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      Depresión en insuficiencia cardíaca crónica:: causa o consecuencia Translated title: Depressão na insuficiência cardíaca crônica: causa ou conseqüência Translated title: Depression in chronic heart failure: cause or consequence

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          Abstract

          La depresión está presente entre el 17%-37% de los pacientes con insuficiencia cardíaca (IC), generando altos costos para la salud pública. Es importante considerar que los pacientes con diagnóstico de depresión presentan un incremento 4 veces mayor en términos de mortalidad comparado con aquellos que no la presentan. Los estudios en IC se han basado en las últimas décadas en los efectos de dicha enfermedad, rehospitalizaciones, calidad de vida y costos para la salud pública, dejándose de lado factores psicosociales como la depresión, la cual tendría un alto impacto nocivo sobre los pacientes. Aun se requiere de un mayor número de estudios e investigaciones para la comprensión de esta enfermedad. La depresión clínica es un desorden que consiste en una combinación de elementos que interfieren con la capacidad de las personas para realizar sus actividades habituales. Se debe tener en cuenta que los pacientes con IC presentan ciclos que varían de períodos de estabilización a períodos de hospitalización, provocando que los síntomas depresivos se modifiquen en el corto tiempo, dependiendo del estado de salud del paciente, ya sea que se encuentre hospitalizado o entre la cuarta y sexta semana posterior al alta. El objetivo de este trabajo es aportar información y datos basados en las investigaciones sobre depresión en IC, para considerar la necesidad de realizar el diagnóstico y aplicar un tratamiento precoz en los pacientes, mejorando la calidad de vida y evitando de esta manera la progresión de su enfermedad.

          Translated abstract

          A depressão está presente entre 17%-37% dos pacientes com insuficiência cardíaca (IC), gerando altos custos para a saúde pública. É importante considerar que os pacientes diagnosticados com depressão têm um aumento de 4 vezes mais elevados em termos de mortalidade em comparação com aqueles que não sofrem desta doença. Nas últimas décadas, os estudos em IC foram com base nos efeitos da doença, reinternações, qualidade de vida e os custos para a saúde pública, deixando de lado fatores psicossociais, como depressão, o que teria um impacto negativo no alto de pacientes. Embora precise de um número maior de estudos e pesquisas para a compreensão desta doença. A depressão clínicaé uma doença que envolve uma combinação de elementos que interferem com a capacidade das pessoas para realizar suas atividades habituais. Deve notar-se que os pacientes com IC têm ciclos que variam de períodos de estabilização à períodos de hospitalização, causando sintomas depressivos alteradas no curto período de tempo, dependendo do estado de saúde do paciente, quer estejam hospitalizados e entre a quarta e a sexta semana após a alta. O objetivo deste estudo é fornecer informação detalhada e com base em pesquisa sobre depressão em dados de IC, a considerar a necessidade de diagnóstico e implementar o tratamento precoce em pacientes, melhorando a qualidade de vida e evitando assim a progressão da sua doença.

          Translated abstract

          Depression is present in 17%-37% of patients with heart failure (HF), generating high costs for public health. It is important to consider that patients with a diagnosis of depression present a 4-fold increase in terms of mortality compared to those who do not. In the last decades, studies on HF have been based on the effects of this disease, rehospitalizations, quality of life and costs for public health, leaving aside psychosocial factors such as depression, which would have a high harmful impact on patients. Even more research and studies are needed to understand this disease. Clinical depression is a disorder consisting of a combination of elements that interfere with people's ability to perform their usual activities. It should be taken into account that patients with HF present cycles that vary from periods of stabilization to periods of hospitalization, causing depressive symptoms to be modified in the short time, depending on the patient's health status, whether hospitalized and between the fourth and sixth week after discharge. The aim of this paper is to provide information and data based on the research on depression in HF, to consider the need to make the diagnosis and to apply an early treatment in patients, improving the quality of life and avoiding the progression of their disease.

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          Most cited references416

          • Record: found
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          An ultra-brief screening scale for anxiety and depression: the PHQ-4.

          The most common mental disorders in both outpatient settings and the general population are depression and anxiety, which frequently coexist. Both of these disorders are associated with considerable disability. When the disorders co-occur, the disability is even greater. Authors sought to test an ultra-brief screening tool for both. Validated two-item ultra-brief screeners for depression and anxiety were combined to constitute the Patient Health Questionnaire for Depression and Anxiety (the PHQ-4). Data were analyzed from 2,149 patients drawn from 15 primary-care clinics in the United States. Factor analysis confirmed two discrete factors (Depression and Anxiety) that explained 84% of the total variance. Increasing PHQ-4 scores were strongly associated with functional impairment, disability days, and healthcare use. Anxiety had a substantial effect on functional status that was independent of depression. The PHQ-4 is a valid ultra-brief tool for detecting both anxiety and depressive disorders.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies.

            With negative treatment trials, the role of depression as an aetiological or prognostic factor in coronary heart disease (CHD) remains controversial. We quantified the effect of depression on CHD, assessing the extent of confounding by coronary risk factors and disease severity. Meta-analysis of cohort studies measuring depression with follow-up for fatal CHD/incident myocardial infarction (aetiological) or all-cause mortality/fatal CHD (prognostic). We searched MEDLINE and Science Citation Index until December 2003. In 21 aetiological studies, the pooled relative risk of future CHD associated with depression was 1.81 (95% CI 1.53-2.15). Adjusted results were included for 11 studies, with adjustment reducing the crude effect marginally from 2.08 (1.69-2.55) to 1.90 (1.49-2.42). In 34 prognostic studies, the pooled relative risk was 1.80 (1.50-2.15). Results adjusted for left ventricular function result were available in only eight studies; and this attenuated the relative risk from 2.18 to 1.53 (1.11-2.10), a 48% reduction. Both aetiological and prognostic studies without adjusted results had lower unadjusted effect sizes than studies from which adjusted results were included (P<0.01). Depression has yet to be established as an independent risk factor for CHD because of incomplete and biased availability of adjustment for conventional risk factors and severity of coronary disease.
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              • Record: found
              • Abstract: found
              • Article: not found

              The concepts of stress and stress system disorders. Overview of physical and behavioral homeostasis.

              This article defines stress and related concepts and reviews their historical development. The notion of a stress system as the effector of the stress syndrome is suggested, and its physiologic and pathophysiologic manifestations are described. A new perspective on human disease states associated with dysregulation of the stress system is provided. Published original articles from human and animal studies and selected reviews. Literature was surveyed utilizing MEDLINE and the Index Medicus. Original articles from the basic science and human literature consisted entirely of controlled studies based on verified methodologies and, with the exception of the most recent studies, replicated by more than one laboratory. Many of the basic science and clinical studies had been conducted in our own laboratories and clinical research units. Reviews cited were written by acknowledged leaders in the fields of neurobiology, endocrinology, and behavior. Independent extraction and cross-referencing by the authors. Stress and related concepts can be traced as far back as written science and medicine. The stress system coordinates the generalized stress response, which takes place when a stressor of any kind exceeds a threshold. The main components of the stress system are the corticotropin-releasing hormone and locus ceruleus-norepinephrine/autonomic systems and their peripheral effectors, the pituitary-adrenal axis, and the limbs of the autonomic system. Activation of the stress system leads to behavioral and peripheral changes that improve the ability of the organism to adjust homeostasis and increase its chances for survival. There has been an exponential increase in knowledge regarding the interactions among the components of the stress system and between the stress system and other brain elements involved in the regulation of emotion, cognitive function, and behavior, as well as with the axes responsible for reproduction, growth, and immunity. This new knowledge has allowed association of stress system dysfunction, characterized by sustained hyperactivity and/or hypoactivity, to various pathophysiologic states that cut across the traditional boundaries of medical disciplines. These include a range of psychiatric, endocrine, and inflammatory disorders and/or susceptibility to such disorders. We hope that knowledge from apparently disparate fields of science and medicine integrated into a working theoretical framework will allow generation and testing of new hypotheses on the pathophysiology and diagnosis of, and therapy for, a variety of human illnesses reflecting systematic alterations in the principal effectors of the generalized stress response. We predict that pharmacologic agents capable of altering the central apparatus that governs the stress response will be useful in the treatment of many of these illnesses.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                ic
                Insuficiencia cardíaca
                Insuf. card.
                Comité Insuficiencia Cardíaca (Ciudad Autónoma de Buenos Aires, , Argentina )
                1852-3862
                December 2016
                : 11
                : 4
                : 173-200
                Affiliations
                [03] Buenos Aires. orgnameServicio de cardiología. orgdiv1Hospital Alemán. República Argentina.
                [01] San Miguel de Tucumán. Tucumán. orgnameCentro Médico Galbermed. República Argentina.
                [04] San Miguel de Tucumán. Tucumán. orgnameDiagnóstico cardiovascular. República Argentina.
                [02] orgnameComité de Insuficiencia Cardíaca orgdiv1Federación Argentina de Cardiología.
                [05] Philadelphia. orgnameDrexel Neuroscience Institute. orgdiv1Drexel University Estados Unidos de Norteamérica.
                Article
                S1852-38622016000400004
                b8797dec-fc0a-4741-b330-b9170d278564

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 04 April 2016
                : 18 August 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 437, Pages: 28
                Product

                SciELO Argentina


                Depresión,Insuficiencia cardíaca,Impacto,Mecanismos fisiopatológicos,Diagnóstico,Tratamiento,Depressão,Insuficiência cardíaca,Tratamento,Depression,Cardiac failure,Impact,Pathophysiological mechanisms,Diagnosis,Treatment

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