Romatolojik Hastalıklar ve Depresyon

Romatolojik hastalıklarda klinik depresyon toplumda görülenin 2 katı oranında görülmektedir. Depresyon tanı kriterlerini karşılamayan psikolojik stresin varlığı ise daha fazla görülmektedir. Kanıtlar bu yüksek prevalansını çok faktörlü olduğunu göstermektedir. Hastalıkta gözlenen bedensel belirtilerin, fiziksel kısıtlılıkların, pro-inflamatuar sitokinlerin, hastalığın tahmin edilemez ve kontrol edilemez seyrine karşı ortaya çıkan çaresizliğin ve kronik bir hastalığa sahip olmanın getirdiği diğer faktörlerin depresyonla ilişkili olduğunu göstermiştir. Romatoid artrit, fibromiyalji, sistemik lupus eritetamatosus, Behçet hastalığı ve osteoartrit gibi romatolojik hastalıklarının tümünde yüksek depresyon oranları gözlenmiştir. Depresyon düşük sosyal işlevselliği ve tedavi yanıtına hatta intihara neden olması sebebi ile tüm bu hastalıklarda önemli bir faktördür. Bu derlemde, romatolojik hastalıklarda depresyon prevalansı, tanı ölçütleri ve depresyonla ilişkili faktörlerin gözden geçirilmesi amaçlanmıştır.

Anahtar Kelimeler:

Romatolojik hastalıklar, depresyon, fibromiyalji

Rheumatic Diseases and Depression

The prevalence of clinical depression in rheumatic diseases is about twice the prevalence seen in the general population. At a milder level, the occurrence of psychological distress that does not fulfil diagnostic criteria of depression is even higher. Evidence indicates that this high prevalence is multifactorial. Correlational studies suggest that possible factors for depression include the suffering accompanying somatic symptoms, functional limitations, pro-inflammatory cytokines, helplessness due to the uncontrollable, unpredictable and progressive nature of the disease, and other factors associated with having a chronic disease Higher prevalence of depression was found in rheumatic diseases like rheumatoid arthritis, fibromyalgia, systemic lupus erythematosus, Behcet's disease and osteoarthritis. Depression is an important factor in all of these disorders because it leads low social functioning, treatment response and even suicide. This article reviews the prevalence and diagnosis of depression and related factors in rheumatic diseases.

Keywords:

Rheumatic disease, depression, fibromyalgia,

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Ceyhan Balcı Şengül, Yrd.Doç.Dr., Pamukkale Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı, Denizli; Nuray Akkaya, Yrd.Doç.Dr., Pamukkale Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Denizli Yazışma Adresi/Correspondence: Ceyhan Balcı Şengül, Pamukkale Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı, Denizli, Turkey. E-mail: melikeceyhan@gmail.com Yazarlar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemiştir. The authors reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol6/no4/ Çevrimiçi yayım / Published online 25 Ocak/January 25, 2014; doi: 10.5455/cap.20140125111548