Clinical Case Database / Category: Patient Management

Diagnosis and management of anxiety and depression in patients with physical illness

Publication details

Dr Alifa Isaacs-Itua BM BS, LLDip, BA (Hons), Dr Jim Bolton MB BS, BSc(Hons), FRCPsyc
Foundation Years Journal, volume 4, issue 8, p.9 (123Doc Education, London, September 2010)


Patients with physical illnesses have higher rates of depression and anxiety, particularly those with a history of mental illness. Physical and psychological co-morbidity are associated with a poorer physical outcome and an increased use of health care resources. Foundation doctors play an important role in identifying patients with anxiety and depression in the context of physical ill health. This can be achieved by observation and careful enquiry about psychiatric symptoms. We describe a case of a patient whose initial recovery and rehabilitation was hindered by anxiety and depression.

Access the Clinical Cases Database

A subscription is required to read the full article. Please subscribe using one of the options below.

Foundation Years Clinical Cases Database£29.006 months
Add to cart
Foundation Years Clinical Cases Database£39.0012 months
Add to cart


Dr Alifa Isaacs-Itua BM BS, LLDip, BA (Hons)

Foundation Doctor

Dr Jim Bolton MB BS, BSc(Hons), FRCPsyc

Consultant Liaison Psychiatrist & Honorary Senior Lecturer
Department of Liaison Psychiatry
St Helier Hospital
Wrythe Lane
Surrey SM5 1AA


1. Whooley MA, Avins AL, Miranda J, et al.(1997) Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med. 12(7):439–445.
2. National Institute for Health and Clinical Excellence (NICE) (2009) Depression in adults with chronic physical health problem.
3. Beck AT, Ward CH, Mendelson M, et al. (1961) An inventory for measuring depression. Arch of Gen Psychiatry. 4:561–571.
4. Snaith RP, Zigmond AS. (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand. 67(6):361–370.
5. Longson D. (2007) Detection of psychiatric disorders in the general hospital: a practical guide. In: GG Lloyd and E Guthrie (eds) Handbook of Liaison Psychiatry. 1st edn. Cambridge: Cambridge University Press; 83–101.
6. Cleare AJ. (2008) Mood disorders in the general hospital setting. Psychiatry. 8(2):67–70.
7. Rao M. (2008) Depression in the physically ill. Primary Psychiatry. 15(9):44–50.


Conflict Of Interest

The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (

Financial Statement

The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.

Patient Consent statement

All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts ( The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.

Animal & Human Rights

When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.

About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.