References

actabiomedica

Acta Biomedica Scientifica

2541-94202587-9596

Scientific Centre for Family Health and Human Reproduction Problems

10.12737/article_59e8bd26de45e8.00423846

actabiomedica-444

Research Article

ПСИХИАТРИЯ, НАРКОЛОГИЯ И ПСИХОЛОГИЯ

PSYCHOLOGY AND PSYCHIATRY

Взаимосвязь депрессии и сердечно-сосудистых заболеваний (обзор литературы)

Relationship between depression and cardiovascular disease (review of literature)

Винокуров

Е. В.

Vinokurov

E. V.

evgeniy_vinokurov@yahoo.com

Собенников

В. С.

Sobennikov

V. S.

vsobennikov@gmail.com

Рычкова

Л. В.

Rychkova

L. V.

iphr@sbamsr.irk.ru

ФГБНУ «Научный центр проблем здоровья семьи и репродукции человека»; ФГБОУ ВО «Иркутский государственный медицинский университет» Минздрава РоссииScientific Centre for Family Health and Human Reproduction Problems; Irkutsk State Medical University

ФГБОУ ВО «Иркутский государственный медицинский университет» Минздрава РоссииIrkutsk State Medical University

ФГБНУ «Научный центр проблем здоровья семьи и репродукции человека»Scientific Centre for Family Health and Human Reproduction Problems

2017

28092017

25(1)124128

2017

Винокуров Е.В., Собенников В.С., Рычкова Л.В.

Vinokurov E.V., Sobennikov V.S., Rychkova L.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.actabiomedica.ru/jour/article/view/444

Статья посвящена актуальной проблеме в области консультативной психиатрии - коморбидным депрессивным расстройствам у пациентов с сердечно-сосудистыми заболеваниями. Депрессия широко распространена среди кардиологических пациентов. Примерно 31-45 % пациентов с ишемической болезнью сердца, включая пациентов со стенокардией напряжения, нестабильной стенокардией или инфарктом миокарда, страдают от клинически выраженных симптомов депрессии. Более того, у 20 % пациентов с ишемической болезнью сердца психические нарушения соответствуют критериям большого депрессивного расстройства. Пациенты с хронической сердечной недостаточностью, мерцательной аритмией и имплантированным кардиовертером-дефибриллятором также находятся в группе повышенного риска развития депрессивных состояний. Депрессия не просто является распространённым спутником сердечно-сосудистых заболеваний, но и оказывает негативное воздействие на различные аспекты течения заболевания, включая качество жизни, частоту госпитализаций, обращений за медицинской помощью и уровень смертности. В статье представлен обзор литературных источников, посвящённых физиологическим механизмам взаимосвязи депрессии и кардиологических заболеваний. Депрессия и кардиологические заболевания имеют двунаправленную связь, в которой воспалительные процессы, эндотелиальная дисфункция, повышенная активность тромбоцитов, дисфункции нейрогуморальной и вегетативной нервной системы, относящиеся к депрессии, и депрессивное поведение взаимно потенцируют друг друга. Несмотря на существование эффективных и безопасных методов лечения депрессии у пациентов с кардиологическими заболеваниями, её часто недооценивают и не лечат. Совместные медицинские программы - один из путей совершенствования выявления и лечения депрессии у кардиологических пациентов. Необходимо проведение дальнейших исследований в этой области с участием кардиологов и психиатров.

The article deals with the important issue in the field of consultative psychiatry - comorbid depressive disorders in patients with cardiovascular diseases. Depression is highly prevalent in cardiac patients. Patients with coronary artery disease, heart failure, atrial fibrillation and those undergoing implantable cardioverter-defibrillator placement are at increased risk for elevated depressive symptoms and for major depressive disorder. In patients with heart diseases, depression is chronic, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. At present, pharmacologic and psychotherapeutic interventions appear to be safe and effective at reducing depressive symptoms in patients with cardiovascular diseases and may impact cardiac outcomes. Despite this, depression remains under-recognized and undertreated in patients at risk for or living with cardiovascular diseases. In this review, we summarize the evidence linking depression to increased risk of cardiovascular diseases and worse patient outcomes. The paper presents a review of the literature on the physiologic mechanisms implicated in the connection between depression and cardiovascular diseases. Impaired adherence to health behaviors and adverse physiological effects of depression, including inflammation, endothelial dysfunction, platelet hyperactivity, and autonomic nervous system abnormalities, may link depression with adverse cardiac outcomes. Future studies in this direction with involvement of cardiologists and psychiatrists should be held.

депрессиякардиоваскулярные заболеваниянеблагоприятные кардиологические исходысardiovascular diseases

depressionadverse cardiac outcomes

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The authors declare that there are no conflicts of interest present.