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The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and select comorbid medical conditions

Rajamannar Ramasubbu, MD, FRCPC, MSc

Department of Psychiatry and Clinical Neurosciences, University of Calgary, Hotchkiss Brain Institute, Calgary, Alberta, Canada

Valerie H. Taylor, MD, PhD, FRCPC

Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada

Zainab Samaan, MD, PhD, FRCPC

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada

Sanjeev Sockalingham, MD, FRCPC

Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada

Madeline Li, MD, PhD, FRCPC

Department of Psychiatry, Psychosocial Oncology and Palliative Care, University Health Network, University of Toronto, Toronto, Ontario, Canada

Scott Patten, MD, PhD

Department of Community Health Sciences, University of Calgary, Hotchkiss Brain Institute, Calgary, Alberta, Canada

Gary Rodin, MD, FRCPC

Department of Psychiatry, Psychosocial Oncology and Palliative Care, University Health Network, University of Toronto, Toronto, Ontario, Canada

Ayal Schaffer, MD, FRCPC

Mood and Anxiety Disorders Program, Sunnybrook Health Sciences Centre, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada

Serge Beaulieu, MD, PhD, FRCPC

Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, Québec, Canada

Roger S. McIntyre, MD, FRCPC

Mood Disorders Psychopharmacology Unit, University Health Network, Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, Ontario, Canada

BACKGROUND: Medical comorbidity in patients with mood disorders has become an increasingly important clinical and global public health issue. Several specific medical conditions are associated with an increased risk of mood disorders, and conversely, mood disorders are associated with increased morbidity and mortality in patients with specific medical disorders.

METHODS: To help understand the bidirectional relationship and to provide an evidence-based framework to guide the treatment of mood disorders that are comorbid with medical illness, we have reviewed relevant articles and reviews published in English-language databases (to April 2011) on the links between mood disorders and several common medical conditions, evaluating the efficacy and safety of pharmacologic and psychosocial treatments. The medical disorders most commonly encountered in adult populations (ie, cardiovascular disease, cerebrovascular disease, cancer, human immunodeficiency virus, hepatitis C virus, migraine, multiple sclerosis, epilepsy, and osteoporosis) were chosen as the focus of this review.

RESULTS: Emerging evidence suggests that depression comorbid with several medical disorders is treatable and failure to treat depression in medically ill patients may have a negative effect on medical outcomes.

CONCLUSIONS: This review summarizes the available evidence and provides treatment recommendations for the management of comorbid depression in medically ill patients.

KEYWORDS: bipolar disorder, cancer, cerebrovascular disease, comorbidity, coronary heart disease, epilepsy, HCV, HIV, major depressive disorder, migraine, multiple sclerosis, osteoporosis

ANNALS OF CLINICAL PSYCHIATRY 2012;24(1):91-109

CORRESPONDENCE: Rajamannar Ramasubbu, MD, FRCPC, MSc, Associate Professor, Department of Psychiatry and Clinical Neurosciences, University of Calgary Mental Health Centre for Research and Education, TRW Building, Room #4D64, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada E-MAIL: rramasub@ucalgary.ca
Annals of Clinical Psychiatry ©2012 Quadrant HealthCom Inc.

 
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