Depresion y Cardiología

Depresión y
Enfermedad Cardiovascular

Murray, C. J., & Lopez, A. D. (1997). Alternative
projections of mortality and disability by cause
1990–2020: Global Burden of Disease Study.
The Lancet, 349(9064), 1498–1504.

Causa –
Consecuencia
“Disease
Risk”
Guthrie, Elspeth, and Geoffrey Gower Lloyd, eds. Handbook of Liaison
Psychiatry. Cambridge [England] ; New York: Cambridge University Press, 2007.

¼
Muertes
Hombres
1/5
Muertes
Mujeres
Pico
55-64 años:
1/3 Muertes

40 años
60 prospective
studies
Lichtman, Judith H., J. Thomas Bigger, James A. Blumenthal, Nancy Frasure-
Smith, Peter G. Kaufmann, François Lespérance, Daniel B. Mark, David S. Sheps,
C. Barr Taylor, y Erika Sivarajan Froelicher. 2008. «Depression and Coronary
Heart Disease Recommendations for Screening, Referral, and Treatment: A
Science Advisory From the American Heart Association Prevention Committee of
the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on
Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care
and Outcomes Research: Endorsed by the American Psychiatric Association».
Circulation 118 (17): 1768-75. doi:10.1161/CIRCULATIONAHA.108.190769.

Distima
Grief
(Duelo)
Trastorno
adaptativo con
ánimo depresivo
Trastorno
depresivo
mayor.
Hare, David L., Samia R. Toukhsati, Peter Johansson, y Tiny Jaarsma. «Depression and
Cardiovascular Disease: A Clinical Review». European Heart Journal 35, n.o 21 (1 de
junio de 2014): 1365-72. doi:10.1093/eurheartj/eht462.

3 x ↘ IAM
15-20 %
IAM +
Depresión
Mujeres en
mayor
riesgo.
Lichtmanet al.r. 2008. «Depression and Coronary Heart Disease
Recommendations for Screening, Referral, and Treatment: A Science Advisory
From the American Heart Association Prevention Committee of the Council on
Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology
and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes
Research: Endorsed by the American Psychiatric Association». Circulation 118
(17): 1768-75. doi:10.1161/CIRCULATIONAHA.108.190769.

= Depresión = Colesterol = p C Reactiva

Hemingway, H., and M. Marmot. “Clinical Evidence: Psychosocial
Factors in the Etiology and Prognosis of Coronary Heart Disease:
Systematic Review of Prospective Cohort Studies.” The Western
Journal of Medicine 171, no. 5–6 (November 1999): 342–50.

Hare, David L., Samia R. Toukhsati, Peter Johansson, y Tiny Jaarsma. «Depression
and Cardiovascular Disease: A Clinical Review». European Heart Journal 35, n.o 21
(1 de junio de 2014): 1365-72. doi:10.1093/eurheartj/eht462.

Simmonds, R. L., Tylee, A., Walters, P., & Rose, D. (2013). Patients’ perceptions of depression and coronary heart disease: a qualitative UPBEAT-
UK study. BMC Family Practice, 14, 38. doi:10.1186/1471-2296-14-38

Factores
Psicosociales
Comportamientos
Saludables
Riesgo de
Enfermedad
Cardiaca
2 Hemingway, H., and M. Marmot. “Clinical Evidence: Psychosocial
1 Guthrie, Elspeth, and Geoffrey Gower Lloyd, eds. Handbook of
Liaison Psychiatry. Cambridge [England] ; New York: Cambridge
University Press, 2007.

Guthrie, Elspeth, and Geoffrey Gower Lloyd, eds. Handbook of
Liaison Psychiatry. Cambridge [England] ; New York: Cambridge
University Press, 2007.

Psychological traits (type A behaviour, hostility)
Psychological states (depression, anxiety)
Psychological work characteristics (job control; demands; support)
Social networks and social supports.
Each of these will be considered in turn.

Comportamiento
tipo A
1970s &
1980s
Anger Vs
Hostility
Williams, R. (2002). Hostility, psychosocial risk factors, changes
in brain serotonergic function, and heart disease. In Stress and
the Heart. Psychosocial Pathways to Coronary Heart Disease,
ed. S. Stansfeld and M. Marmot.
Miller, Todd Q., Timothy W. Smith, Charles W.
Turner, Margarita L. Guijarro, and Amanda J. Hallet.
“Meta-Analytic Review of Research on Hostility and
Physical Health.” Psychological Bulletin 119, no. 2
(1996): 322–48.

Miller, Todd Q., Timothy W. Smith, Charles W. Turner, Margarita L.
Guijarro, and Amanda J. Hallet. “Meta-Analytic Review of Research on
Hostility and Physical Health.” Psychological Bulletin 119, no. 2 (1996):
322–48. doi:10.1037/0033-2909.119.2.322.

Mittleman, Murray A., Malcolm Maclure, Jane B. Sherwood, Richard P. Mulry, Geoffrey H.
Tofler, Sue C. Jacobs, Richard Friedman, Herbert Benson, y James E. Muller. «Triggering of
Acute Myocardial Infarction Onset by Episodes of Anger». Accedido 29 de octubre de 2014.
http://circ.ahajournals.org.

Pobre control sobre su trabajo
Niveles altos de conflicto
Asociación con niveles altos de Fibrinógeno.
Niveles de esfuerzo y recompensa desiguales.

Otros factores
asociados:
•Sin trabajo
•Problemas maritales
•Perdida de seguridad social

Blikman, M. J. C., Jacobsen, H. R., Eide, G. E., & Meland, E. (2014). How Important
Are Social Support, Expectations and Coping Patterns during Cardiac
Rehabilitation. Rehabilitation Research and Practice, 2014.
doi:10.1155/2014/973549

•13-19% Sobrevivientes
post Infarto
•28 % Historia previa
•¼ Psicopatología
persistente a 1 año del
diagnóstico.
¿Qué fue
primero, el
infarto o la
depresión?
Lesperance, F. and Frasure-Smith, N. (1996). Negative
emotions and coronary heart disease: getting to the heart of the
matter. Lancet, 347, 415􏰀16.

Williams, S. A., Kasl, S. V., Heiat, A., Abramson,
J. L., Krumholz, H. M., & Vaccarino, V. (2002).
Depression and risk of heart failure among the
elderly: a prospective community-based study.
Psychosomatic Medicine, 64(1), 6–12.

Depresión
y periodo
Post
Infarto
Nivel de
depresión

3.5
↑
mortalidad
Depresión
V.S
Sin
Depresión
Frasure-Smith, N., Lesperance, F. and Talajic, M. (1995).
Depression and 18 month prognosis after myocardial
infarction. Circulation, 91, 999-1005.

Común
Comorbida
Trayectoria
ansiedad →
Depresión
en IAM Celano, Christopher M., Carol A.
Mastromauro, Emma C. Lenihan, James L.
Januzzi, Bruce L. Rollman, y Jeff C. Huffman.
«Association of baseline anxiety with
depression persistence at 6 months in patients
with acute cardiac illness». Psychosomatic
medicine 74, n.o 1 (2012): 93-99.

Adherencia
↓ Ritmo
cardiaco
Agregación
plaquetaria
Inflamación
Musselman, D., Evans, D. and Nemeroff, C. (1998). The
relationship of depression to cardiovascular disease. Archives
of General Psychiatry, 55, 58-92.

Whooley, Mary A. «Depression and
cardiovascular disease: healing the broken-
hearted». Jama 295, n.o 24 (2006): 2874-81.

Mommersteeg, Paula M. C., Stefanie H. Meeuwis, Johan Denollet, Jos W.
Widdershoven, Wilbert Aarnoudse, Bert L. W. J. J. M. Westerhuis, y Willem
Johan Kop. «C-reactive protein and fibrinogen in non-obstructive coronary
artery disease as related to depressive symptoms and anxiety: Findings from
the TweeSteden Mild Stenosis Study (TWIST)». Journal of Psychosomatic
Research. Accedido 30 de octubre de 2014.
doi:10.1016/j.jpsychores.2014.09.020.

Brouwers, Corline, Paula M. C. Mommersteeg,
Ivan Nyklíček, Aline J. Pelle, Bert L. W. J. J. M.
Westerhuis, Balázs M. Szabó, y Johan Denollet.
«Positive affect dimensions and their
association with inflammatory biomarkers in
patients with chronic heart failure». Biological
Psychology 92, n.o 2 (febrero de 2013): 220-26.
doi:10.1016/j.biopsycho.2012.10.002.

2010
2011
2011
Diagnóstico y tratamiento del trastorno depresivo de 18 a 59 años de edad. (2011)
Diagnóstico y tratamiento de depresión en el adulto mayor en el primer nivel de atención (2012)

3.0 Australian, Royal, and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Depression. “Australian and New Zealand
Clinical Practice Guidelines for the Treatment of Depression,” 2009. http://informahealthcare.com/doi/abs/10.1080/j.1440-1614.2004.01377.x.
3.1 Dodd, Seetal, Gin S. Malhi, John Tiller, Isaac Schweitzer, Ian Hickie, Jon Paul Khoo, Darryl L. Bassett, et al. “A Consensus Statement for Safety
Monitoring Guidelines of Treatments for Major Depressive Disorder.” Australian and New Zealand Journal of Psychiatry 45, no. 9 (September 1,
2011): 712–25. doi:10.3109/00048674.2011.595686
4. Lichtman, Judith H., J. Thomas Bigger, James A. Blumenthal, Nancy Frasure-Smith, Peter G. Kaufmann, François Lespérance, Daniel B. Mark,
David S. Sheps, C. Barr Taylor, and Erika Sivarajan Froelicher. “Depression and Coronary Heart Disease. Recommendations for Screening, Referral,
and Treatment. A Science Advisory From the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing,
Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes
Research.” Circulation, September 29, 2008. doi:10.1161/CIRCULATIONAHA.108.190769.
2009, 2011
2009
2008

Lichtman, Judith H., J. Thomas Bigger, James A. Blumenthal, Nancy Frasure-Smith, Peter G.
Kaufmann, François Lespérance, Daniel B. Mark, David S. Sheps, C. Barr Taylor, y Erika Sivarajan
Froelicher. «Depression and Coronary Heart Disease Recommendations for Screening, Referral,
and Treatment: A Science Advisory From the American Heart Association Prevention Committee
of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology
and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research:
Endorsed by the American Psychiatric Association». Circulation 118, n.o 17 (21 de octubre de
2008): 1768-75. doi:10.1161/CIRCULATIONAHA.108.190769.

Lichtman, Judith H., J. Thomas Bigger, James A. Blumenthal, Nancy Frasure-Smith, Peter G. Kaufmann, François Lespérance,
Daniel B. Mark, David S. Sheps, C. Barr Taylor, y Erika Sivarajan Froelicher. 2008. «Depression and Coronary Heart Disease
Recommendations for Screening, Referral, and Treatment: A Science Advisory From the American Heart Association
Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology
and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: Endorsed by the American
Psychiatric Association». Circulation 118 (17): 1768-75. doi:10.1161/CIRCULATIONAHA.108.190769.

Whooley, Mary A. «Depression and cardiovascular disease: healing the
broken-hearted». Jama 295, n.o 24 (2006): 2874-81.

Hare, David L., Samia R. Toukhsati, Peter Johansson, y Tiny Jaarsma.
«Depression and Cardiovascular Disease: A Clinical Review». European
Heart Journal 35, n.o 21 (1 de junio de 2014): 1365-72.
doi:10.1093/eurheartj/eht462.

Hare, David L., Samia R. Toukhsati, Peter Johansson, y Tiny Jaarsma.
«Depression and Cardiovascular Disease: A Clinical Review». European
Heart Journal 35, n.o 21 (1 de junio de 2014): 1365-72.
42%
↓

Sertralina Citalopram

IMAOs Triciclicos

Lichtman, Judith H., J. Thomas Bigger, James A. Blumenthal, Nancy
Frasure-Smith, Peter G. Kaufmann, François Lespérance, Daniel B.
Mark, David S. Sheps, C. Barr Taylor, y Erika Sivarajan Froelicher.
2008. «Depression and Coronary Heart Disease Recommendations
for Screening, Referral, and Treatment: A Science Advisory From the
American Heart Association Prevention Committee of the Council on
Cardiovascular Nursing, Council on Clinical Cardiology, Council on
Epidemiology and Prevention, and Interdisciplinary Council on
Quality of Care and Outcomes Research: Endorsed by the American
Psychiatric Association». Circulation 118 (17): 1768-75.
doi:10.1161/CIRCULATIONAHA.108.190769.

Hare, David L., Samia R. Toukhsati, Peter
Johansson, y Tiny Jaarsma. «Depression and
Cardiovascular Disease: A Clinical Review».
European Heart Journal 35, n.o 21 (1 de junio
de 2014): 1365-72.
Blumenthal, James A., Andrew Sherwood,
Michael A. Babyak, Lana L. Watkins, Patrick J.
Smith, Benson M. Hoffman, C. Virginia F.
O’Hayer, et al. «Exercise and Pharmacological
Treatment of Depressive Symptoms in Patients
with Coronary Heart Disease: Results from the
UPBEAT Study». Journal of the American
College of Cardiology 60, n.o 12 (18 de
septiembre de 2012): 1053-63.
doi:10.1016/j.jacc.2012.04.040.

1. Blikman, Maria J. C., Hege R. Jacobsen, Geir Egil Eide, y Eivind Meland. «How Important Are Social Support, Expectations and Coping
Patterns during Cardiac Rehabilitation». Rehabilitation Research and Practice 2014 (2014). doi:10.1155/2014/973549.
2. Blumenthal, James A., Andrew Sherwood, Michael A. Babyak, Lana L. Watkins, Patrick J. Smith, Benson M. Hoffman, C. Virginia F.
O’Hayer, et al. «Exercise and Pharmacological Treatment of Depressive Symptoms in Patients with Coronary Heart Disease: Results
from the UPBEAT Study». Journal of the American College of Cardiology 60, n.o 12 (18 de septiembre de 2012): 1053-63.
doi:10.1016/j.jacc.2012.04.040.
3. Brouwers, Corline, Paula M. C. Mommersteeg, Ivan Nyklíček, Aline J. Pelle, Bert L. W. J. J. M. Westerhuis, Balázs M. Szabó, y Johan
Denollet. «Positive affect dimensions and their association with inflammatory biomarkers in patients with chronic heart failure».
Biological Psychology 92, n.o 2 (febrero de 2013): 220-26. doi:10.1016/j.biopsycho.2012.10.002.
4. Celano, Christopher M., Carol A. Mastromauro, Emma C. Lenihan, James L. Januzzi, Bruce L. Rollman, y Jeff C. Huffman. «Association
of baseline anxiety with depression persistence at 6 months in patients with acute cardiac illness». Psychosomatic medicine 74, n.o
1 (2012): 93-99.
5. Hare, David L., Samia R. Toukhsati, Peter Johansson, y Tiny Jaarsma. «Depression and Cardiovascular Disease: A Clinical Review».
European Heart Journal 35, n.o 21 (1 de junio de 2014): 1365-72. doi:10.1093/eurheartj/eht462.
6. Lichtman, Judith H., J. Thomas Bigger, James A. Blumenthal, Nancy Frasure-Smith, Peter G. Kaufmann, François Lespérance, Daniel
B. Mark, David S. Sheps, C. Barr Taylor, y Erika Sivarajan Froelicher. «Depression and Coronary Heart Disease Recommendations for
Screening, Referral, and Treatment: A Science Advisory From the American Heart Association Prevention Committee of the Council
on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on
Quality of Care and Outcomes Research: Endorsed by the American Psychiatric Association». Circulation 118, n.o 17 (21 de octubre
de 2008): 1768-75. doi:10.1161/CIRCULATIONAHA.108.190769.
7. McQueen, Matthew J., Steven Hawken, Xingyu Wang, Stephanie Ounpuu, Allan Sniderman, Jeffrey Probstfield, Krisela Steyn, et al.
«Lipids, lipoproteins, and apolipoproteins as risk markers of myocardial infarction in 52 countries (the INTERHEART study): a case-
control study». The Lancet 372, n.o 9634 (2008): 224-33.
8. Mommersteeg, Paula M. C., Stefanie H. Meeuwis, Johan Denollet, Jos W. Widdershoven, Wilbert Aarnoudse, Bert L. W. J. J. M.
Westerhuis, y Willem Johan Kop. «C-reactive protein and fibrinogen in non-obstructive coronary artery disease as related to
depressive symptoms and anxiety: Findings from the TweeSteden Mild Stenosis Study (TWIST)». Journal of Psychosomatic Research.
Accedido 30 de octubre de 2014. doi:10.1016/j.jpsychores.2014.09.020.
9. Murray, Christopher JL, y Alan D. Lopez. «Alternative projections of mortality and disability by cause 1990–2020: Global Burden of
Disease Study». The Lancet 349, n.o 9064 (1997): 1498-1504.
10. Simmonds, Rosemary L, Andre Tylee, Paul Walters, y Diana Rose. «Patients’ perceptions of depression and coronary heart disease: a
qualitative UPBEAT-UK study». BMC Family Practice 14 (19 de marzo de 2013): 38. doi:10.1186/1471-2296-14-38.
11. Whooley, Mary A. «Depression and cardiovascular disease: healing the broken-hearted». Jama 295, n.o 24 (2006): 2874-81.
12. Williams, Setareh A., Stanislav V. Kasl, Asefeh Heiat, Jerome L. Abramson, Harlan M. Krumholz, y Viola Vaccarino. «Depression and
risk of heart failure among the elderly: a prospective community-based study». Psychosomatic Medicine 64, n.o 1 (2002): 6-12.

14. Guthrie, Elspeth, y Geoffrey Gower Lloyd, eds. 2007. Handbook of liaison
psychiatry. Cambridge [England] ; New York: Cambridge University Press.
15. Hemingway, Harry, y Michael Marmot. 1999. «Clinical Evidence». Western
Journal of Medicine 171 (5-6): 342-50.
16. Hemingway, H., y M. Marmot. 1999. «Clinical Evidence: Psychosocial Factors in
the Etiology and Prognosis of Coronary Heart Disease: Systematic Review of
Prospective Cohort Studies». The Western Journal of Medicine 171 (5-6): 342-
50.
17. Miller, Todd Q., Timothy W. Smith, Charles W. Turner, Margarita L. Guijarro, y
Amanda J. Hallet. 1996. «Meta-analytic review of research on hostility and
physical health». Psychological Bulletin 119 (2): 322-48. doi:10.1037/0033-
2909.119.2.322.
18. Miller, T. Q., T. W. Smith, C. W. Turner, M. L. Guijarro, y A. J. Hallet. 1996. «A
Meta-Analytic Review of Research on Hostility and Physical Health».
Psychological Bulletin 119 (2): 322-48.
19. Mittleman, Murray A., Malcolm Maclure, Jane B. Sherwood, Richard P. Mulry,
Geoffrey H. Tofler, Sue C. Jacobs, Richard Friedman, Herbert Benson, y James
E. Muller. 1995. «Triggering of Acute Myocardial Infarction Onset by Episodes
of Anger». Circulation 92 (7): 1720-25. doi:10.1161/01.CIR.92.7.1720.

• TEST 1º DE ATRACCION SOCIAL.
• Colocar al cachorro dentro del recinto, y
en silencio alejarse unos pasos en sentido
opuesto al lugar de entrada. Arrodillarse y
golpear las palmas suavemente para
llamarle la atención.

• TEST 2 SEGUIR AL AMO.
• Situado al pie, al lado del cachorro,
comenzar a caminar, asegurandose de que
el cachorro se da cuenta.

• TEST 3 OBLIGACION.
• Colocar al cachorro en el suelo, boca arriba
y mantenerlo así unos 30 segundos,
apoyando la mano sobre su pech

• TEST 4 DOMINACION SOCIAL.
• Arrodillado al lado del cachorro,
golpeando suavemente en la parte
superior del craneo, bajando a lo largo de
la columna vertebral sobre el dorso y
acariciando a contrapelo sobre la misma
región durante 30 segundos.

• TEST 5 DIGNIDAD
• Colocar las manos entrecruzadas bajo el
torax del cachorro, y levantarlo de manera
tal que sus patas no toquen el suelo.
Mantenerlo en esa posición 30 segundos.

Dominante
agresivo
Dominante
EquilibradoSumiso
Independiente

Depresion y Cardiología

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