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American Heart Association Scientific Statement: Heart Patients Should Be Screened, Treated for Depression
Date:9/30/2008

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"Since my surgery, I've visited about 1,000 patients. During a visit I always let patients know that this may happen, and encourage them to talk to their doctor about getting treatment," he said. "I've had a number of people call me through the years and thank me for warning them about the possibility of depression."

Experts say depressed cardiac patients have at least twice the risk of second events in the one to two years after a heart attack. Furthermore, studies have shown that more severe depression is associated with earlier and more severe second cardiac events, Froelicher said.

For example, one study found that 15 percent to 20 percent of hospitalized heart attack patients met the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for major depression. An even greater proportion showed more depressive symptoms than usual in the population, though not sufficient to meet these criteria. The study also found that some subgroups of patients, such as young women with heart disease, seem particularly vulnerable to depression.

"Studies show that depression is about three times more common in patients following a heart attack than in the general community," said Judith H. Lichtman, Ph.D., M.P.H., writing co-chair of the statement and associate professor of epidemiology at Yale University School of Medicine in New Haven, Conn. "Because there has been no routine screening for depression in heart patients, we think there is a large group of people who could benefit from appropriate treatment."

Although depression was mentioned in earlier American Heart Association scientific statements, this is the first to specifically target the condition. Lichtman said more research is needed to determine why depression is associated with poorer outcomes.

Recent studies indicate that depressed patients are less likely to take their medicines as directed, improve their diets, exercise and attend cardiac rehabilitat
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SOURCE American Heart Association
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