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2014 | 10 | 2 | 174–189
Article title

Depresja w praktyce lekarza POZ – diagnostyka i farmakoterapia

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Title variants
EN
Depressive disorders at general practitioner’s office – diagnostics and pharmacotherapy
Languages of publication
EN
Abstracts
EN
Depression is one of the most common mental disorders. Epidemiological studies indicate a growing risk of depression as a complication of chronic or severe somatic diseases. Depression itself has also a significant influence on the course and efficacy of therapy of many somatic diseases, thus the relationship between depression and physical illness is bidirectional. There is convincing evidence of comorbidity of depression and diseases such as diabetes, stroke, cardiovascular diseases, cancer, dementia, chronic pain or infectious diseases. Given the prevalence of these diseases and a high population risk of depression, primary care physicians should be prepared to carry out diagnosis and implement proper treatment. Due to the nature of general practitioners’ work, diagnosis of depressive disorders should be limited to the essential minimum. Both current diagnostic criteria as well as simple lists of symptoms may occur helpful. Pharmacotherapy is an effective and widely available treatment of depressive disorders. It is emphasised to individualise the selection of the right antidepressant in a group of patients with somatic burden. When choosing the drug, it is vital to take into account not only depressive symptoms. Potential side effects of antidepressants and their interaction with other drugs are equally important. In the following study, in addition to the characteristics of co-occurrence of depression and somatic diseases as well as guidelines for the diagnosis of depressive disorders, the choice of drugs with proven antidepressant efficacy is presented. Their safety profiles enable their use in outpatient settings.
PL
Depresja należy do najczęstszych zaburzeń psychicznych. Badania epidemiologiczne wskazują na rosnące ryzyko pojawienia się depresji jako powikłania przewlekłych lub ciężkich chorob somatycznych. Wystąpienie tego zaburzenia ma znaczący wpływ na przebieg i skuteczność leczenia wielu z tych schorzeń, zatem zależność między depresją a chorobami somatycznymi jest dwukierunkowa. Istnieją silne dowody na wspołwystępowanie depresji i takich chorob, jak cukrzyca, udar mozgu, choroby układu krążenia, nowotwory, zespoły otępienne, przewlekłe zespoły bolowe czy choroby zakaźne. Wobec powszechności tych schorzeń oraz wysokiego populacyjnego ryzyka zachorowania na depresję lekarze podstawowej opieki zdrowotnej powinni umieć rozpoznawać i leczyć to zaburzenie. Ze względu na specyfikę pracy lekarza rodzinnego diagnostyka w kierunku zaburzeń depresyjnych musi ograniczyć się do niezbędnego minimum. Pomocne mogą w tym być zarowno aktualne kryteria diagnostyczne, jak i proste listy objawow. Farmakoterapia jest skuteczną i szeroko dostępną metodą leczenia zaburzeń depresji – podkreśla się, że wybor właściwego leku przeciwdepresyjnego w grupie pacjentow z obciążeniami somatycznymi powinien być zindywidualizowany. W doborze farmaceutykow istotne jest uwzględnienie nie tylko objawow depresyjnych, lecz rownież potencjalnych działań niepożądanych preparatow przeciwdepresyjnych oraz ich interakcji z innymi lekami. W poniższym opracowaniu, obok charakterystyki wspołwystępowania depresji i chorob somatycznych, a także wskazowek dotyczących diagnostyki zaburzeń depresyjnych, przedstawiono wybor lekow o udowodnionej skuteczności przeciwdepresyjnej. Profil ich bezpieczeństwa umożliwia ich stosowanie w warunkach opieki ambulatoryjnej.
Discipline
Year
Volume
10
Issue
2
Pages
174–189
Physical description
References
  • 1. Kessler RC, Berglund P, Demler O et al.: The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003; 289: 3095–3105.
  • 2. Andrade L, Caraveo-Anduaga JJ, Berglund P et al.: The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res 2003; 12: 3–21.
  • 3. Jarema M, Rabe-Jabłońska J (eds.): Psychiatria. Podręcznik dla studentow medycyny. Wydawnictwo Lekarskie PZWL, Warszawa 2011.
  • 4. Musiał A: Depresja – rys historyczny. Psychiatr Psychol Klin 2007; 7: 42–46.
  • 5. Drożdż W, Wojnar M, Araszkiewicz A et al.: [The study of the prevalence of depressive disorders in primary care patients in Poland]. Wiad Lek 2007; 60: 109–113.
  • 6. Rao M: Depression in the physically ill. Primary Psychiatry 2008; 15: 44–50.
  • 7. Musselman DL, Betan E, Larsen H et al.: Relationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment. Biol Psychiatry 2003; 54: 317–329.
  • 8. Katon W, Von Korff M, Lin E et al.: Population-based care of depression: effective disease management strategies to decrease prevalence. Gen Hosp Psychiatry 1997; 19: 169–178.
  • 9. Katon W, Von Korff M, Ciechanowski P et al.: Behavioral and clinical factors associated with depression among individuals with diabetes. Diabetes Care 2004; 27: 914–920.
  • 10. Goodnick PJ: Use of antidepressants in treatment of comorbid diabetes mellitus and depression as well as in diabetic neuropathy. Ann Clin Psychiatry 2001; 13: 31–41.
  • 11. Sindrup SH, Bjerre U, Dejgaard A et al.: The selective serotonin reuptake inhibitor citalopram relieves the symptoms of diabetic neuropathy. Clin Pharmacol Ther 1992; 52: 547–552.
  • 12. Evans DL, Charney DS, Lewis L et al.: Mood disorders in the medically ill: scientific review and recommendations. Biol Psychiatry 2005; 58: 175–189.
  • 13. Robinson RG: Poststroke depression: prevalence, diagnosis, treatment, and disease progression. Biol Psychiatry 2003; 54: 376–387.
  • 14. Morris PL, Robinson RG, Andrzejewski P et al.: Association of depression with 10-year poststroke mortality. Am J Psychiatry 1993; 150: 124–129.
  • 15. Chen Y, Guo JJ, Zhan S et al.: Treatment effects of antidepressants in patients with post-stroke depression: a meta-analysis. Ann Pharmacother 2006; 40: 2115–2122.
  • 16. Carney RM, Freedland KE: Depression, mortality, and medical morbidity in patients with coronary heart disease. Biol Psychiatry 2003; 54: 241–247.
  • 17. Rudisch B, Nemeroff CB: Epidemiology of comorbid coronary artery disease and depression. Biol Psychiatry 2003; 54: 227–240.
  • 18. Nelson JC, Kennedy JS, Pollock BG et al.: Treatment of major depression with nortriptyline and paroxetine in patients with ischemic heart disease. Am J Psychiatry 1999; 156: 1024–1028.
  • 19. Roose SP, Laghrissi-Thode F, Kennedy JS et al.: Comparison of paroxetine and nortriptyline in depressed patients with ischemic heart disease. JAMA 1998; 279: 287–291.
  • 20. Serebruany VL, Gurbel PA, O’Connor CM: Platelet inhibition by sertraline and N-desmethylsertraline: a possible missing link between depression, coronary events, and mortality benefits of selective serotonin reuptake inhibitors. Pharmacol Res 2001; 43: 453–462.
  • 21. Raison CL, Miller AH: Depression in cancer: new developments regarding diagnosis and treatment. Biol Psychiatry 2003; 54: 283–294.
  • 22. Penninx BW, Guralnik JM, Pahor M et al.: Chronically depressed mood and cancer risk in older persons. J Natl Cancer Inst 1998; 90: 1888–1893.
  • 23. Stommel M, Given BA, Given CW: Depression and functional status as predictors of death among cancer patients. Cancer 2002; 94: 2719–2727.
  • 24. Fawzy FI, Canada AL, Fawzy NW: Malignant melanoma: effects of a brief, structured psychiatric intervention on survival and recurrence at 10-year follow-up. Arch Gen Psychiatry 2003; 60: 100–103.
  • 25. Theobald DE, Kirsh KL, Holtsclaw E et al.: An open-label, crossover trial of mirtazapine (15 and 30 mg) in cancer patients with pain and other distressing symptoms. J Pain Symptom Manage 2002; 23: 442–447.
  • 26. Evans DL, McCartney C, Haggerty JJ Jr et al.: Treatment of depression in cancer patients is associated with better life adaptation: a pilot study. Psychosom Med 1988; 50: 73–76.
  • 27. Holland JC, Romano SJ, Heiligenstein JH et al.: A controlled trial of fluoxetine and desipramine in depressed women with advanced cancer. Psychooncology 1998; 7: 291–300.
  • 28. Lyketsos CG, Steinberg M, Tschanz JT et al.: Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry 2000; 157: 708–714.
  • 29. Taragano FE, Lyketsos CG, Mangone CA et al.: A double-blind, randomized, fixed-dose trial of fluoxetine vs. amitriptyline in the treatment of major depression complicating Alzheimer’s disease. Psychosomatics 1997; 38: 246–252.
  • 30. Katona CL, Hunter BN, Bray J: A double-blind comparison of the efficacy and safety of paroxetine and imipramine in the treatment of depression with dementia. Int J Geriatr Psychiatry 1998; 13: 100–108.
  • 31. Pużyński S.: Depresje i zaburzenia afektywne. Wydawnictwo Lekarskie PZWL. Warszawa 2002.
  • 32. DiMatteo MR, Lepper HS, Croghan TW: Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000; 160: 2101–2107.
  • 33. Stafford RS, MacDonald EA, Finkelstein SN: National Patterns of Medication Treatment for Depression, 1987 to 2001. Prim Care Companion J Clin Psychiatry 2001; 3: 232–235.
  • 34. Gaynes BN, Rush AJ, Trivedi MH et al.: Major depression symptoms in primary care and psychiatric care settings: a cross-sectional analysis. Ann Fam Med 2007; 5: 126–134.
  • 35. Royal College of Physicians, Royal College of Psychiatrists: The Psychological Care of Medical Patients. A Practical Guide. London 2003.
  • 36. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). APA, Washington DC 1994.
  • 37. Stahl SM: Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. Cambridge University Press, New York 2013.
  • 38. Stahl SM: Podstawy psychofarmakologii. Poradnik lekarza praktyka. Via Medica, Gdańsk 2010.
  • 39. Glassman AH: Citalopram toxicity. Lancet 1997; 350, 818.
  • 40. Wellington K, Perry CM: Venlafaxine extended-release: a review of its use in the management of major depression. CNS Drugs 2001; 15: 643–669.
  • 41. Smith D, Dempster C, Glanville J et al.: Efficacy and tolerability of venlafaxine compared with selective serotonin reuptake inhibitors and other antidepressants: a meta-analysis. Br J Psychiatry 2002; 180: 396–404.
  • 42. Wagstaff AJ, Ormrod D, Spencer CM: Tianeptine: a review of its use in depressive disorders. CNS Drugs 2001; 15: 231–259.
  • 43. Święcicki Ł: Depresja. Zwykła choroba? Elsevier Urban & Partner, Wrocław 2010.
  • 44. Martinotti G, Sepede G, Gambi F et al.: Agomelatine versus venlafaxine XR in the treatment of anhedonia in major depressive disorder: a pilot study. J Clin Psychopharmacol 2012; 32: 487–491.
  • 45. Fangmann P, Assion HJ, Juckel G et al.: Half a century of antidepressant drugs: on the clinical introduction of monoamine oxidase inhibitors, tricyclics, and tetracyclics. Part II: tricyclics and tetracyclics. J Clin Psychopharmacol 2008; 28: 1–4.
Document Type
article
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YADDA identifier
bwmeta1.element.psjd-f591d5ff-36f1-4f7e-a9f5-76a234c7d925
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