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Clinical depression raises risk of death for heart attack patients years after attack
Date:3/3/2008

t of depression itself.

"We found that after adjusting for those risk factors, depression continues to play a statistically significant role," he says.

One possible explanation for depression's lingering influence on mortality is its recurring nature. Because the disorder can come and go over many years, it also may continue to increase the risk of death for many years.

"People typically are depressed for a while, then they'll either get better with treatment or it may subside on its own," Carney says. "But depression can always recur, and we think that because it is a recurring problem, whatever depression is doing to mortality risk after a heart attack, it continues doing for quite a long time."

Past studies have differed over how much depression affects survival following a heart attack. But Carney believes these new findings are more reliable because all of the patients in this study were personally interviewed to determine their depression status, whereas other studies have relied on self-reporting.

"In our experience, self-reporting tends to overestimate the risk because it's often not possible to evaluate the causes of various symptoms on self-report questionnaires," he explains. "Say somebody reports having sleeping problems that would go into the depression column as a symptom. But it's possible they are sleeping poorly because of a bad back or because they have to get up and go to the bathroom frequently during the night. During an interview, we can determine whether an individual symptom is related to depression or can be explained in some other way."

Carney's team also found that any clinically relevant depression increases the risk of death in heart attack patients. The risk was elevated both for patients with major depression, which requires the presence of five or more symptoms, and minor depression, which requires between two and four symptoms for diagnosis. Major depression was associated
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Contact: Jim Dryden
jdryden@wustl.edu
314-286-0110
Washington University School of Medicine
Source:Eurekalert

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