うつ病と心血管疾患: 心の傷を癒す
1Veterans Affairs Medical Center and University of California, San Francisco Medical Center, San Francisco, CA 94121, USA. mary.whooley@ucsf.edu
JAMA
|June 29, 2006
まとめ
重度のうつ病は,心臓病のリスクと心血管疾患の悪影響のリスクを大幅に高めます. 心血管疾患患者のうつ病の認識と治療は極めて重要であるが,結果への影響についてはさらなる研究が必要である.
科学分野:
- 心臓病学 心臓病学
- 精神科医は精神病を患っている.
- クリニカル・メディシン 臨床医学
背景:
- 重度のうつ病 (MDD) は,冠動脈性心疾患 (CHD) の発症および既存の心血管疾患 (CVD) の患者における結果の悪化の既知の危険因子です.
- うつ病は,心血管疾患の患者のかなりの部分に影響を与え,心血管疾患の門診患者の20%,充血性心不全患者の33%がうつ病を経験しています.
- 心血管疾患の患者集団におけるうつ病の認識と治療において,大きなギャップが存在します.
研究 の 目的:
- 心血管疾患 (CVD) の個体における重度のうつ病の重要性を評価する.
- 心血管疾患の患者集団におけるうつ病の特定と管理のための実践的な戦略を提供すること.
主な方法:
- 大うつ病と心血管疾患の関係に関する既存の文献のレビュー.
- 外来心血管環境におけるうつ病の罹患率の分析.
- 選択性セロトニン再吸収阻害剤 (SSRI) の心血管疾患患者のうつ病の治療における安全性と有効性の評価.
主要な成果:
- 重度のうつ病は,新たな心血管疾患の発生と,既定の心疾患の患者におけるより悪い結果の両方に対する認識された危険因子です.
- 抗うつ薬の治療,特にSSRIは,一般的に心血管疾患の患者にとって安全です.
- SSRIは,うつ病の症状を軽減し,生活の質を向上させるのに有効であることが示されています.
結論:
- 重度のうつ病は,心臓血管疾患の患者の重大な,しばしば見過ごされる共病です.
- 心血管疾患のアウトカムに対するうつ病治療の直接的な影響については,さらなる調査が必要ですが,SSRIは,うつ病を管理し,患者の健康状態を改善するための安全で効果的な手段を提供します.
- 心血管保健施設におけるうつ病のシステマティックなスクリーニングと治療には,臨床的指導が必要である.
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