Background: The Impact of Chronic Disease on Mental Health
People with chronic diseases are at a higher risk of psychological distress, including depression and anxiety, due to concerns surrounding a decreased quality of life and the inability to control symptoms (Connery et al., 2025). This distress is often referred to as fear of progression or recurrence (FOPR) (Connery et al., 2025) or health anxiety (HA) (Lebel et al., 2020). While FOPR or HA aren’t directly connected to a person’s disease diagnosis or management, their presence can directly impact how they live their life and interact with the world. As a result, addressing an individual’s mental health concerns associated with their chronic disease is an important aspect of a holistic, humanistic approach to patient care. In fact, properly managing a patient’s mental health alongside their disease can have a positive impact on their overall health (e.g., less frequent hospitalization) (Akif et al., 2024).
A Patient Experience
A 60-year-old man with cold agglutinin disease (CAD), an autoimmune disorder triggered by cold temperatures that results in the premature destruction of red blood cells (NORD, 2024), previously lived in a cold climate but recently relocated to a warmer climate. Despite the move, fear and anxiety about his condition continue to impact his quality of life. For example, he has avoided traveling to see his family, who are all located in the area where he lived when his disease first manifested, as he fears being exposed to the cold and experiencing a recurrence. The patient shares these concerns during a visit with his new physician.
Reflection
- How might this patient’s physician validate the emotional impact of their chronic disease?
- What interventions could the physician offer to help reduce the patient’s anxiety and improve their quality of life?
- What other lifestyle shifts could help the patient feel safe while maintaining important social connections?
- More broadly, how can medicine move beyond “disease management” to embrace a more holistic view of treatment and well-being?
References
- Akif, A., Qusar, M.M.A.S., & Islam, M.R. (2024). The impact of chronic diseases on mental health: An overview and recommendations for care programs. Current Psychiatry Reports, 26, 394-404. https://doi.org/10.1007/s11920-024-01510-7
- Connery, T., Riotto, G.D., Macdonald, D., & Menzies, R.E. (2025). Associations between death anxiety and fear of illness progression or recurrence: A protocol for a systematic review and meta-analysis. PLoS One, 20 (6). https://doi.org/10.1371/journal.pone.0325176
- Lebel, S., Mutsaers, B., Tomei, C., Leclair, C.S., Jones, G., Petricone-Westwood, D., Rutkowski, N., Ta, V., Trudel, G., Laflamme, S.Z., Lavigne, A.A., & Dinkel, A. (2020). Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates. PLoS One, 15(7). https://doi.org/10.1371/journal.pone.0234124
- National Organization for Rare Disorders (NORD). (2024). Cold agglutinin disease. https://rarediseases.org/rare-diseases/cold-agglutinin-disease/