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psychoneuro 2004; 30(10): 541-547
DOI: 10.1055/s-2004-836000
Schwerpunkt

© Georg Thieme Verlag Stuttgart · New York

Komorbidität zwischen kardiovaskulären Erkrankungen und Depressionen

Comorbidity between cardiovascular diseases and depressionM. W. Agelink1 , B. Baumann2 , D. Sanner1 , I. Kavuk1 , M. Mueck-Weymann3
  • 1Institut für Biologische Psychiatrie und Klinik für Psychiatrie, Psychotherapie und Psychosomatik an den Evangelischen Kliniken Gelsenkirchen
  • 2Universitätsklinik für Psychiatrie und Psychotherapie der Universität Magdeburg
  • 3Institut für Physiologie und Kardiologie der Universität Erlangen Nürnberg
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Publikationsverlauf

Publikationsdatum:
05. November 2004 (online)

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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.

Key Words:

depression - cardiovascular disease - affective illness

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Korrespondenzadresse:

Dr. Marcus W. Agelink

Institut für Biologische Psychiatrie und Klinik für Psychiatrie, Psychotherapie und Psychosomatik

Evanglische Kliniken Gelsenkirchen

Ruhr Universität Bochum

45879 Gelsenkirchen