Mental Diagnosis in Chronically Medically Ill Patients

Chronically ill patients represent a specific group that often requires much attention from healthcare providers. However, despite being focused on the needs of medically ill patients, clinicians can experience certain difficulties while diagnosing a mental illness in them. The reason is that chronic conditions can cause certain patients’ reactions to their state and provoke negative emotions and moods. Possible difficulties should be discussed in detail to understand what challenges are faced by healthcare providers when they need to diagnose a mental illness in chronically ill patients.

The key mental illness to discuss in this context is depression. Clinicians face difficulties while diagnosing this condition because patients’ chronic diseases can provoke similar symptoms, including problems with sleep and appetite. Furthermore, if patients use certain medications, for instance, steroids, which cause mood changes, their behaviors and emotions can be similar to those exhibited by patients with depression (Turner & Kelly, 2000). As a result, healthcare providers can experience difficulties while distinguishing between depression and problems associated with chronic diseases. In this case, it is important to evaluate possible risk factors for the development of depression to predict or address the problem (Guthrie et al., 2016). Additionally, the problem is that patients do not report some symptoms that disturb them, and clinicians cannot diagnose mental illnesses before their progress and the presence of obvious signs.

The other side of this question is that undiagnosed and untreated depression in chronically ill patients can cause more difficulties for healthcare providers because these patients can refuse following the prescribed treatment, they do not want to continue using drugs, and they can experience problems with managing pain. In this context, risks of developing suicide ideations increase (Avari & Alexopoulos, 2015). Furthermore, it is also important to pay attention to the fact that some diseases and chronic conditions can lead to developing a depressive disorder in most cases, and clinicians should focus on these conditions to help patients cope with their problems (Turner & Kelly, 2000). Such conditions include cardiovascular diseases and other illnesses associated with the risk of death.

From this perspective, clinicians often face situations when they need to diagnose a mental illness in chronically ill patients. Still, diagnosing in these cases is associated with certain difficulties. To overcome these barriers, healthcare providers should recognize conditions with the highest risk of developing depression and pay attention to all changes in patients’ moods and behaviors.


Avari, J. N., & Alexopoulos, G. S. (2015). Models of care for late-life depression of the medically ill: Examples from chronic obstructive pulmonary disease and stroke. The American Journal of Geriatric Psychiatry, 23(5), 477-487.

Guthrie, E. A., Dickens, C., Blakemore, A., Watson, J., Chew-Graham, C., Lovell, K.,… Tomenson, B. (2016). Depression predicts future emergency hospital admissions in primary care patients with chronic physical illness. Journal of Psychosomatic Research, 82, 54-61.

Turner, J., & Kelly, B. (2000). Emotional dimensions of chronic disease. Western Journal of Medicine, 172(2), 124-128.