Перейти к основному содержанию

Consortium Psychiatricum
2021. Том 2. № 4. С. 2–12
doi:10.17816/CP112
ISSN: 2712-7672 / 2713-2919 (online)

Диагностика и лечение депрессивных и тревожных расстройств у пациентов с сердечно-сосудистыми заболеваниями и сахарным диабетом в условиях первичной медицинской сети: улучшит ли ситуацию обучение врачей?

14

Карпенко О.А., Мелихов О.Г., Тяжельников А.А., Костюк Г.П.

PDF (ENG)
GS
Информация
в Google Scholar

Аннотация

ВВЕДЕНИЕ: Тревога и депрессия, являясь распространенными психическими расстройствами, широко представлены среди пациентов с сердечно-сосудистыми заболеваниями (ССЗ) и сахарным диабетом 2 типа (СД), они негативно влияют на результаты лечения и приводят к повышенным затратам со стороны системы здравоохранения. Несмотря на важность диагностики и лечения тревожных и депрессивных расстройств на уровне первичного звена медицинской помощи, в Российской Федерации эта проблема до сих пор не решена.

ЦЕЛЬ: Исследовать, изменится ли количество направлений к психиатру и число случаев корректного лечения депрессивных и тревожных расстройств у пациентов первичной медицинской сети с ССЗ и СД после обучения врачей поликлиник ведению пациентов с коморбидными депрессивными и тревожными расстройствами (включая алгоритм направления к психиатру).

МЕТОДЫ: На первом этапе исследования пациентам с ССЗ и СД, проходящим лечение в поликлинике, проводили скрининг на выявление тревоги и депрессии при помощи Госпитальной Шкалы Тревоги и Депрессии (HADS). Если пациент принимал психофармакотерапию, название лекарства и его доза заносились в карту исследования. Всего было обследовано 400 человек. На втором этапе врачи поликлиники проходили образовательную программу по диагностике тревожно-депрессивных расстройств, в рамках которой они были проинструктированы, что все пациенты с баллами по шкале HADS >7 должны направляться к психиатру. После обучения на третьем этапе исследования была набрана вторая выборка пациентов (n=178) с использованием такого же протокола, как и на первом этапе. Независимым экспертом (психиатром) оценивалась адекватность психофармакотерапии у пациентов обеих выборок по результатам скрининга тревоги и депрессии в соответствии с критериями, разработанными для данного исследования.

РЕЗУЛЬТАТЫ: Доля пациентов с уровнем тревоги и/или депрессии выше нормального по шкале HADS (>7) составляла 365 (91,2%) в первой выборке и 164 (92,1%) во второй выборке. В первой выборке среди пациентов с HADS >7 119 (29,8%) человек получали психофармакотерапию, но только у 46 (38,7%) она соответствовала результатам скрининга. Во второй выборке среди пациентов HADS >7 59 (33,1%) человек получали психофармакотерапию, но только у 14 (23,7%) она соответствовала результатам скрининга. Разница между выборками по этим показателям не достигала статистической значимости, ни один пациент из второй выборки не был направлен к психиатру.

ЗАКЛЮЧЕНИЕ: Тревога и депрессия часто встречаются у пациентов с ССЗ и СД, обращающихся за лечением в поликлинику, но при этом пациенты не получают адекватную психофармакотерапию. Несмотря на проведение целенаправленного обучения и предоставления врачам поликлиник протокола направления пациентов к психиатру, существуют барьеры осуществления таких направлений и получения пациентами консультаций психиатра.

Общая информация

Ключевые слова: депрессия, тревога, первичная помощь, психическое здоровье

Рубрика издания: Редакционные статьи

Тип материала: научная статья

DOI: https://doi.org/10.17816/CP112

Получена: 27.10.2021

Принята в печать:

Для цитаты: Карпенко О.А., Мелихов О.Г., Тяжельников А.А., Костюк Г.П. Диагностика и лечение депрессивных и тревожных расстройств у пациентов с сердечно-сосудистыми заболеваниями и сахарным диабетом в условиях первичной медицинской сети: улучшит ли ситуацию обучение врачей? // Consortium Psychiatricum. 2021. Том 2. № 4. С. 2–12. DOI: 10.17816/CP112

Литература

  1. Smithson S, Pignone MP. Screening Adults for Depression in Primary Care. Med Clin North Am. 2017;101(4):807–821. doi: 10.1016/j.mcna.2017.03.010
  2. Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience. 2015;17(3):327–335. doi: 10.31887/DCNS.2015.17.3/bbandelow
  3. Townsend N, Kazakiewicz D, Lucy Wright F, et al. Epidemiology of cardiovascular disease in Europe. Nat Rev Cardiol. 2021. doi: 10.1038/s41569-021-00607-3
  4. Khan MAB, Hashim MJ, King JK, et al. Epidemiology of Type 2 Diabetes — Global Burden of Disease and Forecasted Trends. J Epidemiol Glob Health. 2020;10(1):107–111. doi: 10.2991/jegh.k.191028.001
  5. Okunrintemi V, Valero-Elizondo J, Michos ED, et al. Association of Depression Risk with Patient Experience, Healthcare Expenditure, and Health Resource Utilization Among Adults with Atherosclerotic Cardiovascular Disease. J Gen Intern Med. 2019;34(11):2427–2434. doi: 10.1007/s11606-019-05325-8
  6. Chazov EI, Oganov RG, Pogosova GV, et al. Kliniko-epidemiologicheskaya programma izucheniya depressii v kardiologicheskoi praktike u bol’nykh arterial’noi gipertoniei i ishemicheskoi bolezn’yu serdtsa (KOORDINATA): rezul’taty mnogotsentrovogo issledovaniya. Kardiologiya. 2007;(3):28–37.
  7. Oganov RG, Pogosova GV, Koltunov IE, et al. Depressivnaya simptomatika ukhudshaet prognoz serdechno-sosudistykh zabolevanii i snizhaet prodolzhitel’nost’ zhizni bol’nykh arterial’noi gipertoniei i ishemicheskoi bolezn’yu serdtsa. Kardiologiya. 2011;(2):59–66.
  8. Egede LE, Zheng D, Simpson K. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2002;25(3):464–470. doi: 10.2337/diacare.25.3.464
  9. Breslow AS, Tran NM, Lu FQ, Alpert JE, Cook BL. Depression Treatment Expenditures for Adults in the USA: a Systematic Review. Curr Psychiatry Rep. 2019;21(10):105. doi: 10.1007/s11920-019-1083-3
  10. Deischinger C, Dervic E, Leutner M, et al. Diabetes mellitus is associated with a higher risk for major depressive disorder in women than in men. BMJ Open Diabetes Res Care. 2020;8(1). doi: 10.1136/bmjdrc-2020-001430
  11. Bickett A, Tapp H. Anxiety and diabetes: Innovative approaches to management in primary care. Exp Biol Med (Maywood). 2016;241(15):1724–1731. doi: 10.1177/1535370216657613
  12. Celano CM, Daunis DJ, Lokko HN, Campbell KA, Huffman JC. Anxiety Disorders and Cardiovascular Disease. Curr Psychiatry Rep. 2016;18(11):101. doi: 10.1007/s11920-016-0739-5
  13. Fleury MJ, Imboua A, Aube D, Farand L. Collaboration between general practitioners (GPs) and mental healthcare professionals within the context of reforms in Quebec. Ment Health Fam Med. 2012;9(2):77–90. PMC3513700
  14. Krasnov VN, Dovzhenko TV, Bobrov AE, et al. Psikhiatriya v pervichnom zvene zdravookhraneniya: novoe reshenie staroi problemy. Sotsial’naya i klinicheskaya psikhiatriya. 2013;23(4):5–13.
  15. Firth J, Siddiqi N, Koyanagi A, et al. The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. Lancet Psychiatry. 2019;6(8):675–712. doi: 10.1016/S2215-0366(19)30132-4
  16. WHO. Mental Health Gap Action Programme (mhGAP): Scaling Up Care for Mental, Neurological and Substance Use Disorders. World Health Organization; 2008.
  17. WHO. WHO Mental Health Gap Action Programme (mhGAP). World Health Organization; 2016.
  18. WHO. mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings: mental health Gap Action Programme (mhGAP), version 2.0. World Health Organization; 2016.
  19. Krasnov VN, Bobrov AE, Starostina EG, Dovzhenko TV. Razrabotka mekhanizmov kompleksnoĭ diagnostiki i poliprofessional’nogo vedeniya bol’nykh s nepsikhoticheskimi rasstroĭstvami v usloviyakh pervichnogo zvena zdravookhraneniya. 2010.
  20. Karpenko O, Kostyuk G. Community-based mental health services in Russia: past, present, and future. Lancet Psychiatry. 2018;5(10):778–780. doi: 10.1016/S2215-0366(18)30263-3
  21. Kostyuk G, Karpenko O, Masyakin A, Burygina L. Mental health law in Russia. European Psychiatry. 2019;56:S157–S158.
  22. Bobrov AE, Kuznetsova MV. Vzaimodeistvie psikhoterapevta i uchastkovykh terapevtov polikliniki: sravnenie rezul’tatov raboty po konsul’tativnoi modeli i modeli soprovozhdeniya. Sotsial’naya i klinicheskaya psikhiatriya. 2013;23(3):72–78.
  23. Martynikhin IA. The Use of ICD-10 for Diagnosing Mental Disorders In Russia, According to National Statistics and a Survey of Psychiatrists’ Experience. Consortium Psychiatricum. 2021;2(2):35–44. doi: 10.17816/cp69
  24. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x
  25. Bauer M, Pfennig A, Severus E, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. World J Biol Psychiatry. 2013;14(5):334–385. doi: 10.3109/15622975.2013.804195
  26. Pogosova NV, Boytsov SA, Oganov RG, et al. Clinical-Epidemiological Program of Studying Psychosocial Risk Factors in Cardiological Practice in Patients With Arterial Hypertension and Ischemic Heart Disease: First Results of a Multicenter Study in Russia. Article in Russian. Kardiologiia. 2018;17(9):47–58. doi: 10.18087/cardio.2018.9.10171
  27. Pogosova NV, Boitsov SA, Oganov RG, et al. Psychosocial Risk Factors in Ambulatory Patients With Arterial Hypertension and Ischemic Heart Disease of 30 Cities in Russia: Data from the КОМЕТА (Сomet) Study. Article in Russian. Kardiologiia. 2018;58(11):5–16. doi: 10.18087/cardio.2018.11.10193
  28. Pierce M, Hope H, Ford T, et al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. Lancet Psychiatry. 2020;7(10):883–892
  29. Simon GE, Fleck M, Lucas R, Bushnell DM, Group L. Prevalence and predictors of depression treatment in an international primary care study. Am J Psychiatry. 2004;161(9):1626–1634. doi: 10.1176/appi.ajp.161.9.1626
  30. Wakida EK, Talib ZM, Akena D, et al. Barriers and facilitators to the integration of mental health services into primary health care: a systematic review. Syst Rev. 2018;7(1):211. doi: 10.1186/s13643-018-0882-7
  31. Keynejad RC, Dua T, Barbui C, Thornicroft G. WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries. Evid Based Ment Health. 2018;21(1):30–34. doi: 10.1136/eb-2017-102750
  32. Spagnolo J, Vasiliadis HM, Berbiche D, et al. The influence of primary care physicians’ mental health knowledge, attitudes and self-efficacy on referrals to specialised services: findings from a longitudinal pilot trial. BJPsych Open. 2020;6(6):e130. doi: 10.1192/bjo.2020.115
  33. Gureje O, Abdulmalik J, Kola L, et al. Integrating mental health into primary care in Nigeria: report of a demonstration project using the mental health gap action programme intervention guide. BMC Health Serv Res. 2015;15:242. doi: 10.1186/s12913-015-0911-3
  34. Steele M, Zayed R, Davidson B, et al. Referral Patterns and Training Needs in Psychiatry among Primary Care Physicians in Canadian Rural/Remote Areas. J Can Acad Child Adolesc Psychiatry. 2012;21(2):111–123. PMC3338177
  35. Wimalaratne IK, McCarthy J, Broekman BFP, et al. General hospital specialists’ attitudes toward psychiatry: a cross-sectional survey in seven countries. BMJ Open. 2021;11(11):e054173. doi: 10.1136/bmjopen-2021-054173
  36. Tyazhelnikov AA, Kostenko EV, Gushchin MV, Kuznetsova AS. Features of professional burnout and subjectively significant stress factors in doctors who provided remote telemedicine services during COVID-19 pandemic. Medical alphabet. 2021(33):21–25. doi: 10.33667/2078-5631-2020-33-21-25
  37. Aksenova EI, Shkrumyzk AR. Professional’’noe vygoranie meditsinskikh rabotnikov v period pandemii. Byulleten’ Nacional’nogo nauchno-issledovatel’skogo instituta obshchestvennogo zdorov’ya imeni N.A. Semashko. 2021;(4):148–155.
  38. Vistorte AOR, Ribeiro WS, Jaen D, et al. Stigmatizing attitudes of primary care professionals towards people with mental disorders: A systematic review. Int J Psychiatry Med. 2018;53(4):317–338. doi: 10.1177/0091217418778620
  39. Heinz I, Baldofski S, Beesdo-Baum K, et al. “Doctor, my back hurts and I cannot sleep.” Depression in primary care patients: Reasons for consultation and perceived depression stigma. PLoS One. 2021;16(3):e0248069. doi: 10.1371/journal.pone.0248069
  40. National Collaborating Centre for Mental Health (UK). NICE Clinical Guidelines, No. 91. Depression in adults with a chronic physical health problem: recognition and management. British Psychological Society; 2010
  41. National Collaborating Centre for Mental Health (UK). Common Mental Health Disorders: Identification and Pathways to Care. British Psychological Society; 2011.
  42. Smithson S, Pignone MP. Screening Adults for Depression in Primary Care. Med Clin North Am. 2017;101(4):807–821. doi: 10.1016/j.mcna.2017.03.010
  43. Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience. 2015;17(3):327–335. doi: 10.31887/DCNS.2015.17.3/bbandelow
  44. Townsend N, Kazakiewicz D, Lucy Wright F, et al. Epidemiology of cardiovascular disease in Europe. Nat Rev Cardiol. 2021. doi: 10.1038/s41569-021-00607-3
  45. Khan MAB, Hashim MJ, King JK, et al. Epidemiology of Type 2 Diabetes — Global Burden of Disease and Forecasted Trends. J Epidemiol Glob Health. 2020;10(1):107–111. doi: 10.2991/jegh.k.191028.001
  46. Okunrintemi V, Valero-Elizondo J, Michos ED, et al. Association of Depression Risk with Patient Experience, Healthcare Expenditure, and Health Resource Utilization Among Adults with Atherosclerotic Cardiovascular Disease. J Gen Intern Med. 2019;34(11):2427–2434. doi: 10.1007/s11606-019-05325-8
  47. Chazov EI, Oganov RG, Pogosova GV, et al. Kliniko-epidemiologicheskaya programma izucheniya depressii v kardiologicheskoi praktike u bol’nykh arterial’noi gipertoniei i ishemicheskoi bolezn’yu serdtsa (KOORDINATA): rezul’taty mnogotsentrovogo issledovaniya. Kardiologiya. 2007;(3):28–37.
  48. Oganov RG, Pogosova GV, Koltunov IE, et al. Depressivnaya simptomatika ukhudshaet prognoz serdechno-sosudistykh zabolevanii i snizhaet prodolzhitel’nost’ zhizni bol’nykh arterial’noi gipertoniei i ishemicheskoi bolezn’yu serdtsa. Kardiologiya. 2011;(2):59–66.
  49. Egede LE, Zheng D, Simpson K. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2002;25(3):464–470. doi: 10.2337/diacare.25.3.464
  50. Breslow AS, Tran NM, Lu FQ, Alpert JE, Cook BL. Depression Treatment Expenditures for Adults in the USA: a Systematic Review. Curr Psychiatry Rep. 2019;21(10):105. doi: 10.1007/s11920-019-1083-3
  51. Deischinger C, Dervic E, Leutner M, et al. Diabetes mellitus is associated with a higher risk for major depressive disorder in women than in men. BMJ Open Diabetes Res Care. 2020;8(1). doi: 10.1136/bmjdrc-2020-001430
  52. Bickett A, Tapp H. Anxiety and diabetes: Innovative approaches to management in primary care. Exp Biol Med (Maywood). 2016;241(15):1724–1731. doi: 10.1177/1535370216657613
  53. Celano CM, Daunis DJ, Lokko HN, Campbell KA, Huffman JC. Anxiety Disorders and Cardiovascular Disease. Curr Psychiatry Rep. 2016;18(11):101. doi: 10.1007/s11920-016-0739-5
  54. Fleury MJ, Imboua A, Aube D, Farand L. Collaboration between general practitioners (GPs) and mental healthcare professionals within the context of reforms in Quebec. Ment Health Fam Med. 2012;9(2):77–90. PMC3513700
  55. Krasnov VN, Dovzhenko TV, Bobrov AE, et al. Psikhiatriya v pervichnom zvene zdravookhraneniya: novoe reshenie staroi problemy. Sotsial’naya i klinicheskaya psikhiatriya. 2013;23(4):5–13.
  56. Firth J, Siddiqi N, Koyanagi A, et al. The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. Lancet Psychiatry. 2019;6(8):675–712. doi: 10.1016/S2215-0366(19)30132-4
  57. WHO. Mental Health Gap Action Programme (mhGAP): Scaling Up Care for Mental, Neurological and Substance Use Disorders. World Health Organization; 2008.
  58. WHO. WHO Mental Health Gap Action Programme (mhGAP). World Health Organization; 2016.
  59. WHO. mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings: mental health Gap Action Programme (mhGAP), version 2.0. World Health Organization; 2016.
  60. Krasnov VN, Bobrov AE, Starostina EG, Dovzhenko TV. Razrabotka mekhanizmov kompleksnoĭ diagnostiki i poliprofessional’nogo vedeniya bol’nykh s nepsikhoticheskimi rasstroĭstvami v usloviyakh pervichnogo zvena zdravookhraneniya. 2010.
  61. Karpenko O, Kostyuk G. Community-based mental health services in Russia: past, present, and future. Lancet Psychiatry. 2018;5(10):778–780. doi: 10.1016/S2215-0366(18)30263-3
  62. Kostyuk G, Karpenko O, Masyakin A, Burygina L. Mental health law in Russia. European Psychiatry. 2019;56:S157–S158.
  63. Bobrov AE, Kuznetsova MV. Vzaimodeistvie psikhoterapevta i uchastkovykh terapevtov polikliniki: sravnenie rezul’tatov raboty po konsul’tativnoi modeli i modeli soprovozhdeniya. Sotsial’naya i klinicheskaya psikhiatriya. 2013;23(3):72–78.
  64. Martynikhin IA. The Use of ICD-10 for Diagnosing Mental Disorders In Russia, According to National Statistics and a Survey of Psychiatrists’ Experience. Consortium Psychiatricum. 2021;2(2):35–44. doi: 10.17816/cp69
  65. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x
  66. Bauer M, Pfennig A, Severus E, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. World J Biol Psychiatry. 2013;14(5):334–385. doi: 10.3109/15622975.2013.804195
  67. Pogosova NV, Boytsov SA, Oganov RG, et al. Clinical-Epidemiological Program of Studying Psychosocial Risk Factors in Cardiological Practice in Patients With Arterial Hypertension and Ischemic Heart Disease: First Results of a Multicenter Study in Russia. Article in Russian. Kardiologiia. 2018;17(9):47–58. doi: 10.18087/cardio.2018.9.10171
  68. Pogosova NV, Boitsov SA, Oganov RG, et al. Psychosocial Risk Factors in Ambulatory Patients With Arterial Hypertension and Ischemic Heart Disease of 30 Cities in Russia: Data from the КОМЕТА (Сomet) Study. Article in Russian. Kardiologiia. 2018;58(11):5–16. doi: 10.18087/cardio.2018.11.10193
  69. Pierce M, Hope H, Ford T, et al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. Lancet Psychiatry. 2020;7(10):883–892
  70. Simon GE, Fleck M, Lucas R, Bushnell DM, Group L. Prevalence and predictors of depression treatment in an international primary care study. Am J Psychiatry. 2004;161(9):1626–1634. doi: 10.1176/appi.ajp.161.9.1626
  71. Wakida EK, Talib ZM, Akena D, et al. Barriers and facilitators to the integration of mental health services into primary health care: a systematic review. Syst Rev. 2018;7(1):211. doi: 10.1186/s13643-018-0882-7
  72. Keynejad RC, Dua T, Barbui C, Thornicroft G. WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries. Evid Based Ment Health. 2018;21(1):30–34. doi: 10.1136/eb-2017-102750
  73. Spagnolo J, Vasiliadis HM, Berbiche D, et al. The influence of primary care physicians’ mental health knowledge, attitudes and self-efficacy on referrals to specialised services: findings from a longitudinal pilot trial. BJPsych Open. 2020;6(6):e130. doi: 10.1192/bjo.2020.115
  74. Gureje O, Abdulmalik J, Kola L, et al. Integrating mental health into primary care in Nigeria: report of a demonstration project using the mental health gap action programme intervention guide. BMC Health Serv Res. 2015;15:242. doi: 10.1186/s12913-015-0911-3
  75. Steele M, Zayed R, Davidson B, et al. Referral Patterns and Training Needs in Psychiatry among Primary Care Physicians in Canadian Rural/Remote Areas. J Can Acad Child Adolesc Psychiatry. 2012;21(2):111–123. PMC3338177
  76. Wimalaratne IK, McCarthy J, Broekman BFP, et al. General hospital specialists’ attitudes toward psychiatry: a cross-sectional survey in seven countries. BMJ Open. 2021;11(11):e054173. doi: 10.1136/bmjopen-2021-054173
  77. Tyazhelnikov AA, Kostenko EV, Gushchin MV, Kuznetsova AS. Features of professional burnout and subjectively significant stress factors in doctors who provided remote telemedicine services during COVID-19 pandemic. Medical alphabet. 2021(33):21–25. doi: 10.33667/2078-5631-2020-33-21-25
  78. Aksenova EI, Shkrumyzk AR. Professional’’noe vygoranie meditsinskikh rabotnikov v period pandemii. Byulleten’ Nacional’nogo nauchno-issledovatel’skogo instituta obshchestvennogo zdorov’ya imeni N.A. Semashko. 2021;(4):148–155.
  79. Vistorte AOR, Ribeiro WS, Jaen D, et al. Stigmatizing attitudes of primary care professionals towards people with mental disorders: A systematic review. Int J Psychiatry Med. 2018;53(4):317–338. doi: 10.1177/0091217418778620
  80. Heinz I, Baldofski S, Beesdo-Baum K, et al. “Doctor, my back hurts and I cannot sleep.” Depression in primary care patients: Reasons for consultation and perceived depression stigma. PLoS One. 2021;16(3):e0248069. doi: 10.1371/journal.pone.0248069
  81. National Collaborating Centre for Mental Health (UK). NICE Clinical Guidelines, No. 91. Depression in adults with a chronic physical health problem: recognition and management. British Psychological Society; 2010
  82. National Collaborating Centre for Mental Health (UK). Common Mental Health Disorders: Identification and Pathways to Care. British Psychological Society; 2011.
  83. Smithson S, Pignone MP. Screening Adults for Depression in Primary Care. Med Clin North Am. 2017;101(4):807–821. doi: 10.1016/j.mcna.2017.03.010
  84. Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience. 2015;17(3):327–335. doi: 10.31887/DCNS.2015.17.3/bbandelow
  85. Townsend N, Kazakiewicz D, Lucy Wright F, et al. Epidemiology of cardiovascular disease in Europe. Nat Rev Cardiol. 2021. doi: 10.1038/s41569-021-00607-3
  86. Khan MAB, Hashim MJ, King JK, et al. Epidemiology of Type 2 Diabetes — Global Burden of Disease and Forecasted Trends. J Epidemiol Glob Health. 2020;10(1):107–111. doi: 10.2991/jegh.k.191028.001
  87. Okunrintemi V, Valero-Elizondo J, Michos ED, et al. Association of Depression Risk with Patient Experience, Healthcare Expenditure, and Health Resource Utilization Among Adults with Atherosclerotic Cardiovascular Disease. J Gen Intern Med. 2019;34(11):2427–2434. doi: 10.1007/s11606-019-05325-8
  88. Chazov EI, Oganov RG, Pogosova GV, et al. Kliniko-epidemiologicheskaya programma izucheniya depressii v kardiologicheskoi praktike u bol’nykh arterial’noi gipertoniei i ishemicheskoi bolezn’yu serdtsa (KOORDINATA): rezul’taty mnogotsentrovogo issledovaniya. Kardiologiya. 2007;(3):28–37.
  89. Oganov RG, Pogosova GV, Koltunov IE, et al. Depressivnaya simptomatika ukhudshaet prognoz serdechno-sosudistykh zabolevanii i snizhaet prodolzhitel’nost’ zhizni bol’nykh arterial’noi gipertoniei i ishemicheskoi bolezn’yu serdtsa. Kardiologiya. 2011;(2):59–66.
  90. Egede LE, Zheng D, Simpson K. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2002;25(3):464–470. doi: 10.2337/diacare.25.3.464
  91. Breslow AS, Tran NM, Lu FQ, Alpert JE, Cook BL. Depression Treatment Expenditures for Adults in the USA: a Systematic Review. Curr Psychiatry Rep. 2019;21(10):105. doi: 10.1007/s11920-019-1083-3
  92. Deischinger C, Dervic E, Leutner M, et al. Diabetes mellitus is associated with a higher risk for major depressive disorder in women than in men. BMJ Open Diabetes Res Care. 2020;8(1). doi: 10.1136/bmjdrc-2020-001430
  93. Bickett A, Tapp H. Anxiety and diabetes: Innovative approaches to management in primary care. Exp Biol Med (Maywood). 2016;241(15):1724–1731. doi: 10.1177/1535370216657613
  94. Celano CM, Daunis DJ, Lokko HN, Campbell KA, Huffman JC. Anxiety Disorders and Cardiovascular Disease. Curr Psychiatry Rep. 2016;18(11):101. doi: 10.1007/s11920-016-0739-5
  95. Fleury MJ, Imboua A, Aube D, Farand L. Collaboration between general practitioners (GPs) and mental healthcare professionals within the context of reforms in Quebec. Ment Health Fam Med. 2012;9(2):77–90. PMC3513700
  96. Krasnov VN, Dovzhenko TV, Bobrov AE, et al. Psikhiatriya v pervichnom zvene zdravookhraneniya: novoe reshenie staroi problemy. Sotsial’naya i klinicheskaya psikhiatriya. 2013;23(4):5–13.
  97. Firth J, Siddiqi N, Koyanagi A, et al. The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. Lancet Psychiatry. 2019;6(8):675–712. doi: 10.1016/S2215-0366(19)30132-4
  98. WHO. Mental Health Gap Action Programme (mhGAP): Scaling Up Care for Mental, Neurological and Substance Use Disorders. World Health Organization; 2008.
  99. WHO. WHO Mental Health Gap Action Programme (mhGAP). World Health Organization; 2016.
  100. WHO. mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings: mental health Gap Action Programme (mhGAP), version 2.0. World Health Organization; 2016.
  101. Krasnov VN, Bobrov AE, Starostina EG, Dovzhenko TV. Razrabotka mekhanizmov kompleksnoĭ diagnostiki i poliprofessional’nogo vedeniya bol’nykh s nepsikhoticheskimi rasstroĭstvami v usloviyakh pervichnogo zvena zdravookhraneniya. 2010.
  102. Karpenko O, Kostyuk G. Community-based mental health services in Russia: past, present, and future. Lancet Psychiatry. 2018;5(10):778–780. doi: 10.1016/S2215-0366(18)30263-3
  103. Kostyuk G, Karpenko O, Masyakin A, Burygina L. Mental health law in Russia. European Psychiatry. 2019;56:S157–S158.
  104. Bobrov AE, Kuznetsova MV. Vzaimodeistvie psikhoterapevta i uchastkovykh terapevtov polikliniki: sravnenie rezul’tatov raboty po konsul’tativnoi modeli i modeli soprovozhdeniya. Sotsial’naya i klinicheskaya psikhiatriya. 2013;23(3):72–78.
  105. Martynikhin IA. The Use of ICD-10 for Diagnosing Mental Disorders In Russia, According to National Statistics and a Survey of Psychiatrists’ Experience. Consortium Psychiatricum. 2021;2(2):35–44. doi: 10.17816/cp69
  106. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x
  107. Bauer M, Pfennig A, Severus E, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. World J Biol Psychiatry. 2013;14(5):334–385. doi: 10.3109/15622975.2013.804195
  108. Pogosova NV, Boytsov SA, Oganov RG, et al. Clinical-Epidemiological Program of Studying Psychosocial Risk Factors in Cardiological Practice in Patients With Arterial Hypertension and Ischemic Heart Disease: First Results of a Multicenter Study in Russia. Article in Russian. Kardiologiia. 2018;17(9):47–58. doi: 10.18087/cardio.2018.9.10171
  109. Pogosova NV, Boitsov SA, Oganov RG, et al. Psychosocial Risk Factors in Ambulatory Patients With Arterial Hypertension and Ischemic Heart Disease of 30 Cities in Russia: Data from the КОМЕТА (Сomet) Study. Article in Russian. Kardiologiia. 2018;58(11):5–16. doi: 10.18087/cardio.2018.11.10193
  110. Pierce M, Hope H, Ford T, et al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. Lancet Psychiatry. 2020;7(10):883–892
  111. Simon GE, Fleck M, Lucas R, Bushnell DM, Group L. Prevalence and predictors of depression treatment in an international primary care study. Am J Psychiatry. 2004;161(9):1626–1634. doi: 10.1176/appi.ajp.161.9.1626
  112. Wakida EK, Talib ZM, Akena D, et al. Barriers and facilitators to the integration of mental health services into primary health care: a systematic review. Syst Rev. 2018;7(1):211. doi: 10.1186/s13643-018-0882-7
  113. Keynejad RC, Dua T, Barbui C, Thornicroft G. WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries. Evid Based Ment Health. 2018;21(1):30–34. doi: 10.1136/eb-2017-102750
  114. Spagnolo J, Vasiliadis HM, Berbiche D, et al. The influence of primary care physicians’ mental health knowledge, attitudes and self-efficacy on referrals to specialised services: findings from a longitudinal pilot trial. BJPsych Open. 2020;6(6):e130. doi: 10.1192/bjo.2020.115
  115. Gureje O, Abdulmalik J, Kola L, et al. Integrating mental health into primary care in Nigeria: report of a demonstration project using the mental health gap action programme intervention guide. BMC Health Serv Res. 2015;15:242. doi: 10.1186/s12913-015-0911-3
  116. Steele M, Zayed R, Davidson B, et al. Referral Patterns and Training Needs in Psychiatry among Primary Care Physicians in Canadian Rural/Remote Areas. J Can Acad Child Adolesc Psychiatry. 2012;21(2):111–123. PMC3338177
  117. Wimalaratne IK, McCarthy J, Broekman BFP, et al. General hospital specialists’ attitudes toward psychiatry: a cross-sectional survey in seven countries. BMJ Open. 2021;11(11):e054173. doi: 10.1136/bmjopen-2021-054173
  118. Tyazhelnikov AA, Kostenko EV, Gushchin MV, Kuznetsova AS. Features of professional burnout and subjectively significant stress factors in doctors who provided remote telemedicine services during COVID-19 pandemic. Medical alphabet. 2021(33):21–25. doi: 10.33667/2078-5631-2020-33-21-25
  119. Aksenova EI, Shkrumyzk AR. Professional’’noe vygoranie meditsinskikh rabotnikov v period pandemii. Byulleten’ Nacional’nogo nauchno-issledovatel’skogo instituta obshchestvennogo zdorov’ya imeni N.A. Semashko. 2021;(4):148–155.
  120. Vistorte AOR, Ribeiro WS, Jaen D, et al. Stigmatizing attitudes of primary care professionals towards people with mental disorders: A systematic review. Int J Psychiatry Med. 2018;53(4):317–338. doi: 10.1177/0091217418778620
  121. Heinz I, Baldofski S, Beesdo-Baum K, et al. “Doctor, my back hurts and I cannot sleep.” Depression in primary care patients: Reasons for consultation and perceived depression stigma. PLoS One. 2021;16(3):e0248069. doi: 10.1371/journal.pone.0248069
  122. National Collaborating Centre for Mental Health (UK). NICE Clinical Guidelines, No. 91. Depression in adults with a chronic physical health problem: recognition and management. British Psychological Society; 2010
  123. National Collaborating Centre for Mental Health (UK). Common Mental Health Disorders: Identification and Pathways to Care. British Psychological Society; 2011.

Информация об авторах

Карпенко Ольга Анатольевна, MD, PhD, ГБУЗ «Психиатрическая клиническая больница № 1 им. Н.А. Алексеева Департамента здравоохранения города Москвы», Москва, Россия, ORCID: https://orcid.org/0000-0002-0958-0596, e-mail: drkarpenko@gmail.com

Мелихов Олег Геннадиевич, кандидат медицинских наук, Руководитель Центра организации и планирования научных исследований в здравоохранении, ФГБНУ «Национальный НИИ общественного здоровья имени Н.А. Семашко», Директор Института клинических исследований; Председатель совета научного общества «Лига содействия клиническим исследованиям», Москва, Россия, ORCID: https://orcid.org/0000-0001-9442-7707

Тяжельников Андрей Александрович, доктор медицинских наук, главный внештатный специалист по первичной медико-санитарной помощи взрослому населению, Департамент здравоохранения Москвы, главный врач ГБУЗ «Консультативно-диагностическая поликлиника №121», Москва, Россия, ORCID: https://orcid.org/0000-0002-2191-0623

Костюк Георгий Петрович, доктор медицинских наук, профессор, врач-психиатр высшей квалификационной категории, Главный врач, ГБУЗ «Психиатрическая клиническая больница № 1 им. Н.А. Алексеева Департамента здравоохранения города Москвы», главный внештатный специалист-психиатр Департамента здравоохранения города Москвы, полковник медицинской службы запаса., Москва, Россия, ORCID: https://orcid.org/0000-0002-3073-6305, e-mail: editorinchief@consortium-psy.com

Метрики

Просмотров

Всего: 68
В прошлом месяце: 6
В текущем месяце: 2

Скачиваний

Всего: 14
В прошлом месяце: 2
В текущем месяце: 0