Mental Health in Allergic Rhinitis: Depression and Suicidal Behavior.
Mental Health in Allergic Rhinitis: Depression and Suicidal Behavior.
复制标题
DOI：
10.1007/s40521-017-0110-z
复制
发表时间：
2017-03
影响因子：
1.1
通讯作者：
Postolache TT
中科院分区：
文献类型：
--
作者：
Amritwar AU;Lowry CA;Brenner LA;Hoisington AJ;Hamilton R;Stiller JW;Postolache TT
自杀者在死亡前一个月去看医生的比例很高，但抑郁症、自杀念头和物质使用很少得到解决。对于临床医生常规治疗大量过敏性疾病患者人群，还有其他问题，因为过敏与抑郁症和自杀行为有关。虽然精神药物可能会影响过敏的诊断，但用于治疗过敏的药物会影响情绪和行为。因此，我们提出了一个概述的重叠过敏性鼻炎与抑郁症和自杀行为的成年人，根据临床和流行病学数据，我们的研究和临床经验。总之，我们建议：1）询问过敏症患者的个人和家族抑郁史，物质使用障碍，自杀意念和企图2）增加关于过敏药物对情绪和行为的潜在影响的正念;和3）对于某些类型的抑郁症或自杀风险增加的人，系统的多层次协作方法。虽然出于实际原因，大多数抑郁症患者将继续接受全科医生或家庭医生的治疗，但过敏治疗提供者应始终考虑对双相、精神病性或自杀性抑郁症和不完全缓解，或复发和高度复发的综合治疗。在等待急需的基础和临床研究结果来指导患有过敏性鼻炎和抑郁症的患者的临床方法的同时，本文推荐的简单步骤有望改善抑郁症的临床结局，包括在很大程度上减少自杀导致的过早死亡。
A high proportion of suicides visit their medical provider in the month prior to death, but depression, suicidal thoughts, and substance use are seldom addressed. For the clinicians routinely treating a substantial patient population with allergic diseases, there are additional concerns, as allergy has been linked with both depression and suicidal behavior. While psychotropic medications may affect diagnosis of allergies, medications used to treat allergies impact mood and behavior. Thus, we present an overview of the overlap of allergic rhinitis with depression and suicidal behavior in adults, based on clinical and epidemiological data, and our research and clinical experience. In summary, we suggest: 1) inquiring among patients with allergies about personal and family history of depression, substance use disorders, suicidal ideation and attempts 2) increased mindfulness regarding the potential effects of allergy medications on mood and behavior; and 3) for people identified with certain types of depression or increased suicide risk, a systematic multilevel collaborative approach. While for practical reasons the majority of patients with depression will continue to be treated by general or family practitioners, the allergy-treating provider should always consider integrated care for bipolar, psychotic or suicidal depression and incomplete remission, or relapsing and highly recurrent course. While awaiting results of much needed basic and clinical research to guide clinical approach for patients with comorbid allergic rhinitis and depression, the simple steps recommended here are expected to improved clinical outcomes in depression, including, on a large scale, reduced premature deaths by suicide.