Treatment of affective disorders in cardiac disease

Abstract

Patients with cardiovascular disease (CVD) commonly have syndromal major depression, and depression has been associated with an increased risk of morbidity and mortality. Prevalence of depression is between 17% and 47% in CVD patients. Pharmacologic and psychotherapeutic interventions have long been studied, and in general are safe and somewhat efficacious in decreasing depressive symptoms in patients with CVD. The impact on cardiac outcomes remains unclear. The evidence from randomized controlled clinical trials indicates that antidepressants, especially selective serotonin uptake inhibitors, are overwhelmingly safe, and likely to be effective in the treatment of depression in patients with CVD. This review describes the prevalence of depression in patients with CVD, the physiological links between depression and CVD, the treatment options for affective disorders, and the clinical trials that demonstrate efficacy and safety of antidepressant medications and psychotherapy in this patient population. Great progress has been made in understanding potential mediators between major depressive disorder and CVD—both health behaviors and shared biological risks such as inflammation.

Prevalence and predictors of psychological distress in congenital heart disease patients

“…Treatment of depression in cardiac patients reduces cardiac disease symptoms, morbidity, and disabilities (Mavrides & Nemeroff, 2015;Pedersen, von Känel, Tully, & Denollet, 2017), so it is important to monitor CHD patients, in particular, CHD patients with increasing NYHA class, to identify psychological distress. In such cases, the optimization of the medical treatment, inclusion in rehabilitation programs (Martínez-Quintana, Miranda-Calderín, Ugarte-Lopetegui, & Rodríguez-González, 2010), the promotion of physical activity and enabling psychological or psychiatric assessment (Sandberg et al, 2015) may be useful.…”

Depression: a predictor of coronary heart disease in Saudi Arabia

“…Furthermore, with the aid of Hospital Anxiety and Depression Scale (HADS), 7.3% of post-AMI patients showed moderate to severe depression at the three-month mark [20]. Similarly, Mavrides 2022 reported that 17-47 % depression were observed in CVD patients during his research work [4]. Women have high prevalence rate of depression after menopause as compare to general population [5].…”