Fava G A, Sonino N, Wise T N
Department of Psychology, University of Bologna, Italy.
Psychother Psychosom. 1988;49(2):81-102. doi: 10.1159/000288073.
The management of depression in the medically ill is a complex task that requires considerable clinical skills. The aim of this review is to outline evaluation strategies which may lead to a more effective use of current psychiatric diagnostic criteria and to suggest clinical guidelines for the use of antidepressant medications and psychotherapeutic techniques. The multifactorial determinants and modes of expression of depression in the medical patient require further research. Treatment outcome studies involving drug treatment or short-term psychotherapeutic approaches or both are needed. Antidepressant drugs remain the most specific and readily available treatment of major depressive disorders in the setting of medical disease. In case of organic affective syndromes, treatment should be primarily directed to the physical condition.
对患有躯体疾病的患者进行抑郁症管理是一项复杂的任务，需要相当多的临床技能。本综述的目的是概述评估策略，这些策略可能会更有效地运用当前的精神科诊断标准，并提出使用抗抑郁药物和心理治疗技术的临床指南。躯体疾病患者抑郁症的多因素决定因素和表现方式需要进一步研究。需要开展涉及药物治疗或短期心理治疗方法或两者兼有的治疗结果研究。在躯体疾病背景下，抗抑郁药物仍然是治疗重度抑郁症最具特异性且最容易获得的治疗方法。对于器质性情感综合征，治疗应主要针对躯体状况。
