Carney Robert M, Freedland Kenneth E
Behavioral Medicine Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63108, USA.
Am J Med. 2008 Nov;121(11 Suppl 2):S20-7. doi: 10.1016/j.amjmed.2008.09.010.
Approximately 20% of patients with coronary heart disease (CHD) have major depression and 20% have minor depression at any given point in the course of their illness. Depression causes significant psychological and social morbidity, and is a risk factor for further cardiac morbidity and mortality. Although there are many possible biological and behavioral mechanisms, the causal pathways through which depression increases the risk for cardiac events and death are not well understood. Despite the morbidity associated with depression, and the devastating impact it has on the quality of life of patients with CHD, it is underdiagnosed and often left untreated. This article describes screening techniques for use in primary care and cardiology settings, and discusses the safety and efficacy of available treatments for depression in patients with CHD.
在冠心病（CHD）患者中，约20%在病程中的任何特定时间点患有重度抑郁症，另有20%患有轻度抑郁症。抑郁症会导致严重的心理和社会疾病，并且是进一步发生心脏疾病和死亡的危险因素。尽管存在许多可能的生物学和行为机制，但抑郁症增加心脏事件和死亡风险的因果途径尚未完全明确。尽管抑郁症会带来疾病，且对冠心病患者的生活质量有毁灭性影响，但它常常未被诊断出来，且往往得不到治疗。本文介绍了在初级保健和心脏病学环境中使用的筛查技术，并讨论了冠心病患者现有抑郁症治疗方法的安全性和有效性。
