Diabetic infarct patients often affected by depression

Experts advise screening

About a quarter of all patients with type 2 diabetes and one in five patients at hospitals with coronary heart disease suffer from depression. "This quality of life is severely impaired to increased mortality of these patients," said Prof. Dr. Stephan Herpertz from the University Hospital Bochum in early January on the 34. Interdisciplinary Forum "Progress and training in medicine," the German Medical Association in Berlin. Sufferers usually led an unhealthy lifestyle, are often physically inactive and tended to obesity. But physical changes, such as the conduction system of the heart, blood clotting or immune defenses are not rarely observed. Treatment recommendations come at difficult. "Depression in primary physically ill people are often not recognized under practical conditions and inadequately treated," says Herpertz. He therefore recommends a regular depression screening for chronic diseases as an integral part of routine care.

"In this case, depression of patients with diabetes or heart disease with antidepressants, psychotherapy or a combination of both nearly as well as treatable depressive patients without physical illness," emphasized Herpertz. However, there is currently no convincing treatment that reliably develops a favorable effect on the medical parameters of diabetes or coronary heart disease. So there is about no sufficient treatment that helps prolong survival in heart attack patients with depression and low social support.

private lecturer dr Tom Bschor, chief physician at the Berlin Schlosspark-Klinik, added that the severity of the depression must be taken into account in antidepressant drug treatment. In a mild form, medication is not generally necessary. In the case of moderate depression, drug therapy would be an option, as would psychotherapy. "Pharmaceutical treatment should only be recommended to the patient in the case of a serious illness," emphasized Bschor. Unfounded fears, such as addiction or personality changes, should be addressed. This would make it easier to work with the patient when taking the medication. "The real art of depression treatment is the consistent exhaustion of the various treatment options available within the framework of an algorithm-supported step-by-step plan, so that the individual therapy steps are carried out for an adequate period of time, then their success is evaluated and, depending on this, the decision is made about the continuation of the therapy will," explained Bschor.

Source: Berlin [Federal Medical Association]