抑郁症和心血管疾病:注意指南中的差距
Dana Blatch Armon1,2, Aliki Buhayer1,3, Kapka Miteva3
1International Center for Multimorbidity and Complexity in Medicine, Healthy Longevity Center, University of Zurich, Stampfenbachstrasse 73, 8050 Zurich, Switzerland.
European heart journal
|August 29, 2025
概括
心血管疾病 (CVD) 患者经常出现抑郁症,影响治疗. 临床实践指南 (CPG) 没有充分解决抑郁症的查和治疗问题,强调在心血管疾病管理中需要综合心理健康支持.
科学领域:
- 心脏病学
- 精神病学
- 公共卫生
背景情况:
- 心血管疾病患者的抑郁率高于一般人群.
- 同时出现的心血管疾病和抑郁症会恶化生活质量,增加死亡率.
- 抑郁症使心血管疾病患者难以治疗,难以服药,难以改变生活方式.
研究的目的:
- 评估心血管疾病临床实践指南如何解决抑郁症.
- 评估CVD CPG中是否包括抑郁症的实际管理指南.
主要方法:
- 在2013年至2024年间出版的CPG系统文献搜索.
- 分析了65个CPG,涵盖了各种心血管和脑血管疾病.
- 评估有关抑郁症查,治疗和专业参与的指南内容.
主要成果:
- 71%的CPG承认抑郁症是危险因素,但只有23%提供了查和治疗建议.
- 很少有CPG (12%) 提及专门的抑郁症CPG;中风CPG提供了大多数建议 (68%).
- 在女性特异性CPG中发现药物与疾病相互作用的指南有限 (3%),并且没有治疗建议.
结论:
- 目前的心血管疾病预防药物不足以治疗抑郁症,缺乏全面的查和治疗指导.
- 让心理健康专家参与CPG开发对于整体患者护理至关重要.
- 需要针对不同患者群体量身定制的抑郁症管理策略.
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