Author/Editor		Marušič, Dorjan; Marušič, Andrej
Title		Psihokardiologija: sočasna preventiva in obravnava koronarne bolezni ter duševnih motenj
Translated title		Psychocardiology: simultaneous prevention and treatment of coronary disease and mental disorders
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 40, št. 1-2
Publication year		2001
Volume		str. 55-60
Language		slo
Abstract		Psychocardiology is a science which explores psychologic factors that are important during the development of coronary disease. As it has been proved that depressive disorder presents an independent indicative factor of earlier mortality following myocardial infarction, more and more attention is devoted to the intertwinning of depression and coronary disease. It is known that depressive disorder can be effectively treated psychologically and/or with antidepressants. It is also known that depression among people with somatic disorder is often overlooked. Depression is thus an important and often overlooked disorder among coronary patients, which can be treated and so eliminated as a risk factor of earlier mortality after myocardial infarction. Knowledge of intertwinning mechanisms between depression and coronary disease would enable a more effective prevention and simultaneous treatment of both diseases. Having reviewed literature regarding the intertwinning of all the classic and psychologic risk factors for coronary disease, seven specific influences of depression and other psychologic factors on this chronic disease can be exposed: behaviour changes connected with health, and six biologic mechanisms as are variability of blood pressure, oxygen supply of heart muscle, blood thickening, blood coagulation, levels of lipids and blood sugar. Studies of the influence of psychologic risk factors on the development of coronary heart disease are relatively copious in Slovenia and could be of help in further development of simultaneous primary and secondary prevention of coronary disease and depression. In the future, an even faster progress can be expected, as cardiologists and other physicians who do not work predominantly on the domain of mental health also show more and more interest in psychological problematics among their patients.
Summary		Psihokardiologija je veda, ki raziskuje psihološke dejavnike, pomembne med razvojem koronarne bolezni. Vse več pozornosti se posveča prepletanju depresije in koronarne bolezni saj je ugotovljeno, da je depresivna motnja neodvisen napovedni dejavnik zgodnejše umrljivosti po miokardnem infarktu. Znano je, da lahko depresivno motnjo učinkovito zdravimo s psihološko terapijo in/ali z antidepresivnimi zdravili. Znano je tudi, da depresijo med osebami s somatsko motnjo pogosto spregledajo. Pri depresiji gre torej za pomembno in pogosto spregledano motnjo med koronarnimi bolniki, ki jo lahko zdravimo in s tem odpravljamo dejavnik tveganja zgodnejše umrljivosti po miokardnem infarktu. Poznavanje mehanizmov povezanosti med depresijo in koronarno boleznijo bi omogočalo učinkovitejšo preventivo in sočasno obravnavo obeg bolezni. Na podlagi pregleda literature na temo prepletanja vseh klasičnih dejavnikov tveganja za koronarno bolezen lahko izpostavimo sedem specifičnih vplivov depresije in drugih psiholoških dejavnikov na to kronično bolezen: spremembe z zdrvjem povezanega vedenja in šest bioloških mehanizmov, med njimi variabilnost krvnega tlaka, oskrba srčne mišice s kisikom, zgoščevanje krvi, strjevanje krvi, raven lipidov in krvnega sladkorja. Slovenske izkušnje na področju raziskovanja vpliva psiholoških dejavnikov tveganja na razvoj koronarne bolezni so razmeroma bogate in bi nam lahko bile v pomoč pri nadaljnem razvoju sočasne primarne in sekundarne preventive koronarne bolezni in depresije. V prihodnosti pa se nam na področju povezovanja obeta še hitrejši napredek, saj se tudi kardiologi in drugi zdravniki, ki ne delajo pretežno na področju duševnega zdravja, vse bolj zanimajo za psihološko problematiko med svojimi bolniki.
Descriptors		MENTAL DISORDERS CORONARY DISEASE RISK FACTORS DEPRESSION PATIENT CARE TEAM