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Depression and anxiety may be the first manifestations of a medical disease

In the current issue of and Psychosomatics, and other italian investigators have analyzed the data available on as early manifestations of medical disease.

Affective disturbances involving alterations of mood, anxiety and irritability may be early symptoms of medical illnesses. The DSM-5 provides examples of that may be associated with mood and anxiety disturbances but not a list of characterized by affective prodromes.

The results of this study showed that depression seems to be the most common affective prodrome of medical disorders and is consistently reported in Cushing’s syndrome, hypothyroidism, hyperparathyroidism, pancreatic and lung cancer, myocardial infarction, Wilson’s disease, and AIDS.

Mania, anxiety and irritability Anxiety and irritability may occur in conjunction with depression, but are less frequent on their own. Mania was not found to be consistently associated with specific medical disorders other than Wilson’s disease.

Physicians may not pursue medical workup of cases that appear to be psychiatric in nature. They should be alerted that disturbances in mood, anxiety and irritability may antedate the appearance of a .

Article: Cosci F, Fava GA, Sonino N. Mood and Anxiety Disorders as Early Manifestations of Medical Illness: A Systematic Review, Psychotherapy and Psychosomatics, DOI:10.1159/000367913, published January 2015.


Source: Journal of Psychotherapy and Psychosomatics