憂鬱症與缺血性心臟病的關係

Coronary Artery Disease and Depression

張景瑞(Ching-Jui Chang) ； 廖士程(Shih-Cheng Liao)

《台灣老年醫學暨老年學雜誌》 4卷3期 (2009/08) Pp. 150-159

https://doi.org/10.29461/TGG.200908.0001

摘要

據推估到了2020年，缺血性心臟病與重鬱症將是造成全球疾病負擔的前兩名。過去15年來憂鬱症與缺血性心臟病的雙向關係是身心醫學最熱門的探討領域之一，本文針對五個重點回顧並整理相關研究報告。一、憂鬱症是缺血性心臟病發生的重要且獨立的非傳統危險因子；二、缺血性心臟病人比起一般人口有更高的憂鬱症及憂鬱性疾患盛行率；三、缺血性心臟病者併有憂鬱症的病患其心臟病預後較差；四、雖然某些研究有不同結論，有幾個大型臨床研究，如SADHART、ENRICHD、CREATE等顯示抗鬱劑對這些病人的療效；五、有幾種病理生理機轉可能解釋兩者之關聯性。深入了解憂鬱症與缺血性心臟病的雙向關係有助於改善對這兩類病人的醫療照顧。

關鍵字

缺血性心臟病 ； 心肌梗塞 ； 憂鬱症

並列摘要

Coronary artery disease and major depressive disorder are common illness and health conditions in the elderly population and projected to be the top two causes by the WHO measurements of global burdens of disease in 2020. Many studies have been conducted to explore the bidirectional relationship between coronary artery disease and depression during the last 15 years. This article reviewed relevant literatures and focused on several major findings. First of all, depression is an important and independent non-conventional risk factor for the onset of coronary artery disease. Secondly, the prevalence of depressive symptoms and disorders has been observed to be higher in the patients with coronary artery disease than in the general population. Thirdly, depression is a predictor of poorer prognosis for coronary artery disease in terms of recurrence of cardiovascular events and mortality. Fourthly, in spite of different findings from other studies, several large-scale clinical trials, notably SADHART, ENRICHD, and CREATE, proved the efficacy of antidepressant and psychotherapy administration in this population. Finally, the underlying mechanisms linking together coronary artery disease and depression are briefly reviewed. More understanding of the relationship between coronary artery disease and depression may improve the treatment and care of both medical conditions.

並列關鍵字

coronary artery disease ； myocardial infarction ； depression