Minor Depression Highly Prevalent among Women Veterans with Complex Chronic Illness
A distinction between major and minor depression is often made in the continuum of depressive disorders, and existing research suggests that the rates of minor depression are higher among those with chronic physical illnesses. Minor depression is often associated with negative outcomes and may lead to major depression; minor depression also negatively affects health and emotional status in individuals with chronic illness. This retrospective cross-sectional study compared the rates of major and minor depression among women Veterans with chronic conditions (diabetes, heart disease, or hypertension) who received VA care in FY02. Using VA and Medicare data, investigators indentified 49,516 women Veterans diagnosed with diabetes, heart disease, or hypertension in FY02. From this group, they identified 13,430 women Veterans (27%) who also had been diagnosed with any type of depression in FY03. In addition, investigators examined other independent variables, such as: ethnicity, age, region of residence, supplemental insurance, substance use, and physical and mental comorbidities.
Findings show that minor depression is highly prevalent among women Veterans with complex chronic illnesses such as diabetes, heart disease, or hypertension. Of the 13,430 women Veterans with depression, 60% were diagnosed with minor depression and 40% with major depressive disorders. The most common form of minor depression was "depression not elsewhere classified," (50%, e.g., time period following the death of a family member, when it's normal to be sad). Compared to major depression, minor depression was significantly more likely among women Veterans who were older, without any other psychiatric condition, and substance use disorders. Results also show that compared to the hypertension only group, women Veterans with diabetes only or diabetes plus hypertension had higher rates of major depression (39% vs. 45% vs. 42%). Moreover, all types of psychiatric conditions and substance use were associated with higher rates of major depression, and 22% of the study population had a substance use disorder. The authors suggest that the generally high rates of depressive disorders among women Veterans with chronic physical illnesses indicate the need for a continuum of care that encompasses both physical and mental illness domains.
Shen C, Findley P, Banerjea R, and Sambamoorthi U. Depressive disorders among cohorts of women veterans with diabetes, heart disease, and hypertension. Journal of Women’s Health August 2010;19(8):1475-86.
This study was funded by HSR&D (IAE 05-255 and IIR 05-016). Drs. Shen, Findley, and Sambamoorthi are part of HSR&D's Center for Healthcare Knowledge Management for Chronic Complex Illness, located in East Orange, NJ.