Н.Н. Протько, А.В. Горюнов, Н.С. Дергач, Г.Д. Ситник, Н.В. Шпигун, С.С. Боричевский, В.А. Костюков, И.В. Патеюк
Институт повышения квалификации и переподготовки кадров здравоохранения УО «Белорусский государственный медицинский университет», Минск, Республика Беларусь1 УЗ «40-я городская клиническая поликлиника», Минск, Республика Беларусь2 УЗ «34-я центральная районная поликлиника Советского района г. Минска», Минск, Республика Беларусь
Тревожно-депрессивные расстройства (ТДР) часто встречаются у пациентов с сердечно-сосудистыми заболеваниями (ССЗ). ТДР снижают качество жизни, утяжеляют течение, повышают риск осложнений
ССЗ. Своевременная диагностика и эффективное лечение ТДР наиболее эффективна в первичном звене здравоохранения. В статье дана
характеристика психосоматической коморбидности у пациентов с разными
кардиологическими заболеваниями, приведены особенности диагностики
и лечения ТДР у пациентов с ССЗ.
ключевые слова: тревожные и депрессивные расстройства, сердечно-сосудистые заболевания, артериальная гипертензия, ишемическая болезнь сердца, антидепрессанты.
для цитирования: Н.Н. Протько, А.В. Горюнов, Н.С. Дергач, Г.Д. Ситник, Н.В. Шпигун, С.С. Боричевский, В.А. Костюков, И.В. Патеюк. Тревожные и депрессивные расстройства у кардиологических пациентов. Неотложная кардиология и кардиоваскулярные риски, 2024, Т. 8, № 1, С. 2193–2200.
ANXIETY AND DEPRESSIVE DISORDERS IN CARDIAC PATIENTS
N. Protko1 , A. Goryunov2 , N. Dergach3 , G.D. Sitnik1 , N. Shpigun1 , S. Borichevsky2 , V.Kostyukov3 , I. Pateyuk1
Anxiety-depressive disorders (ADD) are often found in patients
with cardiovascular diseases (CVD). ADR reduces the quality
of life, aggravates the course, increases the risk of complications
of CVD. Timely diagnosis and effective treatment of ADR is most effective in primary healthcare. The article describes the characteristics
of psychosomatic comorbidity in patients with various cardiac diseases,
presents the features of the diagnosis and treatment of ADR in patients
with CVD.
keywords: anxiety and depressive disorders, cardiovascular diseases, arterial hypertension, coronary heart disease, antidepressants
for references: N. Protko, A. Goryunov, N. Dergach, G.D. Sitnik, N. Shpigun, S. Borichevsky, V. Kostyukov, I. Pateyuk. Anxiety and depressive disorders in cardiac patients. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2024, vol. 8, no. 1, pp. 2193–2200.
1. Volel B.A., Ternovaya E.S., Ermusheva А.A., Syrkina E.A., Ardzinba I.B. Rasstrojstvo
lichnosti i serdechno-sosudistye zabolevaniya (na modeli arterial’noj gipertonii
i ishemicheskoj bolezni serdca) [Personality disorder and cardiovascular diseases
(in the model of arterial hypertension and coronary heart disease)]. Psihicheskie
rasstrojstva v obshchej medicine, 2014, no. 1, pp. 4-13. (in Russian).
2. Psihicheskoe zdorove i hronicheskie somaticheskie zabolevaniya [electronic resource]
[Mental health and chronic physical illness] / World Federation of Mental Health,
2023. Available at https://mokc.by/sites/default/files/ WMHD%202010_0.pdf
(accessed 20 September 2023). (in Russian).
3. Trevozhnost i zabolevaniya serdca [electronic resource] [Anxiety and Heart Disease.
Psychiatry and Neuroscienc. Available at: https://psyandneuro.ru/novosti/anxietyanger-personality-and-heart-disease (accessed 10 October 2023) (in Russian).
4. Depressiya i drugie obshchie psihicheskie rasstrojstva [electronic resource] [Depression
and Other Common Mental Disorders]. Global Health Estimates. World Health
Organization. Available at: https://iris.who.int/bitstream/handle/10665/254610/
WHO-MSD-MER-2017.2-eng.pdf (accessed 10 October 2023) (in Russian).
5. Galeeva K. Pogranichnye psihicheskie rasstrojstva i kachestvo zhizni pacientov na
razlichnyh stadiyah arterial’noj gipertenzii [Borderline mental disorders and quality
of life of patients at various stages of arterial hypertension]: diss. kand. med. nauk:
14.01.06. Tomsk, 2013, 180 p. (in Russian).
6. Alinovskaya, S.V. Affektivnye rasstrojstva u pacientov s kardial’noj patologiej [Affective
disorders in patients with cardiac pathology]. Molodoj uchenyj, 2013, no. 5,
pp. 790-792. (in Russian).
7. Janszky I., Ahnve S., Lundberg I., Hemmingsson T. Early-onset depression, anxiety,
and risk of subsequent coronary heart disease: 37-year follow-up of 49,321 young Swedish
men. J Am Coll Cardiol, 2010, vol. 56(1), pp. 31-37. doi: 10.1016/j.jacc.2010.03.033.
8. Katon, U.Dzh. Epidemiologiya i terapiya depressij u pacientov s hronicheskoj
somaticheskoj patologiej (obzor) [Epidemiology and therapy of depression in patients
with chronic somatic pathology (review)]. Psihicheskie rasstrojstva v obshchej
medicine, 2012, no. 2, pp. 50-56. (in Russian).
9. Shtarik, S.Y. Komorbidnost arterial’noj gipertenzii i trevozhno-depressivnyh rasstrojstv
sredi vzroslogo naseleniya krupnogo promyshlennogo centra Vostochnoj Sibiri
[Comorbidity of arterial hypertension and anxiety-depressive disorders among the
adult population of a large industrial center of Eastern Siberia:]: diss. doct. med.
nauk: 14.01.14. Krasnoyarsk, 2010, 288 p. (in Russian).
10. Smulevich A.B., Volel B.A., Ternovaya E.S., Nikitina Yu.M. Primenenie preparata
pantogam aktiv (D-, L-gopantenovaya kislota) v terapii kognitivnyh i trevozhnyh
rasstrojstv u pacientov s arterial’noj gipertenziej [Use of the drug (D-, L-hopantenic acid)
in the treatment of cognitive and anxiety disorders in patients with arterial hypertension]. Obozrenie psihiatrii i medicinskoj psihologii, 2017, no. 3, pp. 96-108. (in Russian).
11. Repin A., Lebedeva E., Klinicheskoe techenie zabolevaniya u pacientov s IBS v sochetanii
s trevozhno-depressivnymi rasstrojstvami na fone dlitel’noj terapii antidepressantami
[Clinical course of the disease in patients with coronary artery disease in combination
with anxiety and depressive disorders during long-term antidepressant therapy].
Sibirskij Medicinskij zhurnal, 2010, vol. 25(2), no. 2, pp. 20-25. (in Russian).
12. Frasure-Smith N., Lespérance F. Depression and cardiac risk: present status and
future directions. Heart, 2010, vol. 96(3), pp. 173-176. doi: 10.1136/hrt.2009.186957.
13. Vogelzangs N., Seldenrijk A., Beekman A., Hein P., J van Hout, Peter de Jonge, Brenda W.,
Penninx J. Cardiovascular disease in persons with depressive and anxiety disorders.
J Affect Disord, 2010, vol. 125(1-3), pp. 241-248. doi: 10.1016/j.jad.2010.02.112.
14. Repin A. Depressivnye rasstrojstva u pacientov s IBS: vozmozhnosti diagnostiki
i lecheniya v kardiologicheskom stacionare [Depressive disorders in patients
with coronary artery disease: diagnostic and treatment options in a cardiology
hospital]. Medicinskij vestnik. Available at: https://medvestnik.by/technology/
depressivnye-rasstrojstva-u-patsientov-s-ibs-vozmozhnosti-diagnostiki-i-lecheniya-v-kardiologicheskom-statsionare (accessed 15 October 2023) (in Russian).
15. Kayano H., Koba S., Matsui T., Fukuoka H., Toshida T., Sakai T., Akutsu Y., Tanno K.,
Geshi E., Kobayashi Y. Anxiety disorder is associated with nocturnal and early
morning hypertension with or without morning surge: ambulatory blood pressure
monitoring. Circ J, 2012, vol. 76(7), pp. 1670-1677. doi: 10.1253/circj.cj-11-1085.
16.Player M., Peterson L. Anxiety disorders, hypertension, and cardiovascular risk:
a review. Int J Psychiatry Med., 2011;41(4):365-77. doi: 10.2190/PM.41.4.f.
17. Andryushchenko, A.V. Psihicheskie i psihosomaticheskie rasstrojstva v uchrezhdeniyah
obshchesomaticheskoj seti (kliniko-epidemiologicheskie aspekty, psihosomaticheskie
sootnosheniya, terapiya) [Mental and psychosomatic disorders in institutions of the
general somatic network (clinical and epidemiological aspects, psychosomatic relationships, therapy)]: diss. doct. med. nauk: 14.01.06. М., 2011, 385 p. (in Russian).
18. Carvalho A., McIntyre R. Mental Disorders in Primary Care A: Guide to their Evaluation and Management. Dialogues Clin Neurosci, 2003, vol. 5(2), pp. 115-128. doi:
10.31887/DCNS.2003.5.2/huwittchen.
19. Filippova N.V., Barylnik Yu.B., Bogdanova T.M., Blinova V.V., Shchelchkova A.A.,
Mozgacheva E.S. Effektivnost i bezopasnost Vortioksetina v terapii depressivnyh
rasstrojstv u pacientov kardiologicheskogo profilya [Effectiveness and safety
of vortioxetine in the treatment of depressive disorders in cardiac patients]. Obozrenie psihiatrii i medicinskoj psihologii im. V.M. Bekhtereva, 2023, vol. 57(2),
pp. 105-115. doi: 10.31363/2313-7053-2023-817 (in Russian).
20. Wang Y., Nomikos G., Karim A., Munsaka M., Serenko M., Maggie Liosatos M. Effect of
Vor tioxetine on Cardiac Repolarization in Healthy Adult Male Subjects: Results of a Thorough
QT/QTc Study. Clin Pharmacol Drug Dev, 2013, vol. 2(4), pp. 298-309. doi: 10.1002/cpdd.51.
21. Grace C., Zhang W., Serenko M. Lack of Effect of Multiple Doses of Vortioxetine
on the Pharmacokinetics and Pharmacodynamics of Aspirin and Warfarin. J Clin
Pharmacol, 2015, vol. 55(6), pp. 671-679. doi: 10.1002/jcph.456.
22. Baldwin D.S., Necking O., Schmidt S.N., Ren H., Reines E. H. Efficacy and safety of vortioxetine
in treatment of patients with major depressive disorder and common co-morbid physical
illness. J Affect Disord, 2022, vol. 15(3110, pp. 588-594. doi: 10.1016/j.jad.2022.05.098.
23. Alfonso C.T., Pérez-Mandujano A., Ramírez-González R.I., Freasan A. Vortioxetine versus
sertraline in metabolic control, distress and depression in Mexican patients with type 2
diabetes. Ann Transl Med, 2019, vol. 7(22), pp. 656-656. doi:10.21037/atm.2019.10.56.
24. Quilichini J.B., Revet A., Garcia P., Bouquié R., Hamard J., Yrondi A., Montastruc F.
Comparative effects of 15 antidepressants on the risk of withdrawal syndrome:
A real-world study using the WHO pharmacovigilance database. J Affect Disord,
2022, vol. 15(297), pp. 189-193. doi: 10.1016/j.jad.2021.10.041.
25. Shakurai H., Uchida H., Kato M., Suzuki T., Baba H., Watanabe K., Inada K., Kikuchi T.,
Katsuki A., Kishida I., Sugawara Kikuchi Y., Yasui-Furukori N. Pharmacological
management of depression: Japanese Expert Consensus. J Affect Disord. 2020, vol. 266,
pp. 626-632. doi: 10.1016/j.jad.2020.01.149.
26. Kollhorst B., Jobski K., Krappweis J., Schink T., Garbe E., Schmedt N. Antidepressants
and the risk of death in older patients with depression. A population-based cohort
study. PLoS One, 2019, vol. 14(4), pp. e0215289. doi: 10.1371/journal.pone.0215289.