Mood Changes as Early Manifestations of Physical Illnesses – A Review

Abstract

Background: Mood changes have been related to several physical illnesses and, in many cases, they are their first symptoms. An early diagnosis can improve their course and prognosis, so it is important to be aware of the psychiatric manifestations of medical diseases and to know how to suspect of other causes beyond the psychiatric ones.

Aims: The authors aim to review the relationship between mood changes and physical illnesses, highlighting their particularities and the signs that may inform clinicians about the presence of an underlying medical disease.

Methods: Non-systematic review through literature research in PubMed/Medline database, using the key-words medical illness, anxiety, irritability, depression and affective disorders.  The articles were selected according to their relevance to the topic.

Results: There are many physical illnesses that are consistently associated to the early occurrence of mood disorders, namely the metabolic, endocrine, neoplastic, neurologic, infectious and vascular ones. Mood changes that are frequently related to physical illnesses are depression and anxiety, followed by irritability and mania. These often precede the diagnosis of a medical disease and they are frequently refractory to psychiatric treatment. 

Conclusions: Psychiatrist should be familiarized with the possible psychiatric manifestations of physical illnesses, particularly mood changes, and investigate a possible organic cause to them, mainly when they are refractory to psychiatric treatment. This approach can contribute to an early diagnosis and treatment, a better prognosis and an improvement of quality of life.