Comorbid depression in medical diseases
Comorbid depression in medical diseases
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内科疾病中的抑郁共病
DOI：
10.1038/s41572-020-0200-2
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发表时间：
2020-08-20
影响因子：
81.5
通讯作者：
Otte, Christian
中科院分区：
文献类型：
--
作者：
Gold, Stefan M.;Kohler-Forsberg, Ole;Otte, Christian
抑郁症是许多慢性医学疾病的最常见的合并症之一，包括癌症和心血管、代谢、炎症和神经系统疾病。事实上，抑郁症在这些患者群体中的患病率通常大大高于一般人群，抑郁症占这些疾病的心理社会负担的很大一部分。许多因素可以导致共病抑郁症的发生，如共同的遗传因素，趋同的生物学途径，社会因素，健康行为和心理因素。由于症状重叠，诊断患有医学疾病的患者的抑郁症可能特别具有挑战性。虽然药物和心理治疗可能是有效的，但可能需要对患有合并症的患者进行调整。此外，医学疾病的症状或治疗可能会干扰抑郁症的治疗。相反，抑郁症的症状可能会降低对这两种疾病治疗的依从性。因此，全面的治疗计划是必要的，以优化护理。重性抑郁症是常见的内科疾病患者，占这些疾病的心理负担的很大一部分。本书讨论了内科疾病患者共患抑郁症的流行病学、发病机制、诊断和治疗。
Depression is one of the most common comorbidities of many chronic medical diseases including cancer and cardiovascular, metabolic, inflammatory and neurological disorders. Indeed, the prevalence of depression in these patient groups is often substantially higher than in the general population, and depression accounts for a substantial part of the psychosocial burden of these disorders. Many factors can contribute to the occurrence of comorbid depression, such as shared genetic factors, converging biological pathways, social factors, health behaviours and psychological factors. Diagnosis of depression in patients with a medical disorder can be particularly challenging owing to symptomatic overlap. Although pharmacological and psychological treatments can be effective, adjustments may need to be made for patients with a comorbid medical disorder. In addition, symptoms or treatments of medical disorders may interfere with the treatment of depression. Conversely, symptoms of depression may decrease adherence to treatment of both disorders. Thus, comprehensive treatment plans are necessary to optimize care.Major depressive disorder is common in patients with medical diseases and accounts for a substantial part of the psychosocial burden of these diseases. This Primer discusses the epidemiology, mechanisms, diagnosis and treatment of comorbid depression in patients with medical diseases.