Depression in chronic physical illness: A behavioral medicine approach

This chapter addresses the prevalence, consequences, and presumed causes of unipolar depression in chronic, non-lethal, physical illness. It begins by outlining the central role of chronic physical illness (CPI) in medicine. Next, the chapter discusses the various manifestations of depression in CPI, focusing on the distinction between categorical approaches to depression (a diagnosable condition such as major depressive episode) and dimensional approaches (elevated levels of depressive symptoms in the absence of a diagnosable episode) to depression. The chapter points out that from a behavioral medicine point of view, it makes more sense to address depression as a continuous dimension rather than to distinguish between diagnosable and “subsyndromal” depression. It presents a tentative model accounting for depression in CPI, which focuses on person-context exchanges. Finally, the chapter discusses the implications of this view for assessment/screening, treatment, and prevention.