ABSTRACT
La comorbilidad entre depresión y enfermedades físicas es muy frecuente y tiene un impacto importante en el deterioro de la salud así como en la atención y tratamiento recibidos. Impulsado por las Sociedades Españolas de Psiquiatría y Psiquiatría Biológica, y la Sociedad Española de Médicos de Atención Primaria (SEMERGEN) se realizó un consenso sobre la salud física en el paciente con depresión, que de forma resumida se expone en el presente trabajo. La revisión de la literatura puso de manifiesto la elevada frecuencia en pacientes con depresión de trastornos cardiovasculares y trastornos endocrinometabólicos como la obesidad y la diabetes, de tal modo que en pacientes con depresión serían aplicables las recomendaciones de prevención primaria y secundaria establecidas para los individuos con riesgo cardiovascular o metabólico. También es frecuente la comorbilidad entre depresión y dolor crónico, que obliga a la detección activa de ambos trastornos y a una intervención terapéutica integral. La presencia de esta comorbilidad puede condicionar, aunque no impedir el tratamiento farmacológico en cuya elección se deberá tener en cuenta los efectos secundarios y las interacciones de los distintos antidepresivos. Por su parte, la psicoterapia puede contribuir a la recuperación integral del enfermo. Globalmente, en el proceso de atención al paciente con depresión y enfermedades físicas comórbidas es fundamental la coordinación del médico de atención primaria, el psiquiatra y otros especialistas o profesionales implicados (AU)
Comorbidity between depression and physical illnesses is very common and has a significant impact on the health and management of the patient. With the support of the Sociedades Españolas de Psiquiatría y Psiquiatría Biológica, and Sociedad Española de Médicos de Atención Primaria (SEMERGEN) a consensus was prepared on physical health in patients with depression and is summarized in the present work. The literature review highlighted the high frequency of cardiovascular and endocrine-metabolic disorders in patients with depression such as diabetes and obesity, thus making the primary and secondary prevention recommendations for patients with cardiovascular or metabolic risk applicable to patients with depression. Comorbidity between depression and chronic pain is also frequent, and requires an integrated therapeutic approach. The presence of physical illness in patients with depression may condition, but not preclude, the pharmacological treatment; drug selection should take into account potential side-effect and drug-drug interactions. On the other hand, psychotherapy may contribute to the patient's recovery. Overall, coordination between the primary care physician, the psychiatrist and other health professionals involved is essential for the management of patients with depression and concomitant physical illness (AU)
Subject(s)
Humans , Male , Female , Depression/diagnosis , Depression/metabolism , Obesity/diagnosis , Depression/classification , Depression/mortality , Societies/legislation & jurisprudence , Societies/organization & administration , Spain/ethnologyABSTRACT
Comorbidity between depression and physical illnesses is very common and has a significant impact on the health and management of the patient. With the support of the Sociedades Españolas de Psiquiatría y Psiquiatría Biológica, and Sociedad Española de Médicos de Atención Primaria (SEMERGEN) a consensus was prepared on physical health in patients with depression and is summarized in the present work. The literature review highlighted the high frequency of cardiovascular and endocrine-metabolic disorders in patients with depression such as diabetes and obesity, thus making the primary and secondary prevention recommendations for patients with cardiovascular or metabolic risk applicable to patients with depression. Comorbidity between depression and chronic pain is also frequent, and requires an integrated therapeutic approach. The presence of physical illness in patients with depression may condition, but not preclude, the pharmacological treatment; drug selection should take into account potential side-effect and drug-drug interactions. On the other hand, psychotherapy may contribute to the patient's recovery. Overall, coordination between the primary care physician, the psychiatrist and other health professionals involved is essential for the management of patients with depression and concomitant physical illness.
