ДЕПРЕССИЯ И КАРДИОЛОГИЧЕСКИЕ ЗАБОЛЕВАНИЯ (ОБЗОР ЛИТЕРАТУРЫ)

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 коморбидные психические нарушения соответствуют критериям большого депрессивного расстройства. Пациенты с хронической сердечной недостаточностью, мерцательной аритмией и имплантированным кардиовертер-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 физическое функционирование, качество жизни, частоту госпитализаций, обращений за медицинской помощью и уровень смертности. Вероятность неблагоприятного исхода сердечнососудистых заболеваний повышается, если депрессия сопровождается коморбидной патологической тревогой, которую связывают с рецидивами кардиальных событий и обусловленной ими смертностью. В статье представлен обзор литературных источников, посвящённых эпидемиологии, феноменологии, коморбидным состояниям и факторам риска депрессии при кардиологических заболеваниях. 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 врачей-терапевтов, кардиологов и психиатров.

депрессия, кардиологическое заболевание, неблагоприятные кардиологические исходы

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