Acute coronary syndrome and depression: A review of shared pathophysiological pathways

Objective: To examine the evidence for shared pathophysiological pathways in acute coronary syndrome and major depression and to conceptualise the dynamic interplay of biological systems and signalling pathways that link acute coronary syndrome and depression within a framework of neuro-visceral int...

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Bibliographic Details
Published in:Australian & New Zealand Journal of Psychiatry 2015-11, Vol.49 (11), p.994-1005
Main Authors: Granville Smith, Isabelle, Parker, Gordon, Rourke, Poppy, Cvejic, Erin, Vollmer-Conna, Uté
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - complications
Acute Coronary Syndrome - physiopathology
Comorbidity
Coronary heart disease
Depression, Mental
Depressive Disorder, Major - epidemiology
Humans
Mind-Body Relations, Metaphysical
Pathophysiology
Psychiatry
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Summary:Objective: To examine the evidence for shared pathophysiological pathways in acute coronary syndrome and major depression and to conceptualise the dynamic interplay of biological systems and signalling pathways that link acute coronary syndrome and depression within a framework of neuro-visceral integration. Methods: Relevant articles were sourced via a search of published literature from MEDLINE, EMBASE and PubMed using a variety of search terms relating to biological connections between acute coronary syndrome and depression. Additional articles from bibliographies of retrieved papers were assessed and included where relevant. Results: Despite considerable research efforts, a clear understanding of the biological processes connecting acute coronary syndrome and depression has not been achieved. Shared abnormalities are evident across the immune, platelet/endothelial and autonomic/stress-response systems. From the available evidence, it seems unlikely that a single explanatory model could account for the complex interactions of biological pathways driving the pathophysiology of these disorders and their comorbidity. Conclusion: A broader conceptual framework of mind–body or neuro-visceral integration that can incorporate the existence of several causative scenarios may be more useful in directing future research and treatment approaches for acute coronary syndrome–associated depression.
ISSN:0004-8674
1440-1614
DOI:10.1177/0004867415597304