晚期抑郁症患者的诊断与治疗

S. Block
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引用次数: 9

摘要

本文综述了晚期疾病患者常见的痛苦来源,确定了在这种情况下适当诊断和治疗抑郁症的挑战,并探讨了晚期疾病中抑郁症与其他关键临床结局的关系。进行了系统的文献综述。现有的对晚期患者的研究大多是针对癌症患者进行的。大约18%的晚期患者符合重度或轻度抑郁症的标准;多种精神合并症经常发生。随着患者病情加重,患病率也会上升。然而,在晚期疾病的情况下,抑郁症经常被诊断和治疗不足。一个关键的临床挑战是区分抑郁和悲伤。社会心理和精神药物干预已被证明在治疗晚期癌症患者的抑郁症方面是有效的。总之,抑郁症是晚期疾病的常规并发症,降低生活质量,损害家庭成员的功能,干扰治疗决策,并可能缩短生存时间。然而,有许多有效的治疗方法,包括药物治疗和心理治疗,都可以用来缓解抑郁症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnosis and treatment of depression in patients with advanced illness
Abstract This article reviews common sources of suffering in patients with advanced illness, identifies challenges in appropriately diagnosing and treating depression in this setting, and examines the relationship between depression and other key clinical outcomes in the setting of advanced disease. A systematic literature review was conducted. Most of the existing research on patients with advanced illness has been conducted with cancer patients. Approximately 18 percent of patients with advanced illness meet criteria for major or minor depression; multiple psychiatric co-morbidities occur frequently. Prevalence rates increase as patients become sicker. However, depression is frequently underdiagnosed and undertreated in the setting of advanced illness. One of the key clinical challenges is differentiating depression from grief. Both psychosocial and psychopharmacologic interventions have been shown to be effective in treating depression in patients with advanced cancer. In conclusion, depression is a regular complication of advanced illness, reduces quality of life, compromises family member function, interferes with treatment decisions, and may shorten survival. However, numerous effective treatment approaches, including both medications and psychotherapy, exist and can be used to alleviate depression.
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