{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:16:32Z","timestamp":1791926192237,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,7,10]],"date-time":"2017-07-10T00:00:00Z","timestamp":1499644800000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["sigmapubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Nursing Scholarship"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose and Design<\/jats:title><jats:p>This integrative review offers a systematic synthesis of the international literature regarding the role of depression as a risk factor in physical illnesses and the mechanisms of this connection. Special attention is paid to those modifiable factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Published studies of depression and physical illness and disease(<jats:italic>N<\/jats:italic> = 24) from five countries that were indexed in PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), APA PsycNET, Scopus, Dialnet, and CUIDEN were examined. Results suggest that depression is a significant risk factor for the development of physical illnesses and diseases. More commonly studied were the connections between depression and cardiovascular disease, metabolic syndrome, biochemical alterations, diabetes, dementia, cognitive impairment, Alzheimer's disease, somatization and chronic pain, asthma, arthritis, and hyperlipidemia. Less frequently studied conditions connected to depression were cancer, infections, allergies, autoimmune disease, gastric ulcer, rhinitis, thyroiditis, bronchitis, migraines, fractures, and osteoporosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mechanisms connecting depression to physical illness appear to involve alterations in the hypothalamic\u2010pituitary axis, unhealthy lifestyle, chronic or acute stressors including posttraumatic stress, an increase in C\u2010reactive protein (CRP) in men, taking antidepressant medication, and social and emotional loneliness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Relevance<\/jats:title><jats:p>A good patient\u2013provider relationship can help to promote decreased acute or chronic stressors, increased family and social support, decreased loneliness, modification of unhealthy lifestyles such as smoking, obesity, physical inactivity, alcohol, control of CRP, and antidepressant medication. Nurses are well placed to help prevent physical diseases through detection and referral of patients who are depressed or undiagnosed and not receiving adequate mental health treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jnu.12303","type":"journal-article","created":{"date-parts":[[2017,7,10]],"date-time":"2017-07-10T17:05:18Z","timestamp":1499706318000},"page":"389-399","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Depression as a Risk Factor of Organic Diseases: An International Integrative Review"],"prefix":"10.1111","volume":"49","author":[{"given":"Teodora","family":"Bica","sequence":"first","affiliation":[{"name":"Staff Nurse Comarcal Mora d'Ebre Hospital  Mora d'Ebre Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Castell\u00f3","sequence":"additional","affiliation":[{"name":"Staff Nurse Emergency Department. Brighton and Sussex University Hospitals NHS Trust  Brighton England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loren L.","family":"Toussaint","sequence":"additional","affiliation":[{"name":"Professor, Department of Psychology Luther College  Decorah, IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Montes\u00f3\u2010Curto","sequence":"additional","affiliation":[{"name":"Professor Department of Nursing Rovira I Virgili University  Tortosa Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,10]]},"reference":[{"issue":"2","key":"e_1_2_8_2_1","first-page":"141","article-title":"Depression, particularities and consequences in the elderly","volume":"143","author":"Aguilar\u2010Navarro S.","year":"2007","journal-title":"Gaceta M\u00e9dica de M\u00e9xico"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03401301"},{"issue":"10","key":"e_1_2_8_4_1","first-page":"545","article-title":"Comorbidity of major depression with other common mental disorders in primary care patients","volume":"41","author":"Aragon\u00e9s E.","year":"2009","journal-title":"Atenci\u00f3n Primaria"},{"issue":"3","key":"e_1_2_8_5_1","first-page":"141","article-title":"Cardiovascular risk factors, cardiovascular risk and quality of life in patients with a severe mental disorder","volume":"45","author":"Borreu\u2010Foguet Q.","year":"2013","journal-title":"Atenci\u00f3n Primaria"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.NAJ.0000422251.65212.4b"},{"key":"e_1_2_8_7_1","volume-title":"Depression and its masks: Therapeutic aspects","author":"Chinchilla\u2010Moreno A.","year":"2008"},{"issue":"6","key":"e_1_2_8_8_1","first-page":"414","article-title":"Metabolic syndrome: Relevance to antidepressant treatment","volume":"31","author":"Chokka P.","year":"2006","journal-title":"Journal of Psychiatry & Neuroscience"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmt032"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpsmen.2011.02.002"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2011.03932.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1389"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2006.07.009"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.107.038380"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.9.1010"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2009.10.006"},{"key":"e_1_2_8_17_1","first-page":"5","article-title":"Sadness and broken hearts: Neurohumoral mechanisms and co\u2010morbidity of ischemic heart disease and psychological depression","volume":"7","author":"Johnson A. 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