Download Cardiovascular Diseases and Depression: Treatment and by Bernhard T. Baune, Phillip J. Tully PDF

By Bernhard T. Baune, Phillip J. Tully

The global is witnessing a burgeoning worldwide epidemic of persistent cerebro- and heart problems and melancholy problems. The reader will locate this accomplished booklet to be a long-needed, up to date wisdom base on those more and more famous comorbid stipulations that experience long term outcomes for person functionality and health and society regularly. This entire ebook outlines the advanced and bidirectional dating among a variety of kinds of melancholy and cerebro- and cardiovascular ailments. it really is written via a number of specialists within the box, together with psychiatrists, cardiologists, neuroscientists, psychologists, and epidemiologists, with the purpose of featuring and discussing the newest facts at the pathophysiology, neurobiology, and medical presentation of those universal and disabling comorbid stipulations and the to be had pharmacological, mental, and behavioral interventions. via elucidating the underlying scientific and neurobiological mechanisms within the mind and the wealthy interaction among the physique and the mind biology, the ebook brings jointly the newest wisdom of this overlapping zone in Psychiatry and Cardiology. The transparent descriptions of evidence-based techniques to medical remedy make sure that it is going to function either an updated review and a destiny advisor for working towards clinicians and graduate students.

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Additional info for Cardiovascular Diseases and Depression: Treatment and Prevention in Psychocardiology

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The vascular depression hypothesis postulates that cerebrovascular disease confers vulnerability to, triggers and maintains a subtype of depression in older adults (Alexopoulos et al. 1997). While there is still no consensus on the definition of vascular depression to date, it is generally recognised that vascular depression is characterised by a combination of some of the following features (Alexopoulos et al. 1997; Krishnan et al. 1997; Hickie et al. 1995, 1997; Steffens and Krishnan 1998): • Evidence of vascular disease or vascular risk factors • Late depression onset or change in the course of depression following development of vascular disease in those with history of early-onset depression 3 The Risk Relationship Between Depression and CVD During Ageing • • • • • • • • Neuropsychological impairment including executive dysfunction Subcortical neuroimaging abnormalities Reduced depressive ideation Psychomotor retardation Apathy or anhedonia Functional disability Poorer response to antidepressant treatment Absence of family history of mood disorders 27 Over the years, researchers have tried to further refine the notion of vascular depression by incorporating findings from more recent research.

Depressed patients with coronary heart disease have a lower heart rate variability compared to nondepressed patients with coronary heart disease and are, therefore, at a greater risk of ventricular fibrillation (Carney et al. 1995). Potential explanations for these associations are altered autonomic tone, poor adherence and a link with other cardiac risk factors. Some antidepressants (in particular tricyclics and monoamine oxidase inhibitors) may have cardiotoxic side effects, but this accounts only for a very limited number of morbidity and mortality cases in depressed patients as the relationship between depression and cardiovascular disease was observed before antidepressants were developed (Carney et al.

Of course, it can be that in some cases depression may be a prodrome of not yet discovered and diagnosed (and therefore not measurable) subclinical or medical conditions that affect subsequent cardiovascular disease onset. However, it is unlikely that this completely explains the increased cardiovascular risk as results are rather consistent across studies, not restricted to older samples only (in which other health conditions may be present), and have also been found for major depressive disorders with an early age of onset.

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