Depression and cardiac disease: epidemiology, mechanisms, and diagnosis.
Depression and cardiac disease: epidemiology, mechanisms, and diagnosis.
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DOI：
10.1155/2013/695925
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Januzzi JL
中科院分区：
文献类型：
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作者：
Huffman JC;Celano CM;Beach SR;Motiwala SR;Januzzi JL
在心血管疾病（CVD）患者中，抑郁症是常见的、持续的，并与健康相关的生活质量、复发性心脏事件和死亡率相关。生理和行为因素包括内皮功能障碍、血小板异常、炎症、自主神经系统功能障碍和健康促进活动减少可能将抑郁症与不良心脏结局联系起来。由于抑郁症对生活质量和心脏结局的潜在影响，美国心脏协会建议使用2项和9项患者健康量表对所有心脏病患者进行常规抑郁症筛查。然而，尽管有这些易于使用的筛查工具和有效的治疗方法，但CVD患者的抑郁症仍未得到充分认识和治疗。在本文中，我们回顾了心脏病抑郁症的流行病学，现象学，共病条件和危险因素的文献。我们概述了抑郁症和心脏结果之间的关联，以及可能介导这些联系的机制。最后，我们讨论了支持和反对CVD患者进行常规抑郁症筛查的证据，并就何时以及如何评估这一高危人群的抑郁症提出了具体建议。
In patients with cardiovascular disease (CVD), depression is common, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. Both physiological and behavioral factors—including endothelial dysfunction, platelet abnormalities, inflammation, autonomic nervous system dysfunction, and reduced engagement in health-promoting activities—may link depression with adverse cardiac outcomes. Because of the potential impact of depression on quality of life and cardiac outcomes, the American Heart Association has recommended routine depression screening of all cardiac patients with the 2- and 9-item Patient Health Questionnaires. However, despite the availability of these easy-to-use screening tools and effective treatments, depression is underrecognized and undertreated in patients with CVD. In this paper, we review the literature on epidemiology, phenomenology, comorbid conditions, and risk factors for depression in cardiac disease. We outline the associations between depression and cardiac outcomes, as well as the mechanisms that may mediate these links. Finally, we discuss the evidence for and against routine depression screening in patients with CVD and make specific recommendations for when and how to assess for depression in this high-risk population.