(Part 2 of a 4-part series)
In this video, Jonathan E. Alpert, MD, PhD, of Albert Einstein College of Medicine and Montefiore Medical Center, New York City, New York, discusses which medical conditions are associated with high rates of depression and evidence gaps in the research on people with depression and medical comorbidities. Dr. Alpert recently presented "Treating Depression with Other Medical Comorbidity" at the Nevada Psychiatric Association's 26th National Psychopharmacology Update.
In upcoming installments of this video series, Dr. Alpert will discuss adapting depression treatment in patients with comorbid medical conditions and special considerations for patients with depression and COVID‑19.
Watch Part 1 of the series: Medical Comorbidities in Patients With Depression
Read the transcript:
Most medical conditions are associated with an elevated rate of depression, but certain medical conditions have particularly high rates of depression associated with them.
Those conditions include chronic pain conditions, like neuropathic pain conditions or chronic back pain, neurological conditions, such as Parkinson's disease and multiple sclerosis.
Certain other kinds of autoimmune disorders, like rheumatological conditions, are associated with high rates of depression. HIV and certain forms of cancer, like pancreatic cancer, have particularly high rates of depression associated with them.
There are quite a number of gaps in the research literature when it comes to treating depression in people with medical comorbidities.
In particular, most randomized clinical trials that have been designed to study the treatment of depression, particularly major depressive disorder, intentionally exclude people with active, ongoing medical comorbidity. Which means that if we look at most clinical trials related to depression treatment, people with medical comorbidities, particularly active medical comorbidities, are not represented in those cohorts.
There are certainly exceptions. There are certain fields, like cardiology, where there have been a number of large trials looking at depression treatment. Same thing for stroke and some other areas, but there's a great need for more randomized clinical trials looking at depression treatment among people with active forms of medical illness.
Jonathan E. Alpert, MD, PhD, is the Dorothy and Marty Silverman University Chair of the Department of Psychiatry and Behavioral Sciences and Professor of Psychiatry, Neuroscience and Pediatrics at the Albert Einstein College of Medicine and Montefiore Medical Center, New York City, New York. He is also Chair of the American Psychiatric Association Council on Research. Before joining Montefiore Einstein in 2017, Dr. Alpert worked at Massachusetts General Hospital, Boston, for 24 years. His roles included Director of the Depression Clinical and Research Program and Associate Chief of Psychiatry. Dr. Alpert has received numerous awards for excellence in teaching and mentorship, scholarship, and patient care, and has authored more than 220 publications. His academic interests include treatment-resistant depression, treatment of depression with comorbid conditions, mental health disparities, ethical issues in research design, and medical education.