Reviewing the Literature

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Reviewing the Literature

Student Name: Breyauna L. Davis

Summary of Clinical Issue (200-250 words):

PICO Question:

Part 1: Literature Evaluation Table

Locate a minimum of 10-12 peer-reviewed articles that support your proposed topic. Eight of the 10-12 peer-reviewed articles must be research-based (i.e., a study which is qualitative, quantitative, descriptive, or longitudinal).

Begin your search for literature by utilizing the databases located in the GCU Library. Contact your instructor, the librarian, or library staff for additional researching tips and keyword suggestions.

Preview each of the articles chosen by reading the article abstracts and summaries. Article abstracts and summaries provide a concise description of the topic, research outcomes, and significance of findings.

Criteria

Article 1

Article 2

Article 3

APA-Formatted Article Citation With Permalink

Barberio, B., Zamani, M., Black, C. J., Savarino, E. V., & Ford, A. C. (2021). Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis. The Lancet Gastroenterology & Hepatology, 6(5), 359-370. https://doi.org/10.1016/S2468-1253(21)00014-5

Dai, L. L., Wang, X., Jiang, T. C., Li, P. F., Wang, Y., Wu, S. J., … & Cheng, Z. (2020). Anxiety and depressive symptoms among COVID-19 patients in Jianghan Fangcang Shelter Hospital in Wuhan, China. Plos one, 15(8), e0238416. https://doi.org/10.1371/journal.pone.0238416

Jha, M. K., Qamar, A., Vaduganathan, M., Charney, D. S., & Murrough, J. W. (2019). Screening and management of depression in patients with cardiovascular disease: JACC state-of-the-art review. Journal of the American College of Cardiology, 73(14), 1827-1845.

How Does the Article Relate to the PICO Question?

IBD, or inflammatory bowel disease, is a chronic disorder with no known treatment. Due to chronicity and bidirectional communication via the gut-brain axis, individuals with IBD may exhibit signs of common mental illnesses such as anxiety and sadness.

As a preventative effort to avert the coronavirus disease 2019 (COVID-19) pandemic, Fangcang shelter hospitals were set up throughout China. As far as we know, no studies have been done on the patients at the Fangcang shelter hospitals with mental health issues.

Cardiovascular disease (CVD) patients frequently struggle with depression, which is linked to higher mortality, extra disability, higher healthcare costs, and a worse quality of life. One in five people with peripheral arterial disease, heart failure, and coronary artery disease also have depression.

Quantitative, Qualitative (How do you know?)

Quantitative

Quantitative

Qualitative

Purpose Statement

Sought to determine the frequency of anxiety or depressive symptoms in adult IBD patients.

Prospective research findings have repeatedly demonstrated that psychological discomfort predicts future health and illness outcomes. Anxiety and depression symptoms are frequent psychological responses to the COVID-19 epidemic and may be related to As with other infectious illnesses, sociodemographic characteristics and sleep quality, early data shows that COVID-19 also creates public fear and mental health stress.

By aggravating cardiovascular disease risk factors and lowering adherence to healthy lifestyle choices and scientifically proven medical treatments, depression makes it more difficult to manage CVD optimally.

Research Question

Anxiety and depression symptoms are common with inflammatory bowel disease.

To assess the incidence and key determinants of anxiety and depression symptoms amongst COVID-19 patients hospitalised at Fangcang shelter hospitals.

Patients with cardiovascular disease (CVD) who are depressed are more likely to have morbidity and a worse quality of life.

Outcome

Patients with active illness had higher prevalence rates; 50% of these patients matched the criterion for anxiety symptoms, and 33% met the threshold for depressive symptoms. It may be possible to improve the results for IBD patients by urging gastroenterologists to detect and treat these illnesses.

Anxiety and depressive symptoms were more common, with prevalence rates of 18.6% and 13.4%. Two independent risk variables for anxiety symptoms were having a poor sleep and having two present physical complaints. Having two present physical symptoms and being a woman were independent risk factors for depressive symptoms, as were having a familial member with confirmed COVID-19 and having sex with a woman.

Patients with CVD should be treated for depression using a multidisciplinary approach. For the early treatment of mild to severe depression, this strategy may entail cardiologists collaborating closely with primary care practitioners.

Setting

(Where did the study take place?)

UK

China

US

Sample

5544 cites evaluated

307

NA

Method

Carried out a comprehensive review and meta-analysis looking into this problem.

The Jianghan Fangcang Shelter Hospital in Wuhan, China, participated in this cross-sectional study between February 23 and February 26, 2020, using an anonymous online questionnaire. The First Attached Hospital of Zhengzhou University’s ethical committees accepted the study created and carried out by hospital-employed physicians. All study participants supplied previous written informed permission online after being constantly reminded that participation was entirely voluntary.

Data was collected from different hospitals in the US

Key Findings of the Study

Due to the gut-brain axis’ bidirectional connection, the chronicity of symptoms, and the impact on quality of life and social functioning, patients with IBD may exhibit signs of common mental illnesses such as anxiety and depression.

There is now general agreement that the causes of gender variations in depression are multifaceted. For instance, during the pubertal transition, there are hormonal and neurological changes that differ by sex and may have an impact on gender differences in depression.

Antidepressant-resistant depression symptoms continue to put patients at higher risk for later cardiovascular events. Similar to how it is with patients experiencing PAD and heart failure, depression is linked to a greater risk of cardiovascular events following CABG. Those with PAD and concurrent depression had greater rates of vascular complications, less satisfactory functional recovery following patellofemoral revascularisation, and more revascularisation requirements than patients without depression.

Recommendations of the Researcher

By encouraging gastroenterologists to identify and treat these conditions, results may be improved, resulting in better symptom management, improved patient, a better quality of life, and lower societal and healthcare costs associated with managing IBD.

Our findings can help in the future development of therapies to lessen the negative psychological effects of the COVID-19 epidemic on individuals in Fangcang shelter hospitals.

Patients with CVD should be treated for depression using a multidisciplinary approach. For the early treatment of mild to severe depression, this strategy may entail cardiologists collaborating closely alongside primary care specialists. Care coordinators should support collaborative care when it is available for the management of depression.

Criteria

Article 4

Article 5

Article 6

APA-Formatted Article Citation With Permalink

Vaccarino, V., Badimon, L., Bremner, J. D., Cenko, E., Cubedo, J., Dorobantu, M., … & ESC Scientific Document Group Reviewers Lancellotti Patrizio Carneiro António Vaz. (2020). Depression and coronary heart disease: 2018 position paper of the ESC working group on coronary pathophysiology and microcirculation. European heart journal, 41(17), 1687-1696.https://doi.org/10.1093/eurheartj/ehz811

Li, H., Ge, S., Greene, B., & Dunbar-Jacob, J. (2019). Depression in the context of chronic diseases in the United States and China. International journal of nursing sciences, 6(1), 117-122. https://doi.org/10.1016/j.ijnss.2018.11.007

Peng, Y. N., Huang, M. L., & Kao, C. H. (2019). Prevalence of depression and anxiety in colorectal cancer patients: a literature review. International journal of environmental research and public health, 16(3), 411. https://doi.org/10.3390/ijerph16030411

How Does the Article Relate to the PICO Question?

From moderate depressed symptoms to a clinical diagnosis of significant depression, depression has been identified as a risk factor for CHD. Clinical depression, often known as severe depression, is characterised by low mood or anhedonia lasting at least two weeks together with considerable functional impairment and other physical or cognitive symptoms, according to the International classification of diseases and Manual of Mental Disorders, Fifth Edition (DSM-5).

A significant global public health issue is depression. 4.4% of the world’s population, according to the World Health Organization (WHO), suffered from depression in 2015.

We sought to determine the most accurate assessment of the risk of anxiety and depression among colorectal cancer (CRC) patients by reviewing existing research.

Quantitative, Qualitative (How do you know?)

Quantitative

Quantitative

Quantitative

Purpose Statement

All seeking proof that clinical depression (or depressed symptoms) and CHD are connected.

An comprehensive overview of the research on the incidence of depression among people with chronic illnesses in China and the United States and its link to worse health outcomes is provided by this study.

Nearly half of all new instances are thought to occur in Europe and the Americas, where over 65% of new cases are predicted to occur. The past ten years have seen a dramatic improvement in the survival of CRC patients as a result of early diagnosis and developments in chemotherapy, surgeries, and radiation therapy.

Research Question

It does this by summarising key points in our current understanding of the relationship among both depression and CHD within the crisscrossing fields of neuroscience, cardiovascular human biology, and behavioural medicine.

The high rate of depression among people with chronic illnesses in China and the United States raises questions about the underlying processes. Chronic conditions include COPD, cancer, diabetes, cardiovascular disease, and stroke show a bidirectional link with depression.

New difficulties do, however, arise when CRC patient survival rates increase.

Outcome

The goal of this paper is to draw attention to the relationship between depression and CHD and to encourage research activities, clinical awareness, and better care.

In a clinical assessment of depression and coronary heart disease, it has been suggested that the autonomous nervous system, pro-inflammatory mediators, neurohormonal, usage and meaning genetic variables, and platelet receptors are the likely molecular processes linking depression with cardiovascular disease.

Many cancer survivors endure problems with their bodies and minds that are typically brought on by the illness and its treatment. Depression, anxiety, exhaustion, discomfort, and cognitive difficulties are among the symptoms. There is evidence that the disease and its treatment may contribute to these symptoms as well as psychological distress conditions including depression and anxiety.

Setting

(Where did the study take place?)

UK

US and China

Australia, New Zealand, Northern America, and Eastern Asia

Sample

NA

Inflammation is a typical biological mechanism linking depression with chronic illness across a wide range of chronic disorders. Cancer patients’ prognoses can be worsened by depression, and stress can aggravate inflammation by activating the sympathetic nervous system.

Method

Additionally, research has shown that some depression subtypes may have a stronger correlation with the risk of CHD than others. Patients who experience depression for the first time after an ACS, have depression that is resistant to therapy or has physical rather than cognitive signs of depression are all more likely to experience worse CHD outcomes. However, there is disagreement about whether these various phenotypes differ in risk.

With minor variances, both nations show significant rates of depression in patients with COPD, diabetes, cancer, heart disease, and stroke. Depression is more common in people with diabetes, heart disease, and cancer overall in China. These variations can be attributable to different study designs, measurement uncertainty, varied samples between studies, and various risk factors.

Inquiries on the frequency of depression or anxiety in CRC patients were conducted using the PubMed/Medline database, Web of Science, and Google Scholar.

Key Findings of the Study

The majority of the data is in favour of the idea that depression following ACS is a risk factor for cardiac and all-cause mortality as well as for compounded outcomes that include fatalities or non-fatal cardiac events.

In China, elderly women typically have lower levels of education and income. Furthermore, patients with greater levels of education are less anxious than patients with lower levels of education because they are better educated about the illness process.

Recommendations of the Researcher

For the CHD patients who has depression, there are a variety of therapeutic options available, including medication, several types of psychotherapy, exercise programmes, and stress-reduction techniques. Depression should still be treated if it is severe enough in order to maintain patient wellbeing and quality of life, even if it has not been demonstrated that doing so can improve cardiovascular outcomes in CHD patients.

Those with COPD in the United States had a greater rate of depression than patients in China. The disparity in illness burden between the two nations can be used to explain this. Stroke, heart disease, and traffic accidents, as well as heart disease, cancer, and COPD, respectively, were the top three killers in China and the United States, according to the Global Burden of Disease 2016 research. In the United States, COPD is a more troublesome condition than it is in China.

110 US cancer patients participated in this trial, 64 of them had CRC diagnosis. The MMPI was used to test patients for sadness and anxiety, and the results showed that patients with CRC had higher rates of these conditions than those in the control group.

According to the research, 13% of CRC patients had either sadness or anxiety. The research did not include the mean age of the patients, although the authors noted that the majority of them were in their sixth and seventh decades

Criteria

Article 7

Article 8

Article 9

APA-Formatted Article Citation With Permalink

Kalin, N. H. (2020). The critical relationship between anxiety and depression. American Journal of Psychiatry, 177(5), 365-367. https://doi.org/10.1176/appi.ajp.2020.20030305

da Silva, F. C. T., & Neto, M. L. R. (2021). Psychiatric symptomatology associated with depression, anxiety, distress, and insomnia in health professionals working in patients affected by COVID-19: A systematic review with meta-analysis. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 104, 110057.https://doi.org/10.1016/j.pnpbp.2020.110057

Gold, S. M., Köhler-Forsberg, O., Moss-Morris, R., Mehnert, A., Miranda, J. J., Bullinger, M., … & Otte, C. (2020). Comorbid depression in medical diseases. Nature Reviews Disease Primers, 6(1), 69. https://doi.org/10.1038/s41572-020-0200-2

How Does the Article Relate to the PICO Question?

Among the most prevalent mental conditions are anxiety and depressive disorders. These two conditions are commonly comorbid and are together referred to as internalising disorders. According to data from the Mental Health and Substance Abuse Services Administration, major depressive disorder was predicted to affect 7.1% of adults and 13.3% of adolescents in 2017 during the course of a 12-month period.

A variety of clinical symptoms and indicators associated with the novel coronavirus illness (COVID-19), ranging from asymptomatic states to the development of an acute respiratory Syndrome, may appear (SARS). Its reach has rapidly expanded. China acknowledged the human-to-human transmission of COVID-19 on January 20. To stop the spread of sickness, Wuhan’s municipal government stopped all entry points on January 23. But, this proved insufficient.

Those who have a medical condition are more likely to experience depression than the general population; in fact, the risk of depression is multiplied several times higher in many of these patient categories. Both depressed indicators below the diagnostic threshold for MDD and MDD, the diagnostic entity of depression, are at an elevated risk.

Quantitative, Qualitative (How do you know?)

Quantitative

Quantitative

Quantitative

Purpose Statement

Throughout the reproductive years of women, there is an about 2:1 ratio of women to males who suffer from anxiety and depressive disorders.

Information gathering on the behaviour and mental state of health workers may establish suitable approaches that stimulate and protect their health during the war against the pandemic, based on a scenario of increasing pandemic threat, a global atmosphere of anxiety, along with depression caused either by social distancing measures recommended to reduce transmission of disease and an an overload of data disclosed by different media outlets.

Depressive symptoms for subthreshold depression, MDD for the official diagnosis, and depression when both are mentioned or in broader contexts.

Research Question

The onset of anxiety disorders and severe depression both occur during development, with the former usually starting around preadolescence and early adolescence and the latter often appearing during adolescents and early to mid-adulthood.

What psychological effects do the demanding conditions brought on by the COVID-19 epidemic have on medical workers’ physical and psychological health?

In certain patient populations, depression is frequently more common than in the general community, and depression contributes significantly to the psychosocial burden of these conditions.

Outcome

The analytic technique compares the results of high-risk complete sibships versus high-risk half sibships, where at least one sibling was raised at home and the other was adopted out of the family, using a special design from a Swedish sample. The results confirm the significance of parental depression and the quality of the home environment in either reducing or increasing the risk of severe depression.

Due to their narrow scope, the fact that most of the individuals are from Wuhan, China, and the brief duration of the research, the studies under consideration have limitations. Another drawback related to internet research and self-report tools’ psychological evaluations.

Comorbid depression has significant clinical ramifications since both chronic illnesses and depression have a negative impact on overall health that is additive or even synergistic. Furthermore significant, comorbid depression frequently impairs patients’ quality of life.

Setting

(Where did the study take place?)

UK

China

Germany

Sample

NA

90 Papers

NA

Method

The authors employ meta-analytic techniques to comprehend the brain changes connected to abnormal mood regulation that are common to various mental diseases. According to research, changes in the reward, lateral orbital nonreward, and salience networks are typical of diseases including anxiety and depression.

NA

Although methodological variations make comparisons between studies challenging, it has been estimated that individuals with ovarian or brain tumours have a disproportionately high rate of concomitant MDD. In fact, a sizable cross-sectional research in Germany of patients with major cancer types discovered that patients with breast tumours, women having tumours of the reproductive system, and patients with kidney tumours had the highest frequency of mood problems.

Key Findings of the Study

These variations were specifically seen in the inferior temporal cortex’s activity. In their editorial, Dr. Dylan Gee and Sahana Kribakaran of Yale University stress the significance of developmental research in connection to understanding anxiety disorders, set these findings in the perspective of previous research, and posit the potential that these and other data point to age-specific therapies that are neurologically informed.

Hence, in order to fully understand the pathophysiology, treatment approaches, and utilisation of clinical interviews to construct a larger evaluation of the issue, large-scale longitudinal studies that include other health professionals in addition to doctors and nurses are required.

This discovery establishes a connection between the human genetics research that found an association between obesity and MDD and that also included evidence of inflammation.

Recommendations of the Researcher

The issue also offers a developmental viewpoint, highlighting the significance of early upbringing in the likelihood of developing depression, as well as age-related results critical to understanding how individuals with anxiety disorders handle threats.

To further study the pathophysiology, treatment approaches, and utilisation of clinical interviews to construct a broader evaluation of the issue, large-scale longitudinal research with additional health professionals in addition to doctors and nurses are required.

In these situations, it could be beneficial to suggest behavioural activation that is safe for patients and can reduce depression.

Criteria

Article 10

Article 11

Article 12

APA-Formatted Article Citation With Permalink

Zandifar, A., Badrfam, R., Yazdani, S., Arzaghi, S. M., Rahimi, F., Ghasemi, S., … & Qorbani, M. (2020). Prevalence and severity of depression, anxiety, stress and perceived stress in hospitalized patients with COVID-19. Journal of Diabetes & Metabolic Disorders, 19, 1431-1438. https://doi.org/10.1007/s40200-020-00667-1

Pan, X., Wang, J., Lin, Z., Dai, W., & Shi, Z. (2019). Depression and anxiety are risk factors for postoperative pain-related symptoms and complications in patients undergoing primary total knee arthroplasty in the United States. The Journal of arthroplasty, 34(10), 2337-2346. https://doi.org/10.1016/j.arth.2019.05.035

Wang, Y., Duan, Z., Ma, Z., Mao, Y., Li, X., Wilson, A., … & Chen, R. (2020). Epidemiology of mental health problems among patients with cancer during COVID-19 pandemic. Translational psychiatry, 10(1), 263. https://doi.org/10.1038/s41398-020-00950-y

How Does the Article Relate to the PICO Question?

Mental health conditions may be linked to COVID-19, a disease that may spread from person to person and cause major health issues. In this study, we examined a sample of COVID-19 patients who were hospitalised to figure out the prevalence and extent of depression, anxiousness, stress, and stress perception.

In the United States, the prevalences of anxiety and depressive disorders during 2015 reached 5.9% and 6.3%, respectively, with patient counts reaching million and 18 million. The prevalences of both psychiatric illnesses in patients receiving total knee arthroplasty (TKA) approached 20%.

The current study looked on the mental health issues experienced by cancer patients who were diagnosed during the COVID-19 epidemic. In one of China’s major cancer facilities, a cluster selection, cross-sectional study of 6213 people with cancer was carried out.

Quantitative, Qualitative (How do you know?)

Quantitative

Quantitative

Quantitative

Purpose Statement

Among a sample of COVID-19 patients who were hospitalised, the frequency and intensity of sadness, anxiety, stress, and pressure perception.

The objective of the study was to examine the causal mechanisms linking psychiatric comorbidities to postoperative outcomes in individuals having primary total knee arthroplasty.

The results of the current study showed a significant incidence of mental health issues and service gaps for people with cancer, which also suggested a high level of discomfort from COVID-19-raised hazards.

Research Question

After the emergence of COVID-19, this study also looked at the potential effects that patients’ socioeconomic, occupational, and occupational status could have on their mental health. Another topic of inquiry is how demographic variables, including marital status, affect this situation.

Diagnoses of anxiety, sadness, or both became more common in TKA patients over time.

We demand that all cancer patients be routinely screened for their mental health and that targeted psychological therapies be created for this vulnerable group

Outcome

Given that the goal of this study is to evaluate COVID-19 patients’ levels of stress, anxiety, and depression, it is crucial to pay attention to this problem. The relationship between physical and mental disorders is extremely complex and presents a significant challenge for modern medicine. In our investigation, there was no connection between patients’ psychological problems and underlying illnesses. Further research, particularly multicenter samples with bigger sample sizes, are necessary to summarise this conclusion.

The chi-squared test and an analysis of variance were used to determine how these 4 categories differed from one another. Whether psychiatric comorbidities were separate risk factors for postoperative pain and surgery-related discomfort, multivariable regression regression analysis is applied to ascertain this.

For the purpose of identifying and treating various mental health issues in cancer patients, the recent findings have important therapeutic ramifications. Surprisingly, our findings identified both common and distinctive risk factors as well as protective variables for various mental health issues. The identification of elements that may affect mental health might help with effective mental health screening and treatment for cancer patients.

Setting

(Where did the study take place?)

NA

United States

China

Sample

106

Data from 2002 to 2014

3974

Method

In this cross-sectional research, 106 hospitalised COVID-19 patients with stable clinical circumstances underwent psychological evaluation using the following two questionnaires: Perceived stress scale, Depression, Anxiety, and Stress Scales-21

To determine differences between these 4 categories, the chi-squared test and also an analysis of variance were used. It was determined if psychiatric comorbidities were separate risk factors for postoperative pain and discomfort from surgery by multiple logistic regression analysis.

Cancer patients were enrolled in this cross-sectional study at the Sun Yat-sen University Cancer Center in China from April 9 through April 19, 2020, using cluster sampling. One of the biggest and best radiation facilities in the world is the Sun Yat-sen University Cancer Center. We sent a mobile message with an invitation and a website link to the 9978 cancer patients who visited the cancer centre. 65.5% of those who were asked to participate in the survey—6537 patients—did so.

Key Findings of the Study

73.6% of patients reported high levels of felt stress, whereas 22.6% reported moderate levels. Depression and experienced stress were revealed to be strongly positively correlated. Anxiety and anxiety symptoms were statistically significantly correlated.

In this study, patients with mental illnesses had higher odds ratios for major complications and all pain-related symptoms, as well as greater hospital expenses but shorter hospital stays.

In this article it is discovered that the main lifestyle factors for psychological disorders in cancer patients were a history of mental illness, binge drinking, and greater levels of exhaustion and discomfort. In line with other studies, we discovered that somatic comorbidities, particularly in terms of pain and exhaustion, were linked to more serious mental illnesses in cancer patients.

Recommendations of the Researcher

It is advised to undertake larger research with a greater number of participants and in a multidisciplinary fashion due to the disease’s high prevalence in order to get results that are more comprehensive.

Among TKA patients, anxiety and sadness are more common than ever before. The results of TKA were highly linked with psychiatric illnesses.

To provide appropriate treatment from postoperatively pain-related symptoms and to improve quality of life, greater consideration has to be given to the mental health of individuals receiving TKA.

It is likely that we overestimated the prevalence of mental health issues in patients because cancer patients with severe disorders of the mind may quit visiting hospitals for cancer treatment.

Part 2: Analysis of Literature

In 750-1,000 words, write a review of the literature. This section should comprehensively summarize previous research related to your topic and demonstrate support for your PICO question.

Remember, you are building an argument to for your proposed evidence-based project; this is not simply an article review.

Appraise each article and answer the following questions for each (one to two sentences is sufficient to answer each question):

Summarize the purpose of the article or research.

Describe how the article or research relates to the health care problem or issue you selected.

Explain how the evidence in the article or research supports your proposed intervention.

Depression in the elderly is a frequent yet challenging issue, especially for people with long-term physical health issues. The scientific literature on the incidence and treatment of depression in elderly medical patients is reviewed in this work. After providing a basic review of depression in the elderly, we go into some of the specific difficulties related to depression and co-occurring medical illnesses in senior individuals. When there is significant symptomatological overlap, depression in older persons who are medically ill might be challenging to identify. The demographics and evidence foundation for the management of depression in a range of chronic health issues typical of older persons are then covered, including Parkinson’s disease, chronic renal disease, cancer, cardiac illness, and cerebrovascular disease. There is growing evidence that therapies can reduce depression symptoms for several of these diseases. These possible advantages must be weighed against the frequently elevated risk of unfavourable outcomes or interactions with medicinal therapies.

Antidepressant drug studies in depressed Parkinson’s disease patients are few. Five placebo-controlled studies were found by Rocha et al., however a meta-analysis was unable to show a clear positive impact. Anti-Parkinsonian medications are becoming more popular for treating depression in people with this disorder. In the largest study of these drugs, researchers randomly assigned 296 patients to receive either the dopamine agonist pramipexole or a placebo. They discovered that pramipexole considerably reduced depressed symptoms more than the placebo, mostly due to a direct antidepressant effect. Despite the fact that co-morbid depression is regularly linked to worse medical outcomes, there is no proof that typical antidepressant medication offers any significant advantages for outcomes related to physical health. First, many methods for managing depression in elderly medical patients have been investigated. While the bulk of research have concentrated on antidepressants in this demographic, more studies have recently been published that have taken collaborative care or phased care programmes into account.

Depression in older persons who are physically unwell is a common but complicated issue. It can be challenging for physicians to determine whether individuals are depressed since many typical symptoms of sadness might be mistaken for age-related symptoms or co-morbid medical illnesses. Yet, it is crucial to accurately diagnose depression in this patient group since it can have a significant impact on quality of life and is repeatedly linked to worse physical health outcomes. According to the unique medical condition present, different management techniques and particular considerations are required, as described in the sections above it and summarised. There is growing evidence that improved depression therapies can effectively reduce depressed symptoms for many diseases, but this must be weighed against a higher risk of side effects. There are still gaps in our knowledge of the biochemical connections between depression and physical disease, and there is currently no proof that typical depression therapy has extra advantages for outcomes related to physical health. Elderly individuals who are medically ill seem to benefit particularly from collaborative care approaches, which may also have more widespread advantages for both physical and mental health.