Depression medical illness-related

Mood disorders represent a major public health concern around the globe. In the United States alone, the annual cost of major depression is over 40 billion dollars. Less than 30% of the total cost of depression is incurred through direct treatment. The remainder consists of the indirect hidden costs of lost productivity due to absenteeism and poor work efficiency, premature death from suicide or medical illness, and the uncounted losses related to a poor quality of life. 

Attempts have been made to calculate the societal cost of MDD in terms of health care utilization, absenteeism from work, decreased productivity, job-related injuries, and adverse effects on quality control because of impaired concentration and attention. In a prospective study of 3,000 patients, depression was related to poorer physical health and increased health care utilization ( 52). In the same study, employed individuals had a five times greater risk of using disability days. In another study, disability because of major depression was similar to or worse than chronic medical illnesses such as hypertension, diabetes mellitus, and arthritis ( 53). 

The question of insomnia effects on morbidity is more difficult. Since insomnia complaints are associated with depression, anxiety, neuroticism, and a wide variety of medical illnesses (44,49,54,55), it may be difficult to distinguish effects of insomnia from effects of the comorbid processes. In some cases, medications taken by insomniacs may be responsible for impairment. One attempt to assess disability related to insomnia found no association meeting Bonferroni criteria, after adjustment for age, gender, chronic disease, and major depression (56). It is possible that the trend for association would have been entirely eliminated had control been done for subthreshold depression, which was prevalent in the sample. Although sleep symptoms do predict future depression, they are less... 

Obsessive-Compulsive Personality Disorder (OCPD). Despite the similarity in name, OCD and OCPD are not closely related. Therefore, the medications used to treat OCD are not necessarily helpful for OCPD. As a result, we also cannot offer any specific medication recommendations for the treatment of OCPD. The overall anxious nature of the illness and the likelihood that such patients have comorbid depression or anxiety disorders may, however, guide medication selection. 

Hospitalization for eating disorder depends on the weight status of the patient, the presence of medical complications, and the presence of related psychiatric comorbidities, such as depression, suicidal behavior, and OCD. Hospitalization for AN may be brief or extended. Inpatient brief hospitalization (7-14 days) is for patients who have (1) relapsed from previous treatment or have been ill for less than 6 months (2) a weight loss of 10%-15% from normal weight if they have relapsed, or 16%-20% if this is their first episode (3) hypokalemic alkalosis with serum potassium < 2.5 mEq/L and (4) cardiac arrhythmias. To promote rapid weight gain, patients can be placed on a liquid formula... 

Previous reports had suggested that SSRIs can cause cardiovascular abnormalities, and the strongest evidence related to paroxetine. However, the relative contributions of these medications and the effect of depressive illness have remained uncertain. 

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