Subjective and Objective Assessments of Medical Comorbidity in Chronic Depression

While the extent of medical comorbidity in depressive illness is widely recognised, there have been few studies where objective and subjective assessment of comorbidity in chronic depression have been made. The aim of this study was to determine the extent and nature of medical comorbidity, in terms of both physician and patient assessments, in a group of outpatients with chronic depressive symptoms. Eighty-seven outpatients with a history of depressed mood for at least 2 years were assessed using the SCID and the Hamilton Depression scale. Physician and patient assessment of any medical comorbidity were completed. Sixty percent of patients, and significantly more public general hospital outpatients than private outpatients, viewed themselves as suffering from a serious medical illness in addition to their depression. Only 8% were viewed objectively as having a serious medical condition. The discrepancy between patient and physician assessments of medical comorbidity in chronic depression is of note and may relate to depressed mood. Careful evaluation of chronically depressed patients' perceptions of physical illness may help achieve a positive treatment outcome.