Psychological distress in physical long-term conditions

Abstract

Psychological distress including depression, anxiety, and disease specific distress is common in people with physical long-term conditions (LTCs). This chapter focusses on psychological distress in four LTCs associated with the cardiovascular and endocrine systems, specifically: Coronary heart disease (CHD), cerebrovascular disease (CVD), end-stage renal disease (ESRD), and diabetes. The co-occurrence of psychological distress alongside each of these LTCs is associated with increased morbidity, mortality, poorer quality of life, and higher health care costs. Underlying mechanisms as to why psychological distress is associated with poorer physical health outcomes remain unclear, but there is evidence implicating both biological and behavioural mechanisms. Such uncertainty generates difficulties for the development of effective treatment interventions for the management of psychological distress in the context of physical illness. In addition, it is likely that the mechanisms underlying the association between psychological distress and health outcomes are LTC specific. This chapter provides a brief overview of: (i) the conceptualisation and prevalence of psychological distress in LTCs, (ii) the aetiology of psychological distress in LTCs and its proposed mechanisms of action for contributing to poorer physical health outcomes, and (iii) existing treatment interventions for the management of psychological distress in people with LTCs.