0
Commentary |

Does Treating Post–Myocardial Infarction Depression Reduce Medical Mortality?

Alexander H. Glassman, MD
Arch Gen Psychiatry. 2005;62(7):711-712. doi:10.1001/archpsyc.62.7.711.
Text Size: A A A
Published online

Extract

Depression and cardiovascular disease are 2 of the most common public health problems in the Western world1 and are strongly comorbid.2 The increased mortality associated with major depressive disorder (MDD) after myocardial infarction (MI) is equal to or greater than any medical predictor of risk.3 Even though the evidence is strong, physicians rarely think of depression as a medical risk factor and are unlikely to examine for it in patients after MI, whereas screening for heart failure, arrhythmia, or diabetes is a standard of care. Evidence linking depression and cardiac death comes from epidemiologic studies that screen all MI or unstable angina cases, not just patients seeking treatment, and, therefore, includes many mild cases. Even mildly elevated depression symptoms increase risk of cardiac death, although the risk increases with depression severity.4 Physicians who recognize depressed mood after MI frequently dismiss it as an understandable and temporary response to a stressful event. If they do treat post-MI depression, typically they treat only the most symptomatic cases. Even if physicians recognize that mortality is increased with less severe depression, there is no definitive evidence that treating depression reduces the risk of dying. In fact, little has been established about how or even whether to treat MDD in patients after MI.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles
Jobs
JAMAevidence.com

The Rational Clinical Examination
Make the Diagnosis: Depression

The Rational Clinical Examination
Original Article: Is This Patient Clinically Depressed?

brightcove.createExperiences();