Evidence-Based Treatment of Psychiatric Disorders with Comorbid Medical Illnesses: The Need for Large Simple Clinical Trials

When discussing psychiatric illnesses in the elderly, one cannot ignore coexisting medical problems. With aging, there is a rapid increase in the prevalence of medical disorders including cancer, Alzheimer’s disease, stroke, heart disease, and arthritis. It is often these illnesses, not depression, anxiety or other psychiatric symptoms, which bring patients in to see their physician; however the interaction between psychiatric disorders and these illnesses have at best been poorly studied or at worst ignored. The reciprocal relationship between these illnesses is deserving of more intensive study, particularly examining how the treatment of one may influence or be influenced by the other. The topic of medical illnesses coexisting with various psychiatric disorders, such as bipolar disorder, psychosis, anxiety, and addiction, is broad. It also varies with the psychiatric disorder in question. For this editorial, we will use depression, a common psychiatric disorder in the elderly, as an example.