Include coronary artery disease and reduced bone mineral density

The long term social impact of depressive illness has been extensively investigated,1 but far less attention has been paid to its physical consequences. There is, however, an important and accumulating body of evidence to indicate that the physical consequences of depression are far from benign. In particular, the increased risk of coronary artery disease and the impact on bone mineral content have both received recent attention.

A 55 year prospective study that examined the relation between mood disorder and physical health in a male population showed the damaging effects of depression.2 Among 237 healthy men recruited at college entry and assessed at the age of 70, 45% of those who had suffered a depressive episode were dead at follow up compared with only 5% of those in good psychological health. The differences in longevity could not be explained in terms of cigarette smoking, diet, or alcohol intake. In …