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DOI: 10.1055/s-0042-108681
Depression und Herzinsuffizienz – eine gefährliche Kombination
Depression and heart failure – a dangerous combinationPublication History
Publication Date:
24 August 2016 (online)
![](https://www.thieme-connect.de/media/dmw/201617/lookinside/thumbnails/1222_10-1055-s-0042-108681-1.jpg)
Zusammenfassung
Depression ist bei Herzinsuffizienz eine häufige Komorbidität, die Lebensqualität und Prognose verschlechtert. Beides sind Volkskrankheiten mit steigender Prävalenz, verursachen hohe Behandlungskosten, und sind deshalb auch sozioökonomisch relevant. Komplexe sich wechselseitig ungünstig beeinflussende biologische und verhaltensbezogene Faktoren (z. B. geringere Therapieadhärenz bei depressiven Herzinsuffizienten), aber auch eine partiell gemeinsame genetische Disposition scheinen pathophysiologisch relevant zu sein. Wenig aufwändige Screening-Instrumente erleichtern in der Praxis die Diagnose, auch wenn viele Symptome beider Erkrankungen überlappen. Harte Evidenz aus randomisierten kontrollierten Studien, dass antidepressive Pharmaka bei herzinsuffizienten Patienten Depressivität, Mortalität und Morbidität vermindern können, gibt es bisher nicht. Durch körperliches Training, kognitive Verhaltenstherapie und ganzheitliche Versorgungsansätze wurden aber in einzelnen randomisierten Studien depressive Symptome und/oder Prognose gebessert.
Abstract
Depression is common in heart failure and associated with impaired quality of life. It impacts adversely on clinical outcomes. Both diseases are widespread in the general population with increasing prevalence and treatment costs. They are therefore also of socio-economic relevance. Various interrelated biological and behavioral factors (e.g. lower treatment adherence in depressed patients with heart failure) seem to play a pathophysiological role, and there is growing evidence that both diseases may also share genetic susceptibilities. Simple screening tools ease depression diagnosis in clinical practice, although the clinical profile of both disorders overlaps. To date, there is no evidence that antidepressant pharmacotherapy improves depressive symptoms, mortality and morbidity in patients with heart failure and comorbid depression, but physical training, cognitive behavioral therapy and comprehensive disease management improved symptoms and/or prognosis in individual randomized studies.
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