Mood disorders: cardiovascular and diabetes comorbidity
Mood disorders: cardiovascular and diabetes comorbidity
复制标题
DOI：
10.1097/01.yco.0000228765.33356.9f
复制
发表时间：
2006-07-01
影响因子：
6.9
通讯作者：
Stover, Ellen S.
中科院分区：
文献类型：
--
作者：
Fenton, Wayne S.;Stover, Ellen S.
综述的目的：抑郁症通常与医学上的共病有关。新的研究量化了心血管疾病和糖尿病等疾病中情绪障碍的模式，评估了情绪症状的预后意义，并试图确定情绪和内科疾病的共同机制。这篇综述提供了关于共病的最新发现，总结了机制假说，并概述了治疗和服务的发展。最近的发现：多达四分之一的心血管疾病和糖尿病患者会发生抑郁。患有心脏病的抑郁症患者的医疗结果更差，包括再梗塞和全因死亡的风险增加。患有糖尿病和抑郁症的患者血糖控制较差，糖尿病症状较多，全因死亡率较高。抑郁症与生物学(下丘脑-垂体-肾上腺轴失调)和心理社会过程(坚持治疗、较差的饮食和锻炼)有关，可能会导致不良的医疗结果。抗抑郁药物治疗在治疗内科疾病患者的抑郁症方面是有效的，但它们对医疗结果的影响仍有待量化。摘要：抑郁症、心血管疾病和糖尿病是影响老龄化人口的最常见的慢性病。抑郁症在患有内科疾病的患者中是可以治疗的，协作护理模式可以在初级保健环境中产生更好的检测和抑郁治疗，在初级保健环境中，大多数抑郁症患者都是可以看到的。
Purpose of review: Depression is often associated with medical comorbidity. New research quantifies patterns of mood disorder in illnesses such as cardiovascular disease and diabetes, evaluates the prognostic significance of mood symptoms, and seeks to identify common mechanisms for both mood and medical disease. This review provides recent findings on comorbidity, summarizes mechanistic hypotheses, and outlines developments in treatment and services.Recent findings: Depression occurs in up to one-quarter of patients with cardiovascular disease and diabetes. Depressed patients with heart disease have poorer medical outcomes including increased risk of reinfarction and all-cause mortality. Patients with diabetes and depression have poorer glycemic control, more diabetes symptoms, and greater all-cause mortality. Depression is associated with both biological (hypothalamic-pituitary-adrenal axis dysregulation) and psychosocial processes (adherence, poorer diet, and exercise) that may mediate adverse medical outcomes. Antidepressant treatments are effective in treating depression in medically ill patients, but their impact on medical outcomes remains to be quantified.Summary: Depression, cardiovascular disease, and diabetes are among the most common chronic illnesses affecting an aging population. Depression is treatable in patients with medical illnesses, and collaborative care models can yield better detection and depression treatment in primary care settings in which most patients with depression are seen.