Managing medical and psychiatric comorbidity in individuals with major depressive disorder and bipolar disorder

Roger S. McIntyre, Michael Rosenbluth, Rajamannar Ramasubbu, David J. Bond, Valerie H. Taylor, Serge Beaulieu, Ayal Schaffer

Research output: Contribution to journalReview articlepeer-review

33 Scopus citations

Abstract

BACKGROUND: Most individuals with mood disorders experience psychiatric and/or medical comorbidity. Available treatment guidelines for major depressive disorder (MDD) and bipolar disorder (BD) have focused on treating mood disorders in the absence of comorbidity. Treating comorbid conditions in patients with mood disorders requires sufficient decision support to inform appropriate treatment. METHODS: The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force sought to prepare evidence- and consensus-based recommendations on treating comorbid conditions in patients with MDD and BD by conducting a systematic and qualitative review of extant data. The relative paucity of studies in this area often required a consensus-based approach to selecting and sequencing treatments. RESULTS: Several principles emerge when managing comorbidity. They include, but are not limited to: establishing the diagnosis, risk assessment, establishing the appropriate setting for treatment, chronic disease management, concurrent or sequential treatment, and measurement-based care. CONCLUSIONS: Efficacy, effectiveness, and comparative effectiveness research should emphasize treatment and management of conditions comorbid with mood disorders. Clinicians are encouraged to screen and systematically monitor for comorbid conditions in all individuals with mood disorders. The common comorbidity in mood disorders raises fundamental questions about overlapping and discrete pathoetiology.

Original languageEnglish (US)
Pages (from-to)163-169
Number of pages7
JournalAnnals of Clinical Psychiatry
Volume24
Issue number2
StatePublished - May 2012

Keywords

  • Anxiety disorders
  • Attention-deficit/ hyperactivity disorder
  • Bipolar disorder
  • Cardiovascular disease
  • Comorbidity
  • Dyslipidemia
  • Hypertension
  • Major depressive disorder
  • Obesity
  • Personality disorders
  • Substance use disorders

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