Depressão maior em pacientes com dor torácica não cardíaca - Quem vai tratar?

Translated title of the contribution: Major depression in patients with non-cardiac chest pain - Who is going to treat?

Renério Fráguas, Moacyr Roberto Cuce Nobre, Mauricio Wajngarten, Marcus Vinicius Cardeal, João Augusto Bertuol Figueiró, Dan V. Iosifescu, Manoel Jacobsen Teixeira

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: To investigate the presence of psychiatric disorders in patients with chest pain not responsive to treatment. Method: We evaluated 18 patients judged by their physicians to have a chest pain not responsive to usual treatment, which included anti-pain medicines and investigation and treatment of possible etiological causes such as coronary artery disease, and gastroesophageal reflux disease. A psychiatrist interviewed the patients using the Present State Examination and made the diagnosis based on the DSM-III-R criteria. Current major depression was diagnosed in 6 (30%) patients, somatization in 1 (6%) and panic disorder in 1 (6%) patient. Seven patients were receiving tricyclics antidepressant with doses ≥ 75 mg/day. Discussion: Patients were receiving doses of tricyclics antidepressants efficacious for pain but not for major depression. It is possible that the low dose of antidepressants used to treat pain may partially ameliorate depressive symptoms, making the appropriate diagnosis and treatment of major depression even more difficult, consequently contributing to the persistence of pain and other complains. Considering the wide alternatives to effectively treat depression, a focus on detection and treatment of major depression in patients with chest pain is warranted by clinicians and researchers.

Translated title of the contributionMajor depression in patients with non-cardiac chest pain - Who is going to treat?
Original languagePortuguese
Pages (from-to)83-87
Number of pages5
JournalRevista de Psiquiatria Clinica
Volume36
Issue numberSUPPL. 3
DOIs
StatePublished - 2009
Externally publishedYes

Keywords

  • Cardiology
  • Depression
  • Pain
  • Primary care
  • Treatment

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