Прогностическая роль депрессии в качестве предиктора манифестации хронических соматических заболеваний
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Ключевые слова: депрессия, соматические заболевания, болезни наследственного предасположения, факторы риска, генетика, генетический риск, превентивная медицина.
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The negative impact of depression on the course and outcome of somatic disorders is well-known and has a solid theoretical basis. The analyses of prospective studies confirm the role of depression as an independent and significant risk factor for widespread chronic somatic disorders including such severe and life-threatening conditions as cardiovascular diseases, diabetes and oncological pathology. The majority of somatic disorders and depression are the part of the big class of hereditary diseases with multifactorial character and polygenic nature. It is likely, that the genetic risk diversity of these diseases in population is close. There is also a high probability of genetic risks levels overlap (or of common «cluster») of two or more diseases in one individual, with one disorder being major depression. In that case such diseases could be considered «genetically comorbid» and manifestation of one disease could alter the risks of other. Precise and informative diagnostic tools could detect subsyndromal depression that could be the prognostic sign of the high risk and rapid manifestation of somatic diseases. Thus, patients with depressive disorder could be considered as a group with high risks of diverse range of somatic pathology. The coalescence of fundamental biomedical scientists and internists (psychiatrists and other physicians) could lead to the elaboration of specific complex preventative measures including social ones.
Keywords: depression, somatic diseases, hereditary disorders, risk factors, genetics, henetic risks, preventive medicine.
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1 ФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Минздрава России, Санкт-Петербург, Россия;
2 ФГБУ «Федеральный медицинский исследовательский центр психиатрии и наркологии им. В.П. Сербского» Минздрава России, Москва, Россия
________________________________________________
N.G. Neznanov 1, A.O. Kibitov 2, G.V. Rukavishnikov 1, G.E. Mazo 1
1 V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia;
2 V.P. Serbsky National Medical Research Center on Psychiatry and Addicitions of the Ministry of Health of the Russian Federation, Moscow, Russia