Physicians have long known that depression casts an enormous shadow on functioning. The resultant anguish for the patient and family is massive, the cost of depression in terms of productivity is high,1 and the risk for suicide is ever present. More recently, we have become aware that there are other serious consequences of depression as well. A number of well-designed studies have demonstrated that depressed patients have a poorer prognosis from diverse illnesses such as stroke and myocardial infarction.2-4 The problem with such studies is that one always wonders which came first: is the depression a prodrome to other illness or is it that patients with more severe illness are also more depressed?
See also the January/February 1997 issue of Archives of Family Medicine.
One way of disentangling this problem is to study a large enough population so one can statistically control for the likely confounders of a
Dimsdale JE. Symptoms of Anxiety and Depression as Precursors to Hypertension. JAMA. 1997;277(7):574-575. doi:10.1001/jama.1997.03540310072038