Comorbidity of depression with physical disorders: research and clinical implications.
Comorbidity of depression with physical disorders: research and clinical implications.
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DOI：
10.4068/cmj.2015.51.1.8
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Kim JM
中科院分区：
文献类型：
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作者：
Kang HJ;Kim SY;Bae KY;Kim SW;Shin IS;Yoon JS;Kim JM
抑郁症在身体疾病患者中很普遍，特别是在那些患有严重疾病如癌症、中风和急性冠状动脉综合征的患者中。抑郁症对这些疾病的病程有不利影响，包括生活质量差，功能障碍更多，死亡率更高。有身体障碍的患者患抑郁症的风险更高。这对于具有遗传和表观遗传预测因子、环境脆弱性（如过去的抑郁症）、较高残疾和压力性生活事件的患者尤其如此。这些患者应密切监测。为了适当地管理这些患者的抑郁症，应提供全面和综合的护理，包括抗抑郁药治疗（考虑不良反应和药物相互作用），身体疾病的治疗和协作护理，包括疾病教育，认知重构和应对方式的改变。本综述的目的是介绍和总结抑郁症合并躯体疾病的患病率、危险因素、临床相关因素、目前的病理生理学方面（包括遗传学）以及治疗方法。特别是，我们试图关注死亡率高的严重身体疾病，如癌症、中风和急性冠状动脉综合征，这些疾病与抑郁症高度共病。这篇综述将增强我们目前对抑郁症与严重疾病之间关系的理解，这将使临床医生能够在常规临床实践中为这些患者开发更先进和个性化的治疗方案。
Depression is prevalent in patients with physical disorders, particularly in those with severe disorders such as cancer, stroke, and acute coronary syndrome. Depression has an adverse impact on the courses of these diseases that includes poor quality of life, more functional impairments, and a higher mortality rate. Patients with physical disorders are at higher risk of depression. This is particularly true for patients with genetic and epigenetic predictors, environmental vulnerabilities such as past depression, higher disability, and stressful life events. Such patients should be monitored closely. To appropriately manage depression in these patients, comprehensive and integrative care that includes antidepressant treatment (with considerations for adverse effects and drug interactions), treatment of the physical disorder, and collaborative care that consists of disease education, cognitive reframing, and modification of coping style should be provided. The objective of the present review was to present and summarize the prevalence, risk factors, clinical correlates, current pathophysiological aspects including genetics, and treatments for depression comorbid with physical disorders. In particular, we tried to focus on severe physical disorders with high mortality rates, such as cancer, stroke, and acute coronary syndrome, which are highly comorbid with depression. This review will enhance our current understanding of the association between depression and serious medical conditions, which will allow clinicians to develop more advanced and personalized treatment options for these patients in routine clinical practice.