Depression is not only a significant
public health concern,
it is also linked to many other diseases. The interaction
of depression with other diseases was recently discussed
at ORWH’s Women’s Health Seminar Series, “Sex and Gender Research: the Interaction of Depression with Other Diseases.” Several current and former NIMH grantees participated in the discussions.
NIMH grantee Dr. Jill Goldstein of Brigham and Women’s Hospital discussed sex differences that are pervasive in depression.
“The higher incidence of major depressive disorder in women is initiated during
sexual differentiation in the brain,” she explained. “Fetal development, puberty, pregnancy and menopause are all windows of opportunity in which to study the differences seen clinically in rates of major depression and mood disorder.”
There is a similarity of developmental risk factors during the second and third trimesters of pregnancy for depression and cardiovascular disease, she continued.
These factors include small gestational age, low birth weight, pre-eclampsia
and prenatal exposure of the mother to famine.
“Sex differences exist in every tissue of the body,” she concluded. “Disruption in the amygdala, hippocampus, hypothalamus and white matter lead to the sex differences seen in depression, mood disorders, endocrine dysfunction and heart rate.”
Osteoporosis is also a major public health problem costing billions of dollars
and affecting millions of individuals each year. However, its relationship to depression is still largely unrecognized. NIDDK investigator and former NIMH collaborator Dr. Giovanni Cizza presented data showing that chronic stress and depression result in significant bone loss, particularly in the hip.
“We found that one in five premenopausal women with major depressive disorder exhibited low bone mineral density in the hip area,” Cizza noted. “Depressed premenopausal patients exhibited the equivalent of one year of bone loss seen in post-menopausal patients.”
Cancer is another health concern in which depression can play a role in the course of treatment. While 10 to 30 percent of people with cancer are found to be depressed, the rates of depression vary with age of onset of cancer, type of cancer and stage of treatment. Dr. Mary Jane Massie of Memorial Sloan-Kettering Cancer Center presented data showing that at diagnosis a third of patients said they were depressed, 15 percent said they were depressed at 1 year after diagnosis and 45 percent after recurrence.
Dr. Viola Vaccarino of Emory School of Medicine focused on the social and behavioral determinants of cardiovascular disease in women. Depression is more prevalent in heart patients than in the general population, especially in young women with acute heart disease. “The links between depression and cardiovascular disease may be more important for women,” she said. “Obviously,
interventions must be tailored to women’s stressors. However, treating both depression and CVD is controversial. No study has shown that treating both conditions results in improved CVD and this is disappointing.”