Psychiatric and Psychological Interventions for Depression in Patients With Heart Disease: A Scoping Review.
Psychiatric and Psychological Interventions for Depression in Patients With Heart Disease: A Scoping Review.
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心脏病患者抑郁症的精神科和心理干预：一项范围综述
DOI：
10.1161/jaha.120.018686
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发表时间：
2020-11-17
影响因子：
5.4
通讯作者：
Huffman JC
中科院分区：
文献类型：
--
作者：
Zambrano J;Celano CM;Januzzi JL;Massey CN;Chung WJ;Millstein RA;Huffman JC
心血管疾病患者的抑郁与心脏病进展、主要不良心脏事件和死亡率独立相关。随着该领域努力确定这一人群的最佳抑郁治疗方法，各种抑郁治疗策略已在随机对照试验中得到研究。对文献进行当代范围综述有助于整合和综合关于心血管疾病患者抑郁治疗试验的日益增多且各不相同的文献。我们通过4个数据库（PubMed、PsycINFO、EMBASE和谷歌学术）从数据库建立到2020年3月对文献进行了系统检索，从而开展了一项范围综述。我们确定了42项针对心脏病患者的抑郁治疗干预的相关随机对照试验（其中冠心病患者n = 9181例，心力衰竭患者n = 1981例）。选择性5 - 羟色胺再摄取抑制剂在心脏病患者中似乎是安全的，并且对冠心病患者的抑郁有有益影响（并且有一些对心脏有益的迹象），但在心力衰竭患者中其疗效的证据较少。相比之下，心理治疗似乎对冠心病和心力衰竭患者的抑郁有效，但对心脏有益的证据较少。更新的多模式抑郁护理管理方法采用灵活的患者护理方式，研究较少，但在心脏病患者群体中似乎很有前景。在冠心病患者的治疗中可能首选选择性5 - 羟色胺再摄取抑制剂，在心力衰竭患者中可能首选心理治疗，而更灵活的抑郁护理管理方法通过根据患者需求可能同时使用这两种方法显示出了前景。
Depression in patients with cardiovascular disease is independently associated with progression of heart disease, major adverse cardiac events, and mortality. A wide variety of depression treatment strategies have been studied in randomized controlled trials as the field works to identify optimal depression treatments in this population. A contemporary scoping review of the literature can help to consolidate and synthesize the growing and disparate literature on depression treatment trials in people with cardiovascular disease. We conducted a scoping review utilizing a systematic search of the literature via 4 databases (PubMed, PsycINFO, EMBASE, and Google Scholar) from database inception to March 2020. We identified 42 relevant randomized controlled trials of depression treatment interventions in patients with cardiac disease (n=9181 patients with coronary artery disease, n=1981 patients with heart failure). Selective serotonin reuptake inhibitors appear to be safe in patients with cardiac disease and to have beneficial effects on depression (and some suggestion of cardiac benefit) in patients with coronary artery disease, with less evidence of their efficacy in heart failure. In contrast, psychotherapy appears to be effective for depression in coronary artery disease and heart failure, but with less evidence of cardiac benefit. Newer multimodal depression care management approaches that utilize flexible approaches to patients' care have been less studied but appear promising across cardiac patient groups. Selective serotonin reuptake inhibitors may be preferred in the treatment of patients with coronary artery disease, psychotherapy may be preferred in heart failure, and more flexible depression care management approaches have shown promise by potentially using both approaches based on patient needs.