Major depression and physical illness. Special considerations in diagnosis and biologic treatment.

Diagnosis of depression in the physically ill may be obscured and complicated by the presence of pervasive somatic complaints that may or may not be due to the primary disease process. In addition, concurrent medical illness and physiologic instability may make treatment with antidepressants hazardous. This article reviews descriptive approaches to he diagnosis of depression in the physically ill, as well as discusssing modifications in psychopharmaco-logic and electroconvulsive therapy that may be necessary in treating the medically compromised patient.