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

ion sessions, all of which could contribute to a worse outcome, Lichtman said.

It's also possible that biological changes associated with depression such as reduced heart rate variability and increases in blood factors that encourage clot formation could increase risk, the statement said.

Other recommendations in the statement include:

-- Patients who have depressive symptoms should be evaluated by a

professional qualified in diagnosing and managing depression, and should

be screened for other psychiatric disorders, such as anxiety.

-- Treatment options include cognitive behavioral therapy, physical

activity, cardiac rehabilitation, antidepressant drugs or combinations

of those treatments.

-- Selective serotonin reuptake inhibitor (SSRI) treatment soon after a

heart attack is considered safe, relatively inexpensive and may be

effective for treating depression.

-- Routine screening for depression in coronary heart disease patients

should be done in multiple settings, including the hospital,

physician's office, clinic and cardiac rehabilitation center, to

avoid missing the opportunity to effectively treat depression in cardiac

patients and improve physical health outcomes.

-- Coordination of care between health providers is essential for patients

with combined medical and psychiatric diagnoses.

"Depression and heart disease seem to be very much intertwined," Lichtman said. "You can't treat the heart in isolation from the patient's mental health.

"There is no direct evidence yet that treating depression improves coronary heart disease outcomes, but plenty of evidence shows that having depression worsens those outcomes. By understanding the prevalence of depression and learning more about the subgroups of heart patients at particular risk of depression, we can begin to understand the best ways
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SOURCE American Heart Association
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