Diagnóstico, tratamento e impactos dos problemas de saúde mental no pós-infarto: uma revisão sistemática
DOI:
https://doi.org/10.11606/issn.1679-9836.v101i3e-185514Palavras-chave:
Infarto do miocárdio, Depressão, Ansiedade, Saúde mental, Atenção primáriaResumo
Depressão e ansiedade são transtornos prevalentes no período pós-infarto do miocárdio e constituem fatores que acrescem incapacidades e influenciam a morbimortalidade do paciente previamente infartado. No entanto, não há diretrizes nacionais no que diz respeito às repercussões na qualidade de vida, às estratégias para diagnóstico e ao melhor tratamento dessas comorbidades. Além disso, as evidências existentes frequentemente não se encontram reunidas em protocolos específicos internacionalmente aceitos, dificultando a reprodutibilidade da conduta mais adequada. Dessa forma, o objetivo desta revisão sistemática é analisar as repercussões dos problemas de saúde mental para o indivíduo previamente infartado, buscando apresentar opções terapêuticas que possam ser ofertadas pela Saúde Primária. Assim, realizou-se pesquisa nas bases de dados PubMed, Lilacs, SciELO e BVS com os Mesh Terms “myocardial infarction”, “mental health” e “primary care” e o boleano “AND”. Foram selecionados 30 artigos em língua portuguesa e inglesa que mais adequadamente se relacionavam com os objetivos deste trabalho, utilizando-se os critérios PRISMA. O recorte temporal analisado compreende os anos de 2011 a 2021. Os resultados da pesquisa mostraram associações entre ansiedade, depressão e outros problemas de saúde mental e diminuição da qualidade de vida, como readmissão hospitalar, maiores custos em saúde, dor torácica, e maior risco de desfechos cardiovasculares. As escalas validadas mostraram-se ferramentas úteis no diagnóstico das comorbidades mentais no pós-infarto. Dentre as opções terapêuticas mais eficazes encontradas, estão as de enfoque psicossocial e a Terapia Cognitivo-Comportamental, havendo grande divergência literária a respeito dos antidepressivos. Dada a grande repercussão na qualidade de vida do indivíduo pós-infartado, mais estudos são necessários para definir melhores abordagens terapêuticas com evidente redução na mortalidade.
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Copyright (c) 2022 Samantha Tembra, Henrique José Pegorini, Lucimar de Lara Aires Reis

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