Komorbidität zwischen kardiovaskulären Erkrankungen und Depressionen

Zusammenfassung

Etwa 20-25 % aller Patienten mit Herz-Kreislauf-Erkrankungen leiden gleichzeitig an Depressionen. Depressive Erkrankungen erhöhen das kardiovaskuläre Morbiditäts- und Mortalitätsrisiko. Vieles spricht für eine multikausale Interaktion zwischen depressiven und kardiovaskulären Erkrankungen; neben genetischen Faktoren werden endokrine, neurokardiologische, metabolische und behaviorale Faktoren diskutiert. Obwohl Depressionen überzufällig häufig ältere und multimorbide Patienten betreffen, werden sie in der klinischen Praxis nur bei etwa der Hälfte dieser Patienten korrekt diagnostiziert, und selbst im Falle einer korrekten Diagnose zumeist nur unzureichend behandelt. Die meisten dieser Patienten werden primär nicht von Psychiatern, sondern von Ärzten anderer Fachrichtungen betreut. In Anbetracht der signifikanten Interaktion zwischen depressiven und kardiovaskulären Erkrankungen ist eine engmaschige Vernetzung aller am Behandlungsprozess beteiligten Arztgruppen nicht zuletzt auch aus ökonomischen Gründen zur Vermeidung von Folgekosten zwingend notwendig.

Summary

Some 20-25 % of all patients with cardiovascular diseases simultaneously suffer from depression. Depressive diseases increase the cardiovascular morbidity and mortality risk. There is much evidence for a multicausal interaction between depressive and cardiovascular diseases; apart from genetic factors, endocrine, neurocardiological, metabolic and behavioural factors are under discussion. Although depression is found disproportionately often in the elderly and multimorbid patient, it is correctly diagnosed in only about one-half of these patients, and even when correctly diagnosed, is usually inadequately treated. Most of these patients are under the care not of psychiatrists, but other specialists. In light of the significant interaction between depressive and cardiovascular diseases, close cooperation of all the physicians involved in the management process is urgently mandated, not least for economic reasons to avoid follow-up costs.

depression - cardiovascular disease - affective illness

Literatur

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