Depression in Patients Recovering From a Myocardial Infarction

Depression is common among patients recovering from a myocardial infarction (MI). Approximately 1 in 6 patients with MI experience major depression and at least twice as many as that have significant symptoms of depression soon after the event. Post-MI depression is an independent risk factor for in...

Full description

Saved in:
Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2001-10, Vol.286 (13), p.1621-1627
Main Author: Ziegelstein, Roy C
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Antidepressive Agents - therapeutic use
Biological and medical sciences
Cardiology. Vascular system
Case studies
Coronary heart disease
Depression
Depression - etiology
Depression - prevention & control
Depressive Disorder - etiology
Depressive Disorder - prevention & control
Heart
Heart attacks
Humans
Male
Medical sciences
Mental depression
Middle Aged
Mood disorders
Mortality
Myocardial Infarction - physiopathology
Myocardial Infarction - psychology
Myocardial Infarction - rehabilitation
Prognosis
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Rehabilitation
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Depression is common among patients recovering from a myocardial infarction (MI). Approximately 1 in 6 patients with MI experience major depression and at least twice as many as that have significant symptoms of depression soon after the event. Post-MI depression is an independent risk factor for increased mortality. Although the mechanism responsible for this association has not yet been defined, depression is clearly associated with poor compliance with risk-reducing recommendations, with abnormalities in autonomic tone that may make patients more susceptible to ventricular arrhythmias, and with increased platelet activation. Coronary revascularization procedures also appear to be used less often in those with post-MI depression than in comparable patients without mood disorder. Ongoing research will address whether treating depression improves prognosis. Until this question is answered, efforts should focus on enhancing adherence to treatment regimens in this group of patients, who are clearly at risk for noncompliance. Cardiac rehabilitation programs and increasing levels of social support may help improve symptoms and should be recommended to all patients. Treatment of depression itself should be individualized until safety and efficacy are determined for antidepressant therapy in patients who recently have had an MI.
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.286.13.1621