–compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is associated with reduced quality of life, and functional impairments.[APA, 2013, pg. 240] It is defined as:[APA, 2013, pg. 237] obsession; recurrent and persistent thoughts, urges, or images, that are experienced as unwanted or intrusive and…

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Major Depressive Disorder – Comorbidities – slide 10
Post-traumatic stress disorder (PTSD)

The essential feature of PTSD is the development of a certain set of symptoms after exposure to a traumatic event; the symptoms include fear-based re-experiencing of the traumatic event, but can also include anhedonia, and dysphoric mood states.[APA, 2013,…

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Major Depressive Disorder – Comorbidities – slide 11
Attention deficit hyperactivity disorder (ADHD)

The essential feature of ADHD is a persistent pattern of inattention and/or hyperactivity that interferes with functioning or development.[APA, 2013, pg. 61] For example, wandering off task, or difficulty sustaining focus, and excessive motor activity, or fidgeting, or talkativeness.[APA,…

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Major Depressive Disorder – Comorbidities – slide 12
Schizophrenia

The essential feature of schizophrenia is the presence of hallucinations, delusions, disorganised speech or behaviour, or of negative symptoms.[APA, 2013, pg. 100] As noted on the slide, some of the diagnostic criteria for schizophrenia overlap with those for MDD, particularly…

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Major Depressive Disorder – Comorbidities – slide 13
Substance-use disorder

Substance-use disorders are a group of cognitive, behavioural, and physiological symptoms indicating that the individual continues to use a substance despite problems related to the use of that substance.[APA, 2013, pg. 483] Substances can include alcohol, cannabis, hallucinogens, opioids,…

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Major Depressive Disorder – Comorbidities – slide 14
Neurological disorders and MDD

See Slide deck #3 of this series – ‘Neurobiology and aetiology’ to read more about the potential shared pathways underlying MDD and other neurological disorders. Disentangling the various comorbidities of MDD is a herculean challenge, because many conditions are…

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Major Depressive Disorder – Comorbidities – slide 15
Alzheimer’s disease (AD) and MDD

Whether or not, and to what extent, depression is a risk factor for, or a constituent part of the prodrome of, dementia, is still a contentious issue.[Cha et al., 2014; Mirza et al., 2014] One study followed >4, 300…

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