Even minimal symptoms of depression increase mortality risk after acute myocardial infarction

Bush, David E.; Ziegelstein, Roy C.; Tayback, Matthew; Richter, Daniel; Stevens, Sandra; Zahalsky, Howard; Fauerbach, James A.

doi:10.1016/s0002-9149(01)01675-7

Cited by 542 publications

(409 citation statements)

References 17 publications

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“…One study which used interview assessment for depression within a comparable timeframe (i.e. 2-5 days after admission) achieved a 40.9% response rate [8]. Our 73% response rate compares favourably to this figure.…”

Section: Discussionmentioning

confidence: 47%

“…Previous studies of depression in this area have typically involved assessment of patients using clinical interviews and lengthy patient-completion questionnaires [3,8,18]. This approach is not feasible in most centres.…”

Section: Discussionmentioning

confidence: 99%

“…Morbidity and mortality post-AMI are determined by a number of independent risk factors, including extent of coronary artery disease, infarct size, severity of left ventricular dysfunction, and depression [2][3][4][5][6]. Depression following ACS has been found to be an important risk factor for further coronary events, with even low levels of depression having a significant effect on mortality risk [7][8][9]. A recent meta-analysis has concluded that post-AMI depression is associated with a 2-to 2.5-fold increased risk of impaired cardiovascular outcome [10].…”

Section: Introductionmentioning

confidence: 99%

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The Hospital Anxiety and Depression Scale depression subscale, but not the Beck Depression Inventory-Fast Scale, identifies patients with acute coronary syndrome at elevated risk of 1-year mortality

Doyle

McGee

Harpe

et al. 2006

Journal of Psychosomatic Research

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Hospital Anxiety and Depression Scale depression subscale, but not the Beck Depression Inventory-Fast Scale, identifies patients with acute coronary syndrome at elevated risk of 1-year mortality

Doyle

McGee

Harpe

et al. 2006

Journal of Psychosomatic Research

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“…Numerous studies have found that symptoms of depression are related to increased risk of mortality following acute myocardial infarction (AMI) after controlling for demographic and disease severity variables [1][2][3][4], although not all studies have reported a significant association [5,6]. Several recent systematic reviews or meta-analyses of the independent association between post-AMI depression and mortality have concluded that unambiguous conclusions could not be reached because of incomplete control for confounding [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Probit structural equation regression model: general depressive symptoms predicted post-myocardial infarction mortality after controlling for somatic symptoms of depression

Thombs

Ziegelstein

Parakh

et al. 2008

Journal of Clinical Epidemiology

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Objective: Reported links between depression and post-acute myocardial infarction (AMI) mortality may be due to confounding between somatic symptoms of depression and symptoms related to the AMI. The objective of this study was to assess the relationship between depressive symptoms and 12-month post-AMI mortality after removing potential bias from somatic symptoms of depression.Study Design and Setting: Four hundred seventy-seven hospitalized AMI patients from 12 cardiac care units. The relationship of a General Depression factor with mortality was assessed using a probit structural equation regression model, controlling for an uncorrelated somatic symptom factor, age, Killip class, previous AMI, and other potential confounders.Results: Mortality was significantly predicted by the General Depression factor (P = 0.009), controlling for age (P = 0.128), Killip class (P = 0.210), history of AMI (P = 0.001), and other predictors in a structural equation model that removed variance related to somatic factors, but unrelated to the General Depression factor.Conclusion: This study demonstrated that the use of structural equation modeling presents a viable mechanism to test links between symptoms of depression and health outcomes among patients with AMI after explicitly removing variance due to somatic symptoms that is unrelated to the General Depression factor.

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“…The rationale for screening follows from the observation that patients with depression are usually first seen in the primary care setting and that depression escapes clinical detection, causes substantial morbidity if untreated, and may complicate the course of chronic medical disease (9–11). Depression screening in U.S. general medical practice has been advocated for, and such screening is required in the U.S. Department of Veterans Affairs health care system (12).…”

mentioning

confidence: 99%

Positive Screens for Psychiatric Disorders in Primary Care: A Long-Term Follow-Up of Patients Who Were Not in Treatment

Weissman¹,

Neria²,

Gameroff³

et al. 2010

Psychiatric Services

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Objective Screening for psychiatric disorders has gained acceptance in some general medical settings, but critics argue about its value. The purpose of this study was to determine the clinical utility of screening by conducting a long-term follow-up of patients who screened positive for psychiatric disorders but who were initially not in treatment. Methods A cohort of 519 low-income, adult primary care patients were screened for major depression and bipolar, anxiety, and substance use disorders and reassessed with the Structured Clinical Interview for DSM-IV after a mean of 3.7 years by a clinician blind to the initial screen. Data on treatment utilization was obtained through hospital records. The sample consisted of 348 patients who had not received psychiatric care in the year before screening. Results Among 39 patients who screened positive for major depression, 62% (95% confidence interval=45.5%–77.6%) met criteria for current major depressive disorder at follow-up. Those who screened positive reported significantly poorer mental and social functioning and worse general health at follow-up than the screen-negative patients and were more likely to have visited the emergency department for psychiatric reasons (12.1% and 3.0%, odds ratio [OR]=6.4) and to have major depression (OR=7.6). Generally similar results were observed for patients who screened positive for other disorders. Conclusions Commonly used screening methods identified patients with psychiatric disorders; about four years later, those not initially in treatment were likely to have enduring symptoms and to use emergency psychiatric services. Screening should be followed up by clinical diagnostic assessment in the context of available mental health treatment.

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Even minimal symptoms of depression increase mortality risk after acute myocardial infarction

Cited by 542 publications

References 17 publications

The Hospital Anxiety and Depression Scale depression subscale, but not the Beck Depression Inventory-Fast Scale, identifies patients with acute coronary syndrome at elevated risk of 1-year mortality

The Hospital Anxiety and Depression Scale depression subscale, but not the Beck Depression Inventory-Fast Scale, identifies patients with acute coronary syndrome at elevated risk of 1-year mortality

Probit structural equation regression model: general depressive symptoms predicted post-myocardial infarction mortality after controlling for somatic symptoms of depression

Positive Screens for Psychiatric Disorders in Primary Care: A Long-Term Follow-Up of Patients Who Were Not in Treatment

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