Approach to Depression in the Medically Ill

  • Kyung Bong Koh


It is desirable to evaluate patients’ medical and psychiatric status at the same time and consider multidimensional approaches in order to make a diagnosis of depression in the medically ill. Sometimes psychological instruments can be used to assess depression. For treatment, first, it is important to get rid of organic factors than any other things. Second, therapists should address patients’ resistance to psychiatric approaches and despondency response to severe physical diseases. Third, it is important to choose appropriate antidepressants as biological treatment. The selection of antidepressants in the medically ill should be considered after evaluating patients’ primary depressive symptoms, drug kinetics and dynamics, and side effects of antidepressants. Therapists also need to pay attention to drug-disease and drug-drug interactions. Antidepressants such as SSRIs, bupropion, and venlafaxine are effective for depression in the medically ill. However, tricyclic antidepressants can still be used effectively for patients with pain. In addition, collaborative care interventions are found to be effective in medically ill patients with depression. Therefore, clinicians’ therapeutic approach should be tailored to the specific needs of such patients in terms of biopsychosociospiritual perspectives.


Multidimensional approaches Depression in the medically ill Despondency response Selection of antidepressants Drug-disease interactions Drug-drug interactions Collaborative care interventions 


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Authors and Affiliations

  • Kyung Bong Koh
    • 1
  1. 1.Department of PsychiatryYonsei University College of MedicineSeoulKorea

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