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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Nonpharmacologic treatments for depression in patients with coronary heart disease.
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Nonpharmacologic treatments for depression in patients with coronary heart disease.

机译：冠心病患者抑郁症的非药物治疗。

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OBJECTIVES: We review nonpharmacologic treatments for depression in patients with coronary heart disease (CHD), including psychological therapies such as cognitive behavior therapy (CBT) and interpersonal therapy (IPT), aerobic exercise, St. John's wort (SJW), essential fatty acids (EFAs), S-Adenosylmethionine (SAMe), acupuncture, and chromium picolinate (CP). METHOD: Medline searches and reviews of bibliographies were used to identify relevant articles. Each treatment was reviewed with particular attention paid to empirical support, as well as to potential mechanisms of action that might affect not only depression but also CHD endpoints. RESULTS: Nearly all randomized controlled trials (RCTs) of depression treatments have been conducted with non-CHD patients. These studies have provided the most support for psychological treatments, particularly CBT and IPT. Aerobic exercise, SJW, and SAMe also have considerable empirical support in otherwise healthy persons, but SJW may have undesirable side effects for CHD patients. Data for EFAs, CP, and acupuncture are limited; however, the use of aerobic exercise shows considerable promise for cardiac patients. CONCLUSIONS: There are few RCTs of patients with clinical depression and CHD, and those that exist have significant methodological limitations. Nonetheless, there is preliminary evidence that nonpharmacologic treatments are effective for cardiac patients with depression. In terms of reducing depression, the most evidence exists for psychological treatments, particularly CBT and IPT. However, there is little evidence that such treatment would also improve CHD risk factors. Aerobic exercise offers more promise to improve both mental and physical health due to its effect on cardiovascular risk factors and outcomes and thus warrants particular attention in future trials.
机译：目的：我们综述了冠心病（CHD）患者的非药物治疗抑郁症，包括心理治疗，例如认知行为疗法（CBT）和人际关系疗法（IPT），有氧运动，圣约翰草（SJW），必需脂肪酸（EFAs），S-腺苷甲硫氨酸（SAMe），针灸和吡啶甲酸铬（CP）。方法：使用Medline搜索和书目评论来识别相关文章。审查了每种治疗方法，并特别注意经验支持以及可能不仅影响抑郁症而且影响冠心病终点的潜在作用机制。结果：几乎所有抑郁治疗的随机对照试验（RCT）都是针对非冠心病患者进行的。这些研究为心理治疗，尤其是CBT和IPT提供了最大的支持。有氧运动，SJW和SAMe在原本健康的人中也具有相当大的经验支持，但是SJW对CHD患者可能有不良副作用。 EFA，CP和针灸的数据有限;但是，有氧运动对心脏病患者显示出很大的希望。结论：临床抑郁和冠心病患者的随机对照试验很少，并且存在的随机对照试验在方法学上存在明显的局限性。尽管如此，有初步证据表明，非药物治疗对患有心脏病的心脏病患者有效。在减轻抑郁方面，最有力的证据是心理治疗，尤其是CBT和IPT。但是，几乎没有证据表明这种治疗也可以改善冠心病的危险因素。有氧运动对心血管危险因素和结局有影响，因此有望改善精神和身体健康，因此在以后的试验中应特别注意。

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