Depresja w praktyce lekarza POZ – diagnostyka i farmakoterapia

• Authors: Piotr Krawczyk

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.

Keywords

EN

POZ; antidepressants; comorbidity; depresja; depression; general practitioner; leki przeciwdepresyjne; psychiatria; psychiatry; współwystępowanie chorób

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Pediatria i Medycyna Rodzinna
• Year: 2014
• Volume: 10
• Issue: 2
• Pages: 174–189

Contributors

author

Piotr Krawczyk

• II Klinika Psychiatryczna, Oddział Chorób Afektywnych, Instytut Psychiatrii i Neurologii, Polska. Kierownik Oddziału: dr hab. n. med. Łukasz Święcicki. Kierownik Kliniki: dr hab. n. med. Tadeusz Parnowski

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• Document Type: article